Impact of a heart failure multidisciplinary clinic on the reduction of healthcare-related events and costs: the GEstIC study.

Introduction: Heart failure (HF) is the leading cause of hospitalization in the elderly in developed countries and significantly impacts public health expenditures. Patients with HF usually have associated comorbidities that require multidisciplinary management. This study aims to demonstrate the benefits of a multidisciplinary clinic in reducing all-cause hospitalizations and HF events (HF hospitalizations and urgent HF visits) in a real-world setting. Finally, the study evaluates the associated costs of HF events. Methods: This observational study included patients admitted to GEstIC, a multidisciplinary Portuguese HF clinic, from January 2013 to February 2019, who had one-year follow-up. Hospitalizations and HF events, total days spent in the hospital during HF hospitalizations, and HF events-related costs, in the year before and the year after GEstIC admission, were compared. Results: Of the 487 patients admitted to the GEstIC, 287 were eligible for the study sample. After one year of HF patients' multidisciplinary management at GEstIC, there was a 53.7% reduction in all-cause hospitalizations (462 vs. 214), a 71.7% reduction in HF hospitalizations (392 vs. 111), and a 39.1% reduction in urgent HF visits (87 vs. 53). As a result, there was a significant decrease of 12.6 days in the length of hospital stay due to HF per patient (15.6 vs. 3.0, p < 0.001). This translated into the release of 9.9 hospital beds in the year following admission to GEstIC. The average total savings associated with the reduction of HF events was €5,439.77 per patient (6,774.15 vs. 1,334.38, p < 0.001), representing a total cost reduction of €1,561,213. Furthermore, the significant reduction in the number of all events was independent of the patient's left ventricular ejection fraction (LVEF). Discussion: Significant reductions in all-cause and HF hospitalizations and urgent HF visits were observed with the implementation of this multidisciplinary clinic for HF patients' management. This was particularly important for patients with LVEF >40%. Before GEstIC, there was no medical intervention to improve the prognosis of these patients. The reduction of over one million euros in health-related costs after only one year of person-centered multidisciplinary management highlights the need to replicate this approach in other national healthcare institutions.

Prevalence of musculoskeletal disorders in the lower limbs among artisanal fisherwomen / shellfish gatherers of Brazil / Prevalência de distúrbios musculoesqueléticos nos membros inferiores de pescadoras artesanais/marisqueiras do Brasil

Introduction: Small-scale fishing is responsible for at least 40% of the fish consumed in the world. In Brazil, the worker in this sector is the artisanal fisherman, who accounts for one in every 200 Brazilians. Artisanal fishing is part of the informal economy; therefore, the pathologies that affect these fishermen are invisible in the country's official statistics. Musculoskeletal disorders represent a major socioeconomic and public health problem, but their prevalence is little known among non-formal workers. Objective: to estimate the prevalence of musculoskeletal disorders (MSDs) in the lower limbs and to verify the associated factors among artisanal fishermen/ fisherwomen from Saubara, Bahia, Brazil. Methodology: a cross-sectional study, using the Nordic Musculoskeletal Questionnaire (NMQ), the Brazilian version of the Job Content Questionnaire (JCQ) and a questionnaire about physical demands, were used to collect information in a random sample of artisanal fishermen/shellfish gatherers, in 2013. Results: the prevalence of MSDs in lower limbs in the sample was 65.5% (n=137). The prevalence of MSDs in the thigh/knee segment, leg and ankle/foot were 48.7% (n=92), 47.7% (n=95) and 38.1% (n=72), respectively. There was also a high frequency of obesity, poor education, low wages, early age at onset of labor, and excessive workload. Factors such as age, smoking, physical demands, working time, absence of breaks and having had a previous job were associated with MSDs in the lower limbs. Conclusion: the high prevalence of MSDs in lower limbs in female artisanal fishermen indicates the need to develop strategies for prevention, diagnosis and reporting of these diseases.

Introdução: a pesca em pequena escala é responsável por pelo menos 40% do pescado consumido no mundo e, no Brasil, o trabalhador desse setor é o pescador artesanal, que contabiliza um a cada 200 brasileiros. Por se tratar de uma atividade da economia informal, as patologias que afetam esses pescadores são praticamente invisíveis nas estatísticas oficiais do país. Nesse contexto, os distúrbios musculoesqueléticos representam um grande problema socioeconômico e de saúde pública, mas sua prevalência é pouco conhecida entre trabalhadores não formais. Objetivo: estimar a prevalência de distúrbios musculoesqueléticos nos membros inferiores e fatores associados, em pescadores artesanais/marisqueiras de Saubara, Bahia, Brasil. Metodologia: trata-se de um estudo transversal, utilizando o Nordic Musculoskeletal Questionnaire, a versão brasileira do Job Content Questionnaire e um questionário sobre demandas físicas, para a coleta de informações em uma amostra aleatória de pescadores artesanais/marisqueiras, ocorrida em 2013. Resultados: a prevalência de distúrbios musculoesqueléticos em membros inferiores na amostra foi de 65,5% (n=137); a prevalência no segmento coxa/joelho, perna e tornozelo/pé foi de 48,7% (n=92), 47,7% (n=95) e 38,1% (n=72), respectivamente. Observaram-se também alta frequência de obesidade, baixa escolaridade, baixos salários, idade precoce para o início do trabalho e carga horária excessiva. Fatores como idade, tabagismo, demandas físicas, tempo de trabalho, ausência de pausas e trabalho anterior, estavam associados aos referidos distúrbios. Conclusão: A alta prevalência de distúrbios musculoesqueléticos dos membros inferiores em pescadoras artesanais indica a necessidade de desenvolver estratégias de prevenção, diagnóstico e notificação dessas doenças

A Gelatinous Pleural Effusion as a Diagnostic Clue.

Pleural effusion is a common presentation of several pathologies, and the determination of its cause is facilitated by macroscopic, biochemical, microbiological, and cellular analysis. A systematic approach to analyzing the fluid allows for a reduction in clinical diagnoses. Only a select number of diagnoses can be established definitively by thoracentesis, including effusions because of malignancy. We report the case of an 84-year-old male with a right large-volume pleural effusion with an initial diagnostic thoracocentesis demonstrating an exudate with a gelatinous appearance and exudate characteristics. The physical characteristics of the pleural effusion quickly raised the suspicion of mesothelioma, a rare tumor associated with a poor prognosis. In most diseases related to pleural effusion, fluid analysis yields important diagnostic information, and in certain cases, fluid analysis alone is enough for diagnosis. Malignant pleural mesothelioma may present as a viscous pleural effusion with gelatinous characteristics, which may immediately raise suspicion and contribute as a diagnostic clue in the initial study of a pleural effusion. This article was previously presented as a meeting abstract at the 28º Congresso Nacional de Medicina Interna in October 2022.

Prevalence of constipation on an internal medicine ward.

In hospitalized patients the prevalence of constipation is high, especially among elderly patients. Constipation impacts significantly the quality of life of patients and is associated with increased morbidity and length of hospital stay. This retrospective observational study intended to identify the prevalence of constipation in patients hospitalized in an internal medicine ward. In a sample of 80 patients, the median age was 79 years and 53% (n = 42) were women. We identified constipation in 68% (n = 56) of the patients during hospitalization. The medical team prescribed treatment only to 70% of those patients. Constipation was responsible for delirium in 11% of patients and 5% suffered urinary retention. This study shows constipation is prevalent among patients admitted in an internal medicine ward. Systematic assessment of this problem can improve the overall care of the patients, alleviate symptoms, and prevent complications.

The Caloric Necessities of Critical Care Patients During the First Week of Admission.

INTRODUCTION:  The nutritional needs of critically ill patients have been the subject of intense controversy. In accordance with international guidelines, it is advocated to optimize a nutritional intake based on the following recommendation: 25-30 kcal/kg body weight per day. However, there still are authors who recommend permissive underfeeding in the first week of hospitalization. Nevertheless, energy expenditure (EE) and necessity are influenced by the catabolic phase of critical illness, which may vary over time on a patient and from patient to patient. OBJECTIVE: The objective of this study is to assess if the energy needs of critically ill patients admitted in our intensive care unit (ICU) in the first week of hospitalization are in line with those recommended by the European Society for Clinical Nutrition and Metabolism (ESPEN) international guidelines. METHODS: A prospective cross-sectional study was carried out from September to December 2019. The energy needs were evaluated by indirect calorimetry and by the Harris-Benedict equation. Stress variables were evaluated, namely, the type of pathology, hemodynamic support, sedation, temperature, sequential organ failure assessment (SOFA) score, and state at discharge. RESULTS: Forty-six patients were included in this study, with an average energy expenditure by indirect calorimetry of 19.22 ± 4.67 kcal/kg/day. The energy expenditure was less than 20 kcal/kg/day in 63% of the measurements. The concordance rate did not show the relationship between the Harris-Benedict equation and the values of indirect calorimetry. Stress variables were analyzed, with the SOFA score as the only variable with values close to statistical significance. CONCLUSION: In our ICU, the energy needs of critically ill patients in the first week of hospitalization are lower than the intake recommended by the guidelines.

Prevalence of Musculoskeletal Disorders and Self-Reported Pain in Artisanal Fishermen from a Traditional Community in Todos-os-Santos Bay, Bahia, Brazil.

Musculoskeletal disorders (MSDs) can be characterized from their occupational etiology and their occurrence; their chronicity generates negative repercussions for the health of workers, especially of artisanal fishing. To investigate the prevalence of generalized musculoskeletal disorders by body region and self-reported pain in a fishing population of northeastern Brazil, an epidemiological cross-sectional study was carried out in Santiago do Iguape, Bahia-Brazil, in 2017. The Brazilian version of the Nordic Musculoskeletal Questionnaire (NMQ), in addition to a questionnaire containing the socio-demographic and labor conditions were applied to a random stratified sample of 248 artisanal fisheries. There were 170 female shellfish gatherers and 78 fishermen, with a mean age of 36.7 years (SD = 10.5 years) and 43.3 years (SD = 11.8 years), respectively. The beginning of the labor activity was initiated at approximately 11 years of age. The average weekly income varied from 17.64 USD to 29.10 USD. The prevalence of MSD independent of occupation occurred in at least one body region in 93.5% and the presence of musculoskeletal pain/discomfort over the last seven days in 95.2% of the fishing workers. The highest prevalence of MSD was found in shellfish gatherers in: lower back (86.4%), wrist and hand (73.5%), and upper back (66.8%). In relation to the presence of pain in the last year, the frequency of pain was greater in the fishermen compared to the shellfish gatherers. The generalized severity of the MSD in 93.5% of this community of fishermen is evident, with emphasis in the following regions: lower back, wrist and hand and upper back in both groups, with occurrence of pain in more than one body region at the same time.

Desastres com petróleo e ações governamentais ante os impactos socioambientais e na saúde: scoping review / Oil disasters and government actions in the face of social, environmental, and health-related impacts: A scoping review

RESUMO Este artigo teve por objetivo analisar as ações desenvolvidas pelos governos para o enfrentamento dos impactos socioambientais e na saúde em decorrência dos desastres envolvendo petróleo no mundo. Trata-se de uma revisão de escopo realizada na Bireme, Lilacs, SciELO, PubMed, Cochrane Library e Embase, considerando artigos publicados entre 1973 e 2021. As buscas efetuadas nas bases de dados resultaram em 22 artigos sobre 10 desastres de petróleo ao redor do mundo em três continentes (Ásia, América e Europa), cujas causas dos desastres foram encalhe (3), naufrágio (1), colisão (2), derrame (3) e explosão (1). As ações desenvolvidas foram caracterizadas como intersetoriais, econômicas, ambientais e na saúde, sendo que as mais frequentes foram ações ambientais e econômicas. Nas ações desenvolvidas, observaram-se críticas ao controle, mitigação ou prevenção dos danos instantâneos ou futuros decorrentes dos desastres por petróleo, sendo essa uma agenda ainda em aberto para os movimentos sociais na luta pela garantia de um ambiente saudável, promotor de saúde e com preservação de toda a sua biodiversidade. Conclui-se que as ações para o enfrentamento dos desastres por petróleo nos diferentes países parecem ter sido incipientes, revelando uma incapacidade governamental de orientar o enfrentamento dos impactos desse evento inusitado.

ABSTRACT This article aims to analyze the actions taken by governments to face the social, environmental, and health impacts of oil spill disasters worldwide. This scoping review was conducted in Bireme, Lilacs, SciELO, PubMed, Cochrane Library, and Embase databases, considering articles published between 1973 and 2021. The database search returned 22 articles on ten global oil disasters in three continents (Asia, the Americas, and Europe), whose causes were grounding (03), shipwreck (01), collision (02), spill (03), and explosion (01). The actions developed were characterized as intersectoral, economic, environmental, and health-related, and the most frequent were environmental and economic actions. In the actions developed, we observed criticisms of controlling, mitigating, or preventing instantaneous or future damages resulting from oil disasters, which is still an open agenda for social movements in the struggle to ensure a healthy, health-promoting environment that preserves all its biodiversity. The actions to face oil disasters in different countries seem incipient, revealing a governmental inability to guide the confrontation of the impacts of this unusual event.

Ocorrência de distúrbio musculoesquelético em pescadoras artesanais/ marisqueiras na Baía de Todos os Santos: uma análise sobre horas dedicadas ao trabalho / Occurrence of musculoskeletal disorders in artisanal /shellfish fisherwomen in Baía de Todos os Santos: an analysis of hours dedicated to work

Introdução: os distúrbios musculoesqueléticos são caracterizados por comprometimentos inflamatórios e/ou degenerativos, em diversos segmentos corporais, e atingem diversos grupos de trabalhadores, no entanto, ainda existem poucas evidências científicas que verificam possíveis relações desses distúrbios e horas de trabalho diárias dos pescadores artesanais. Objetivo: analisar as horas diárias dedicadas ao trabalho de pescadora e a prevalência de distúrbio musculoesquelético em regiões de membros superiores (ombro) e pescoço. Metodologia: realizou-se um estudo de corte transversal, envolvendo amostra probabilística da população de pescadoras artesanais/marisqueiras do município de Saubara, totalizando 209 pessoas. Utilizaram-se instrumentos validados para população brasileira, tais como: o Nordic Musculoskeletal Questionnaire, Job Content Questionnaire e Demandas físicas adaptadas para o trabalho. Resultados: evidenciou-se a prevalência de distúrbios musculoesqueléticos em região de pescoço ou ombro, em 71,2% (n=146) das marisqueiras. Ressalta-se que não houve interação entre as variáveis horas trabalhadas/dia e idade, com o p-valor = 0,1807. Verificaram-se associações positivas entre as marisqueiras que trabalhavam mais que 11h por dia com razão de prevalência de 1,23 e intervalo de confiança 95%: [1,04; 1,45] em relação às que trabalhavam menos que 11h, bem como a razão de prevalência de 1,38 e intervalo de confiança 95%: [1,15; 1,65] nas pescadoras com idade superior a 38 em comparação com as mais jovens. Desta forma denotando a degradação da saúde com a carga exaustiva de trabalho.

Introduction: musculoskeletal disorders are characterized by inflammatory and/or degenerative impairments in several body segments and reach different groups of workers; however, there is still little scientific evidence to verify the possible relationships between MSD and daily working hours of artisanal fishermen. Objective: to analyze the daily hours dedicated to work as a fisherwoman and prevalence of musculoskeletal disorders in regions of upper limbs (shoulder) and neck. Methodology: a cross-sectional study was carried out involving a probabilistic sample of the population of artisanal/shellfish fisherwomen in the municipality of Saubara, for a total of 209 individuals. Validated instruments were used for the Brazilian population, such as: the Nordic Musculoskeletal Questionnaire, the Job Content Questionnaire and the Physical Demands adapted to this work. Results: the prevalence of musculoskeletal disorders in the neck or shoulder region was found in 71.2% (n = 146) of shell fisherwomen. It should come to attention that there was no interaction between the variables worked hours/day and age, with p-value = 0.1807. There were positive associations among the shellfish workers that worked more than 11h with the prevalence ratio of 1.23 and 95% confidence interval: [1.04; 1.45] than those who worked less than 11 hours, as well as the prevalence ratio of 1.38 and 95% confidence interval: [1.15; 1.65] in fisherwoman aged over 38 compared to younger ones. Thus denoting health degradation with an exhaustive workload.

Factors associated with musculoskeletal disorders in artisanal fisherwomen/shellfish gatherers in Saubara, Bahia, Brazil. / Fatores associados com os distúrbios musculoesqueléticos em pescadoras artesanais/marisqueiras em Saubara, Bahia, Brasil.

This article aims to identify the factors associated with musculoskeletal disorders (MSDs) in the neck/shoulder and distal upper limb in artisanal fisher/shellfish gatherers in Saubara, Bahia, Brazil. This cross-sectional epidemiological study was conducted with shellfish gatherers. The Brazilian version of the Job Content Questionnaire (JCQ), the Nordic Musculoskeletal Questionnaire (NMQ), and a questionnaire containing physical demands adapted to the labour of shellfish gatherers were used in this study. Factor analysis was performed to aggregate the physical demands. Multivariate analyses were performed according to the risk factors for MSDs in the neck or shoulder and MSDs in the distal upper limb. For MSDs in the neck or shoulders, a prevalence ratio (PR) of 1.28 (95% confidence interval [95% CI]: 1.09-1.49) was found, according to the aggregate physical demands. For MSDs in the distal upper limb, the PRs were as follows: 1.26 (95% CI: 1.07-1.47) according to the daily hours devoted to work as shellfish gatherers, 0.74 (95% CI: 0.57-0.96) according to the development of other current work and 1.38 (95% CI: 1.05-1.83) according to the aggregate physical demands. The activities performed by shellfish gatherers contribute to the occurrence of MSDs.

O presente artigo tem como objetivo identificar os fatores associados com os distúrbios musculoesqueléticos (DME) em pescoço/ombro e membros superiores distais em pescadoras artesanais/marisqueiras em Saubara, Bahia, Brasil. Trata-se de um estudo de corte transversal realizado com 209 pescadoras artesanais/marisqueiras. Foram utilizados para este estudo a versão brasileira do questionário de conteúdo do trabalho e do questionário nórdico e um questionário das demandas físicas para o trabalho. As análises multivariadas foram feitas de acordo com os principais fatores de risco para DME. Algumas demandas físicas agrupadas, nas etapas da coleta dos mariscos e na cata, se associaram, respectivamente, com DME em pescoço ou ombro [Razão de Prevalência - RP: 1,28 (IC95%: 1,09-1,49)] e DME em membros superiores distais [RP: 1,38 (IC95%: 1,05-1,83)], no modelo final ajustado. As RP ajustadas para DME em membros superiores distais foram de 1,26 (IC95%: 1,07-1,47), de acordo com as horas diárias dedicadas ao trabalho como marisqueira, e 0,74 (IC95%: 0,57-0,96) de acordo com o desenvolvimento de outro trabalho atualmente. O modo em que é desenvolvido o trabalho da marisqueira é importante para ocorrência dos DME.

Fatores associados com os distúrbios musculoesqueléticos em pescadoras artesanais/marisqueiras em Saubara, Bahia, Brasil / Factors associated with musculoskeletal disorders in artisanal fisherwomen/shellfish gatherers in Saubara, Bahia, Brazil

Resumo O presente artigo tem como objetivo identificar os fatores associados com os distúrbios musculoesqueléticos (DME) em pescoço/ombro e membros superiores distais em pescadoras artesanais/marisqueiras em Saubara, Bahia, Brasil. Trata-se de um estudo de corte transversal realizado com 209 pescadoras artesanais/marisqueiras. Foram utilizados para este estudo a versão brasileira do questionário de conteúdo do trabalho e do questionário nórdico e um questionário das demandas físicas para o trabalho. As análises multivariadas foram feitas de acordo com os principais fatores de risco para DME. Algumas demandas físicas agrupadas, nas etapas da coleta dos mariscos e na cata, se associaram, respectivamente, com DME em pescoço ou ombro [Razão de Prevalência - RP: 1,28 (IC95%: 1,09-1,49)] e DME em membros superiores distais [RP: 1,38 (IC95%: 1,05-1,83)], no modelo final ajustado. As RP ajustadas para DME em membros superiores distais foram de 1,26 (IC95%: 1,07-1,47), de acordo com as horas diárias dedicadas ao trabalho como marisqueira, e 0,74 (IC95%: 0,57-0,96) de acordo com o desenvolvimento de outro trabalho atualmente. O modo em que é desenvolvido o trabalho da marisqueira é importante para ocorrência dos DME.

Abstract This article aims to identify the factors associated with musculoskeletal disorders (MSDs) in the neck/shoulder and distal upper limb in artisanal fisher/shellfish gatherers in Saubara, Bahia, Brazil. This cross-sectional epidemiological study was conducted with shellfish gatherers. The Brazilian version of the Job Content Questionnaire (JCQ), the Nordic Musculoskeletal Questionnaire (NMQ), and a questionnaire containing physical demands adapted to the labour of shellfish gatherers were used in this study. Factor analysis was performed to aggregate the physical demands. Multivariate analyses were performed according to the risk factors for MSDs in the neck or shoulder and MSDs in the distal upper limb. For MSDs in the neck or shoulders, a prevalence ratio (PR) of 1.28 (95% confidence interval [95% CI]: 1.09-1.49) was found, according to the aggregate physical demands. For MSDs in the distal upper limb, the PRs were as follows: 1.26 (95% CI: 1.07-1.47) according to the daily hours devoted to work as shellfish gatherers, 0.74 (95% CI: 0.57-0.96) according to the development of other current work and 1.38 (95% CI: 1.05-1.83) according to the aggregate physical demands. The activities performed by shellfish gatherers contribute to the occurrence of MSDs.

Prevalence and Work-Related Factors Associated with Lower Back Musculoskeletal Disorders in Female Shellfish Gatherers in Saubara, Bahia-Brazil.

Lower back musculoskeletal disorders (MSDs) are an important public health problem and the leading cause of disability worldwide, but with yet unknown prevalence among shellfish gatherers. To investigate the prevalence and work-related factors associated with lower back MSD in a population of female shellfish gatherers, an epidemiological cross-sectional study was carried out in Saubara, Bahia-Brazil, in 2013. The Brazilian version of the Job Content Questionnaire (JCQ) and the Nordic Musculoskeletal Questionnaire (NMQ), in addition to a questionnaire containing the physical demands adapted to the artisanal work, were applied to a random sample of 209 female shellfish gatherers. The prevalence of lower back MSD was 72.7%. Using multivariate logistic regression, the shellfish gatherers who had worked for more than 26 years in the activity showed a prevalence of 1.22 (95% CI: 1.04⁻1.44) times higher compared to those unexposed. Lower back MSD was 1.24 (95% CI: 1.08⁻1.42) times higher among those more exposed to work sitting with trunk flexion. Those performed manual handling and muscle force with the arms had a prevalence ratio of 1.18 (95% CI: 1.01⁻1.39). These results show the need for greater awareness of health and social welfare factors impacting workers in small-scale fisheries and will promote the elaboration of health care policies for this occupational class.

T-cell receptor gene-modified cells: past promises, present methodologies and future challenges.

Immunotherapy constitutes an exciting and rapidly evolving field, and the demonstration that genetically modified T-cell receptors (TCRs) can be used to produce T-lymphocyte populations of desired specificity offers new opportunities for antigen-specific T-cell therapy. Overall, TCR-modified T cells have the ability to target a wide variety of self and non-self targets through the normal biology of a T cell. Although major histocompatibility complex (MHC)-restricted and dependent on co-receptors, genetically engineered TCRs still present a number of characteristics that ensure they are an important alternative strategy to chimeric antigen receptors (CARs), and high-affinity TCRs can now be successfully engineered with the potential to enhance therapeutic efficacy while minimizing adverse events. This review will focus on the main characteristics of TCR gene-modified cells, their potential clinical application and promise to the field of adoptive cell transfer (ACT), basic manufacturing procedures and characterization protocols and overall challenges that need to be overcome so that redirection of TCR specificity may be successfully translated into clinical practice, beyond early-phase clinical trials.

Artigo científico na área de saúde: diretrizes para sua elaboração e avaliação / Scientific article in the health area: guidelines for preparing and evaluating

Introdução: o aumento da velocidade, da diversidade e do volume das publicações científicas, tanto em escala global como no que diz respeito às pesquisas em saúde, tem levado a comunidade científica a reconhecer a necessidade do estabelecimento de critérios e padrões de qualidade para a avaliação, tanto do rigor metodológico, quanto das publicações. Objetivo: ante o exposto, na perspectiva de subsidiar os pesquisadores na sua tarefa de qualificar sua produção, o presente artigo tem como objetivo apresentar, de forma sucinta, a descrição de algumas iniciativas que têm sido utilizadas, cada vez mais e por diferentes revistas científicas, como parâmetro para medir a qualidade dos artigos submetidos para publicação, segundo os tipos de estudo. Metodologia: a base de consulta foi o Equator Network e as iniciativas selecionadas foram: STROBE, SAMPL, PROSPERO, AMSTAR, PRISMA, COREQ, SRQR. Conclusão: a rede Equator Network, com a finalidade de subsidiar a qualificação das pesquisas em saúde e da sua divulgação, contempla, nas suas diretrizes, diferentes tipos de investigação para que autores, revisores e editores disponham de elementos de verificação do rigor científico e do atendimento às recomendações de editores e revisores de periódicos científicos.

Introduction: increasing the speed, diversity and volume of scientific publications, both on a global scale and in health research, has led the scientific community to recognize the need to establish quality criteria and standards for evaluation, both of methodological rigor, and of publications. Objective: in view of the above, in order to subsidize the researchers in their task of qualifying their production, this article aims to present, briefly, the description of some initiatives that have been used, increasingly and by different scientific journals, as parameter to measure the quality of articles submitted for publication, according to the types of study. Methodology: the consultation base was Equator Network and the initiatives were selected: STROBE, SAMPL, PROSPERO, AMSTAR, PRISMA, COREQ, SRQR. Conclusion: the Equator Network, in order to subsidize the qualification of health research and its dissemination, includes, in its guidelines, different types of research for authors, reviewers and editors to have elements of verification of scientific rigor and attendance to recommendations of editors and reviewers of scientific journals.

Vigilância em saúde do trabalhador da pesca artesanal na Baía de Todos os Santos: da invisibilidade à proposição de políticas públicas para o Sistema Único de Saúde (SUS) / Occupational health surveillance of artisanal fishermen in the Baía de Todos os Santos: from invisibility to the proposal of public policies for the Unified Health System (SUS)

Resumo Introdução: pescadores são uma das maiores e mais tradicionais categorias de trabalhadores no mundo. Para reduzir lacunas do conhecimento sobre os problemas de saúde relacionados a essa atividade e desenvolver ações com o Sistema Único de Saúde (SUS), em 2006 foram iniciados estudos e ações dirigidos aos trabalhadores da pesca artesanal e mariscagem, envolvendo 13 municípios, na Baía de Todos os Santos, nos estado da Bahia. Objetivo: discutir resultados alcançados em intervenções e estudos realizados, para subsidiar ações de vigilância em saúde do trabalhador (Visat) da pesca. Métodos: foram referidos e discutidos estudos qualitativos e quantitativos desenvolvidos a partir de pesquisa participativa de base comunitária. Resultados: os estudos e intervenções revelaram as condições de trabalho e os riscos ocupacionais dessa atividade, sobretudo a exposição excessiva a movimentos repetitivos, e possibilitaram a quantificação da prevalência das lesões por esforço repetitivo e distúrbio osteomuscular relacionado ao trabalho (LER/Dort). Também contribuíram para analisar a qualidade de vida desses trabalhadores, a organização dos serviços de diagnóstico, a adaptação de protocolo clínico de LER/Dort e a capacitação das Equipes da Estratégia Saúde da Família atuantes em territórios pesqueiros. Conclusão: os estudos e as intervenções indicaram a possibilidade de reprodutibilidade desta experiência no âmbito da Visat no SUS.

Abstract Introduction: fishermen are one of the largest and most traditional categories of workers in the world. In order to address the knowledge gaps in health problems related to this activity, and to develop actions together with the Unified Health System (SUS), in 2006 a set of studies and activities aimed at artisanal fishermen and shellfish gatherers was initiated, involving 13 municipal districts in Baía de Todos os Santos, Bahia, Brazil. Objective: to discuss results achieved in interventions and studies carried out with the purpose of subsidizing actions concerning fishermen's occupational health surveillance (Visat). Methods: we discuss and refer to qualitative and quantitative studies developed through community-based participatory research. Results: studies and interventions revealed artisanal fishermen's working conditions and occupational risks, especially those related to repetitive movements leading to high RSI/RMSDs prevalence. The results also contributed to the analysis of the workers' quality of life, organization of diagnostic services, adaptation of the RSI/WRMSDs clinical protocol, and training the Family Health Strategy Teams operating in fishing territories. Conclusion: the studies and interventions indicate the possibility of reproducing this experience within the framework of Visat at SUS.

Artisanal fisherwomen/shellfish gatherers: analyzing the impact of upper limb functioning and disability on health-related quality of life.

The aim is to analyze upper limb functioning and disability, and its association with health-related quality of life among artisanal fisherwomen from Bahia, Brazil. Cross-sectional epidemiological study was conducted with a sample of 209 fisherwomen. Structured questionnaires were used for socio-demographic and comorbidity information, as well as the instruments Disabilities of the Arm, Shoulder and Hand (DASH) and Short-Form Healthy Survey (SF-36) respectively, to evaluate the upper limbs and health-related quality of life. The results demonstrated that the presence of musculoskeletal disorders in the upper limbs directly affects the values of the DASH instrument and the SF-36v01 questionnaire scores, while also generating a negative correlation between the DASH and SF-36v01. The varying functioning abilities, pain and social aspects negatively affect upper limb function, and the daily activities and work of fisherwomen. The presence of chronic disease and the absence of intervention and rehabilitation for these professionals, that could produces, in a long-term, cases of disability.

Artisanal fisherwomen/shellfish gatherers: analyzing the impact of upper limb functioning and disability on health-related quality of life / Pescadoras artesanais/marisqueiras: análise do impacto da funcionalidade e incapacidade de membros superiores sobre a qualidade de vida relacionada com a saúde

Abstract The aim is to analyze upper limb functioning and disability, and its association with health-related quality of life among artisanal fisherwomen from Bahia, Brazil. Cross-sectional epidemiological study was conducted with a sample of 209 fisherwomen. Structured questionnaires were used for socio-demographic and comorbidity information, as well as the instruments Disabilities of the Arm, Shoulder and Hand (DASH) and Short-Form Healthy Survey (SF-36) respectively, to evaluate the upper limbs and health-related quality of life. The results demonstrated that the presence of musculoskeletal disorders in the upper limbs directly affects the values of the DASH instrument and the SF-36v01 questionnaire scores, while also generating a negative correlation between the DASH and SF-36v01. The varying functioning abilities, pain and social aspects negatively affect upper limb function, and the daily activities and work of fisherwomen. The presence of chronic disease and the absence of intervention and rehabilitation for these professionals, that could produces, in a long-term, cases of disability.

Resumo O objetivo foi analisar a incapacidade e a funcionalidade de membros superiores e verificar sua associação com a qualidade de vida relacionada com a saúde de pescadoras artesanais da Bahia, Brasil. Estudo epidemiológico, de corte transversal, envolvendo uma amostra de 209 pescadoras artesanais. Foram utilizados questionários estruturados para informações sociodemográficas e comorbidades e os instrumentos Disabilities of the Arm, Shoulder and Hand (DASH) e Medical Outcomes Study 36-Item Short-Form Healthy Survey (SF-36), para, respectivamente, avaliação dos membros superiores e qualidade de vida relacionada com a saúde. Os resultados encontrados demonstram que a presença de distúrbios musculoesqueléticos (DME) em membros superiores afeta diretamente os valores do instrumento DASH e os escores do SF-36v01, bem como a correlação negativa encontrada entre o DASH e os domínios do SF-36v01. As variáveis capacidade funcional, dor e aspectos sociais afetam negativamente a funcionalidade de membros superiores e as atividades do cotidiano e do trabalho de pescadoras artesanais. A presença de doença crônica e a ausência de intervenção e reabilitação desses profissionais geram, a longo prazo, casos de incapacidade.

Paternidade e amamentação: mediação da enfermeira / Paternity and breastfeeding: mediation of nurses

Resumo Objetivo Identificar como o pai percebe sua contribuição no apoio e estímulo à amamentação com base no aprendizado e verificar como a companheira compreendeu esta participação. Métodos Estudo qualitativo, participaram oito famílias, entrevistadas antes e após a realização dos quatro encontros grupais, acompanhadas em seus domicílios no puerpério. Os dados foram analisados com compreensão dos conteúdos manifestos dos discursos dos casais, fundamentados por meio da teoria do vínculo. Resultados Evidenciou-se que pais demonstram satisfação em prestar cuidados aos filhos e apoiar a amamentação para contentamento de suas companheiras. Conclusão Os pais revelam-se verdadeiros partícipes, principalmente quando suas iniciativas são valorizadas por parte da companheira e pela enfermeira, sendo recomendada ampliação de atividades de apoio a casais, desde o pré-natal e após o nascimento do filho de forma sistematizada na rede pública de atenção à saúde.

Abstract Objective To identify how fathers perceive their contribution to the support and encouragement of breastfeeding based on learning, and see how their partners understood this participation. Methods Qualitative study with eight families interviewed before and after the completion of four group meetings and in follow-up during home visits in the postpartum period. Data were analyzed to understand the content of the couples’ speeches based on the attachment theory. Results The fathers show satisfaction in providing care to children, and support the breastfeeding for their partners’ contentment. Conclusion The fathers demonstrated to be true participants, especially when their efforts are valued by their partners and nurses. The expansion of support activities to couples is recommended since the prenatal period and after childbirth in a systematic way on the public health care network.

Health-Related Quality of Life among Artisanal Fisherwomen/Shellfish Gatherers: Lower than the General Population.

Quality of life is an indicator of how well one perceives that he/she is functioning physically and mentally. The aim of this paper is to determine the health-related quality of life (HRQOL) of artisanal fisherwomen/shellfish gatherers from the Saubara municipality in Bahia, Brazil in comparison to the general population. A structured questionnaire was administered to a sample of 209 artisanal fisherwomen selected at random. The HRQOL questionnaire, known as the 36-Item Short-Form Health Survey version 1 (SF-36v01), was also used, having been translated and verified cross-culturally for the Brazilian population. Sociodemographic, lifestyle and comorbidity information was also collected. Chronic diseases and indicators of musculoskeletal disorders (MSDs) were self-reported. The study population consisted primarily of individuals between 30 and 45 years of age (78%), of self-classified races black or brown (96.2%), with no more than an elementary school education (77%) and married (64.6%). In all the SF-36v01 dimensions, the values in the sample were lower than in the general population of Brazil, which was used as the reference population. In the "Physical Health" domain (Physical Functioning; Physical Role Limitations; Bodily Pain; General Health Perception) a tendency toward a lower health-related quality of life was observed among those who were older, had a lower education level, and had a prevalence of MSDs, hypertension or arthritis. The interference of health conditions linked to the fisherwomen's work activities may contribute to lower HRQOL in all analyzed aspects, in comparison to the general population. In light of these findings, public health policies must consider these informal workers who contribute greatly to Brazil's economy and food system.