Presenteeism in Non-Academic Staff in a Public University Context: Prevalence, Associated Factors, and Reasons to Work While Sick during the COVID-19 Pandemic.

Presenteeism negatively affects worker performance. We aimed to know the prevalence of presenteeism in non-academic university staff, identify health problems and associated factors, as well as explore the reasons that led to presenteeism during the COVID-19 pandemic. A cross-sectional study was conducted with a convenience sample of 332 non-academic staff. The Portuguese version of the Stanford Presenteeism Scale (SPS-6) was used, and socio-demographic and occupational data were collected. Participants were divided into groups according to the presenteeism cut-off score (no presenteeists, presenteeists with high job performance, presenteeists with low job performance). Multinomial regression was used to identify occupational and demographic characteristics associated with presenteeism. An open question replies analysis made it possible to explore the reasons for going to work while sick. Presenteeism was experienced by 30.1%. Presenteeism with high job performance was not associated with socio-demographic and work factors. Professionals who performed only physical work (OR = 9.4; 95% CI: 1.7; 51.0) and those who conducted hybrid work (OR = 4.1; 95% CI: 1.8; 9.6) showed a higher risk of belonging to the presenteeist group with low job performance. Financial reasons led professionals to work while sick. This study raises the importance of evaluating presenteeism in non-academic staff to create conditions for them to maintain high performance despite presenteeism and to intervene when there is low performance due to presenteeism.

The relationship between presenteeism, quality of life and social support in higher education professionals: A cross-sectional path analysis.

Presenteeism is the practice of being present at workplace, but not being able to carry out all the tasks due to health problems. Social support globally associated with health and wellbeing might positively influence presenteeism and consequently, the quality of life of these professionals. With this in mind, the aim of this study was to investigate the relationships between presenteeism, quality of life and social support in the work of non-teaching and non-research professionals within the context of higher education. A cross-sectional study was conducted, in which sociodemographic data were collected and the Portuguese versions of the Stanford Presenteeism Scale (SPS-6) (which includes the dimensions work-completed and distraction avoided) and Quality of Life Index (EUROSHIS-QOL-8) and the subscales of Supervisor's Social Support and Peers' Social Support of the Copenhagen Psychosocial Questionnaire (COPSOQ) were used. The questionnaire was applied online, and 322 professionals from a public university higher education institution in Northern Portugal participated in the study. Presenteeism was reported by 97 (30.1%) professionals. The peers' social support was positively associated with quality of life. The supervisor's social support was positively associated with distraction avoided and work completed and positively indirectly associated with quality of life, and the association was mediated by distraction avoided. We conclude that implementing strategies that can promote social support in the work context, namely strengthening networks between colleagues and competent and well-trained supervisors may prevent or reduce presenteeism in higher education professionals, as well as, provide a better quality of life.

[Stigmas, studies, and strife: a history of Brazilian pemphigus, nineteenth and twentieth centuries]. / Estigmas, pesquisas e embates: uma história do pênfigo brasileiro, séculos XIX e XX.

This paper presents a historical narrative about the incidence of pemphigus foliaceus in Brazil in the nineteenth and twentieth centuries. This autoimmune blistering skin disease is more common in children, adolescents, and young adults who live in rural areas of endemic regions. It was first described in Brazil in 1903 by the physician Caramuru Paes Leme. The main foci of the disease are in the Federal District and the states of Goiás, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Paraná, and São Paulo. This research topic, which has attracted widespread attention from medical practice, especially dermatology, has not received similar attention from historians of health and disease.

O artigo apresenta uma narrativa histórica sobre a incidência do pênfigo foliáceo no Brasil ao longo dos séculos XIX e XX. Doença bolhosa autoimune da pele que acomete com mais frequência crianças, adolescentes e adultos jovens que vivem nas áreas rurais de regiões endêmicas. Foi descrita pela primeira vez no país em 1903, pelo médico Caramuru Paes Leme. Os principais focos se situam no Distrito Federal e nos estados de Goiás, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Paraná e São Paulo. Temática de pesquisa amplamente visitada pela ciência médica, em especial a dermatologia, não tem merecido a atenção peculiar por parte dos historiadores da saúde e da doença.

Estigmas, pesquisas e embates: uma história do pênfigo brasileiro, séculos XIX e XX / Stigmas, studies, and strife: a history of Brazilian pemphigus, nineteenth and twentieth centuries

Resumo O artigo apresenta uma narrativa histórica sobre a incidência do pênfigo foliáceo no Brasil ao longo dos séculos XIX e XX. Doença bolhosa autoimune da pele que acomete com mais frequência crianças, adolescentes e adultos jovens que vivem nas áreas rurais de regiões endêmicas. Foi descrita pela primeira vez no país em 1903, pelo médico Caramuru Paes Leme. Os principais focos se situam no Distrito Federal e nos estados de Goiás, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Paraná e São Paulo. Temática de pesquisa amplamente visitada pela ciência médica, em especial a dermatologia, não tem merecido a atenção peculiar por parte dos historiadores da saúde e da doença.

Abstract This paper presents a historical narrative about the incidence of pemphigus foliaceus in Brazil in the nineteenth and twentieth centuries. This autoimmune blistering skin disease is more common in children, adolescents, and young adults who live in rural areas of endemic regions. It was first described in Brazil in 1903 by the physician Caramuru Paes Leme. The main foci of the disease are in the Federal District and the states of Goiás, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Paraná, and São Paulo. This research topic, which has attracted widespread attention from medical practice, especially dermatology, has not received similar attention from historians of health and disease.

Estigmas, pesquisas e embates: uma história do pênfigo brasileiro, séculos XIX e XX / Stigmas, studies, and strife: a history of Brazilian pemphigus, nineteenth and twentieth centuries

O artigo apresenta uma narrativa histórica sobre a incidência do pênfigo foliáceo no Brasil ao longo dos séculos XIX e XX. Doença bolhosa autoimune da pele que acomete com mais frequência crianças, adolescentes e adultos jovens que vivem nas áreas rurais de regiões endêmicas. Foi descrita pela primeira vez no país em 1903, pelo médico Caramuru Paes Leme. Os principais focos se situam no Distrito Federal e nos estados de Goiás, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Paraná e São Paulo. Temática de pesquisa amplamente visitada pela ciência médica, em especial a dermatologia, não tem merecido a atenção peculiar por parte dos historiadores da saúde e da doença.

Histórias de doenças: percepções, conhecimentos e práticas / Disease histories: perceptions, knowledge and practices

Este livro apresenta um conjunto de temas e abordagens, diferentes recortes espaciais e temporais em torno do problema da história da saúde e das doenças, situando as doenças numa perspectiva histórica, biológica e humana. Oferece observações e interpretações de trajetórias de pessoas e de doenças que, no geral, revelam lutas e sofrimentos, mas também, dignidade e superação. Ao percorrerem as sendas das doenças, em meio à obscuridade do tempo e das fontes trouxeram a baila o desespero,as dores, as crenças, as esperanças e as instituições que lhes foram e são inerentes ou derivadas, revelando-nos as raízes biológicas e sociais de várias moléstias, bem como, suas formas de expansão e as ações empreendidas para combatê-las.

Histórias de doenças: percepções, conhecimentos e práticas / Disease histories: perceptions, knowledge and practices

Este livro apresenta um conjunto de temas e abordagens, diferentes recortes espaciais e temporais em torno do problema da história da saúde e das doenças, situando as doenças numa perspectiva histórica, biológica e humana. Oferece observações e interpretações de trajetórias de pessoas e de doenças que, no geral, revelam lutas e sofrimentos, mas também, dignidade e superação. Ao percorrerem as sendas das doenças, em meio à obscuridade do tempo e das fontes trouxeram a baila o desespero,as dores, as crenças, as esperanças e as instituições que lhes foram e são inerentes ou derivadas, revelando-nos as raízes biológicas e sociais de várias moléstias, bem como, suas formas de expansão e as ações empreendidas para combatê-las.(AU)

Call to Publish in an Undergraduate Medical Course: Dissemination of the Final-Year Research Project.

PROBLEM: Today's medical doctors must not only have the clinical skills to treat patients effectively but also keep current with new advances in medicine and critically analyze evidence to choose the best treatments and explain the risks and benefits of different options. In this article, we aim to share the approach taken at a Portuguese medical school to promote a close connection between research and learning. INTERVENTION: In a blended-learning approach, students studied research and scientific methods and undertook one of three faculty-supervised research and dissemination projects. To support immediate application of new research knowledge, students were offered optional short lectures and problem sets. All course information was featured on a website that also supported a discussion forum. We analyzed 1,350 theses leading to the medical degree, defended in six consecutive academic years (2007-2013). Our aim was to estimate the publication rates and factors associated with publication of the final-year undergraduate research projects. CONTEXT: The present research curriculum was developed at the University of Porto Faculty of Medicine as part of the Bologna process curriculum implemented in the 2007-2008 academic year. From May to June 2014 we looked for corresponding articles published over the period of September 2007 to April 2014. We searched PubMed, Scielo, Scopus, and IndexRMP databases to locate publications resulting from student theses. OUTCOMES: Over 6 years, the diffusion of knowledge produced by medical students, who engaged in clinical practice concurrently with research projects, was fairly low (10.4%). Program modifications that increased student accountability and engagement allowed for an increased rate of publication from 1.0% to 23.9%. Factors associated with publication were research area, publication as a performance assessment criterion, and publication language. LESSONS LEARNED: The results of this study suggest that it is helpful to provide research opportunities that allow aspiring future medical doctors to begin their research careers. Further research is needed to understand difficulties students and supervisors face in project development and to achieve greater balance in topic coverage among projects and, consequently, in departmental involvement in the program.

Impact of atrial fibrillation type during acute coronary syndromes: Clinical features and prognosis.

INTRODUCTION: Atrial fibrillation (AF) is widely recognized as an adverse prognostic factor during acute myocardial infarction, although the impact of AF type - new-onset (nAF) or pre-existing (pAF) - is still controversial. OBJECTIVES: To identify the clinical differences and prognosis of nAF and pAF during acute coronary syndromes (ACS). METHODS: We performed a retrospective observational cohort study including 1373 consecutive patients (mean age 64 years, 77.3% male) admitted to a single center over a three-year period, with a six-month follow-up. RESULTS: AF rhythm was identified in 14.5% patients, of whom 71.4% presented nAF and 28.6% pAF. When AF types were compared, patients with nAF more frequently presented with ST-elevation ACS (p=0.003). Patients with pAF, in turn, were older (p=0.032), had greater left atrial diameter (p=0.001) and were less likely to have significant coronary lesions (p=0.034). Regarding therapeutic strategy, nAF patients were more often treated by rhythm control during hospital stay (p<0.001) and were less often anticoagulated at discharge (p=0.001). Compared with the population without AF, nAF was a predictor of death during hospital stay in univariate (p<0.001) and multivariate analysis (OR 2.67, p=0.047), but pAF was not. During follow-up, pAF was associated with higher mortality (p=0.014), while nAF patients presented only a trend towards worse prognosis. CONCLUSIONS: AF during the acute phase of ACS appears to have a negative prognostic impact only in patients with nAF and not in those with pAF.

Atrial ectopic activity in cryptogenic ischemic stroke and TIA: a risk factor for recurrence.

BACKGROUND: To characterize atrial ectopic activity in patients with cryptogenic ischemic stroke (CIS) or transient ischemic attack (TIA) and determine its prognostic significance. METHODS: Retrospective cohort study, in which 184 patients with CIS or TIA who had performed 24-hour Holter electrocardiogram were included. The median follow-up was 27.5 months. Baseline clinical and imagiologic characteristics, etiologic investigation results, and ischemic stroke and TIA recurrences information were collected. Number of atrial premature complexes (APCs) per hour was categorized as less than 10 APCs/hour, 10-30 APCs/hour, and more than 30 APCs/hour. RESULTS: Most of the patients had less than 10 APCs/hour (82.6%), 8.2% had 10-30 APCs/hour, and 9.2% had more than 30 APCs/hour. Patients with more than 30 APCs/hour had a greater median left atrium diameter than patients with 30 APCs/hour or less (42 mm vs. 38 mm; 95% confidence interval [CI], .50-7.00; P = .003). Annual recurrence rate of CIS or TIA was 2.9% in patients with less than 10 APCs/hour, 11.0% in 10-30 APCs/hour, and 22.6% in more than 30 APCs/hour (P = .001). More than 30 APCs/hour were independently associated with recurrence risk in multivariate survival analysis (hazard ratio, 3.40; 95% CI, 1.12-10.32; P = .030). CONCLUSIONS: In patients with CIS or TIA, frequent atrial ectopic activity (>30 APCs/h) was independently associated with increased risk of stroke or TIA recurrence. Further studies need to validate frequent atrial ectopic activity as a risk factor for recurrence in cryptogenic stroke and confirm its role as a predictor of occult atrial fibrillation.

New-onset atrial fibrillation during acute coronary syndromes: predictors and prognosis.

INTRODUCTION: New-onset atrial fibrillation (AF) frequently complicates myocardial infarction, with an incidence of 6-21%. OBJECTIVE: To assess the predictors and prognosis of new-onset AF during acute coronary syndromes (ACS). METHODS: We performed a retrospective observational cohort study including 902 consecutive patients (mean age 64 years, 77.5% male) admitted to a single center over a two-year period, with a six-month follow-up. RESULTS: AF rhythm was identified in 13.8% patients, of whom 73.3% presented new-onset AF and 26.8% pre-existing AF. New-onset AF was more frequent in older (p<0.001) and hypertensive patients (p=0.001) and in those with previous valvular heart disease (p<0.001) and coronary artery bypass grafting (p=0.049). During hospitalization, patients with new-onset AF more often had respiratory infection (p=0.002) and heart failure (p<0.001), and higher values of NT-proBNP (p=0.007) and peak creatinine (p=0.001). On echocardiography they had greater left atrial (LA) diameter (p<0.001) and more frequent significant mitral regurgitation (p<0.001) and left ventricular ejection fraction (LVEF) ≤40% (p<0.001) and were less likely to have significant coronary lesions (p=0.009) or to have undergone coronary revascularization (p<0.001). In multivariate analysis, age (OR 1.06, p=0.021), LVEF ≤40% (OR 4.91, p=0.002) and LA diameter (OR 1.14, p=0.008) remained independent predictors of new-onset AF. Together with age, diabetes and maximum Killip class, this arrhythmia was an independent predictor of overall mortality (OR 3.11, p=0.032). CONCLUSIONS: Age, LVEF ≤40% and LA diameter are independent predictors of new-onset AF during ACS. This arrhythmia is associated with higher overall mortality (in-hospital and in follow-up).

Pheochromocytoma diagnosed after anticoagulation for atrial fibrillation ablation procedure: a giant in disguise.

Pheochromocytoma is a rare catecholamine-producing tumor, discovered incidentally in 50% of cases. We present the case of a 44-year-old male with a history of paroxysmal palpitations. Baseline ECG, transthoracic echocardiogram and ECG stress test showed no relevant alterations. Paroxysmal atrial fibrillation was detected on 24-hour Holter ECG. After antiarrhythmic therapy, the patient remained symptomatic, and was accordingly referred for electrophysiological study and atrial fibrillation ablation. Anticoagulation was initiated before the procedure. After ablation and still anticoagulated, he complained of hematospermia. The abdominal and pelvic imaging study showed a 10-cm left adrenal mass, predominantly cystic, compatible with pheochromocytoma, which was confirmed after biochemical tests (increased urine metanephrines and plasma catecholamines). Metaiodobenzylguanidine scintigraphy scanning confirmed localized disease in the adrenal gland, excluding other uptake foci. Following appropriate preoperative management, surgical resection of the giant mass was performed successfully and without complications.

Males do sertão: alimentação, saúde e doenças em Goiás no século XX / Evils of the hinterland: food, health and disease in Goias in the twentieth century

O livro que o leitor tem em mãos apresenta minuciosa pesquisa sobre o papel determinante da alimentação na ocorrência de doenças no estado de Goiás. O trabalho sustenta-se em vasta pesquisa documental e aloja-se no contexto da Nova História, que privilegia aspectos da cultura material como a alimentação, a saúde e as doenças, peculiarmente no domínio da História Cultural. A autora mostra que o repasto cotidiano dos goianos não passou por mudanças significativas na transição dos séculos XVIII para o XIX. Continuaram a comer farinha de milho e de mandioca, acompanhada de carne-seca, quando era possível, e frutos silvestres provenientes do cerrado. Aliás, esse bioma foi importantíssimo para essa gente, que vivenciou longos períodos de escassez de víveres e, por vezes, enfrentou episódios de fome declarada. As recorrentes crises de fome e a carestia dos mantimentos determinaram as possibilidades e as preferências alimentares dessa gente. Mesmo as pessoas mais abastadas, em diversos momentos, sofreram os efeitos daquela conjuntura de dificuldades. Os desprovidos de renda, mormente os livres pobres e escravos, periodicamente padeciam de fome e mesmo em condições normais de abastecimento sofriam privações. Se essa dieta restrita saciou a fome de muitos, ao longo do tempo criou brechas para a instalação de inúmeras doenças

Mesalamine-induced myocarditis following diagnosis of Crohn's disease: a case report.

Mesalamine is a common treatment for Crohn's disease, and can be rarely associated with myocarditis through a mechanism of drug hypersensitivity. We present the case of a 19-year-old male who developed chest pain two weeks after beginning mesalamine therapy. The electrocardiogram showed slight ST-segment elevation with upward concavity in the inferolateral leads; blood tests demonstrated elevated troponin I and the echocardiogram revealed moderately depressed left ventricular systolic function with global hypocontractility. Cardiac magnetic resonance imaging confirmed the diagnosis of myocarditis, revealing multiple areas of subepicardial fibrosis. The onset of symptoms after mesalamine, and improvement of chest pain, cardiac biomarkers and left ventricular systolic function after discontinuing the drug, suggest that our patient suffered from a rare drug-hypersensitivity reaction to mesalamine.

Batalha contra o charlatanismo: institucionalização da medicina científica na província de Goiás / The battle against charlatanism: the institutionalization of scientific medicine in the province of Goiás

Enfoca os embates entre os tipos de medicina praticados em Goiás no século XIX, momento em que o discurso médico científico se impõe e define os espaços de atuação dos médicos diplomados em detrimento dos não diplomados, considerados charlatães pelos primeiros. Sobrelevam-se da análise os conflitos derivados da tentativa da medicina acadêmica de impor-se sobre as demais artes de curar, evidenciando sua dificuldade em instituir o privilégio exclusivo das atividades terapêuticas. Destaca ainda, por meio da trajetória profissional de três médicos que fizeram carreira no interior do Brasil, o lento processo de consolidação da medicina.

The article centers on conflicts between the types of medicine practiced in nineteenth-century Goiás, when the discourse of scientific medicine imposed its presence and defined the spaces where physicians holding medical degrees could practice while precluding those without degrees, viewed as charlatans by the former. The analysis underscores the clashes triggered as academic medicine endeavored to hold sway over other healing arts, along with the challenges it encountered in establishing an exclusive claim to the practice of medical treatment. The careers of three physicians from the interior of Brazil serve to illustrate the slow process by which medicine achieved institutionalization.

[The battle against charlatanism: the institutionalization of scientific medicine in the province of Goiás]. / Batalha contra o charlatanismo: institucionalização da medicina científica na província de Goiás.

The article centers on conflicts between the types of medicine practiced in nineteenth-century Goiás, when the discourse of scientific medicine imposed its presence and defined the spaces where physicians holding medical degrees could practice while precluding those without degrees, viewed as charlatans by the former. The analysis underscores the clashes triggered as academic medicine endeavored to hold sway over other healing arts, along with the challenges it encountered in establishing an exclusive claim to the practice of medical treatment. The careers of three physicians from the interior of Brazil serve to illustrate the slow process by which medicine achieved institutionalization.

A transitoriedade e o bem-dizer / The transcience and the well-said

No texto de Freud A transitoriedade (1915), fomos buscar os elementos para a construção deste trabalho. Freud observa, neste seu artigo, duas tendências psíquicas que o ser humano apresenta diante da constatação da impossibilidade do existir sem perecer: “o doloroso cansaço do mundo” e “a rebelião contra o fato consumado”. Este trabalho vem situar-se em torno dessas posições que remetem à “perda do objeto” - segundo Freud, e ao “universo mórbido da falta” - segundo Lacan. Trabalhando essas questões, buscamos fazer uma articulação com a ética da psicanálise, que revaloriza o desejo e propõe uma saída do mal- dito ao bem-dizer.(AU)

This work is based on Freud´s text The transience (1915). Freud points out in this essay two psychological tendencies that human beings have on the realization of the impossibility of existence without perishing, "the painful weariness of the world" and "the rebellion against the fait accompli." This work has the focus on those positions that refers to "lack of the object" - according to Freud, and "morbid universe of missing" - according to Lacan. Working on these issues, we make a links with the ethics of psychoanalysis, which revalues the desire and proposes a way out of bad-said to well-said.(AU)