Protease and gag diversity and drug resistance mutations among treatment-naive Mexican people living with HIV.

INTRODUCTION: In Mexico, HIV genotyping is performed in people living with HIV (PLWH) failing their first-line antiretroviral (ARV) regimen; it is not routinely done for all treatment-naive PLWH before ARV initiation. The first nationally representative survey published in 2016 reported that the prevalence of pretreatment drug mutations in treatment-naive Mexican PLWH was 15.5% to any antiretroviral drug and 10.6% to non-nucleoside reverse transcriptase inhibitors (NNRTIs) using conventional Sanger sequencing. Most reports in Mexico focus on HIV pol gene and nucleoside and non-nucleoside reverse transcriptase inhibitor (NRTI and NNRTI) drug resistance mutations (DRMs) prevalence, using Sanger sequencing, next-generation sequencing (NGS) or both. To our knowledge, NGS has not be used to detect pretreatment drug resistance mutations (DRMs) in the HIV protease (PR) gene and its substrate the Gag polyprotein. METHODS: Treatment-naive adult Mexican PLWH were recruited between 2016 and 2019. HIV Gag and protease sequences were obtained by NGS and DRMs were identified using the WHO surveillance drug resistance mutation (SDRM) list. RESULTS: One hundred PLWH attending a public national reference hospital were included. The median age was 28 years-old, and most were male. The median HIV viral load was 4.99 [4.39-5.40] log copies/mL and median CD4 cell count was 150 [68.0-355.78] cells/mm3. As expected, most sequences clustered with HIV-1 subtype B (97.9%). Major PI resistance mutations were detected: 8 (8.3%) of 96 patients at a detection threshold of 1% and 3 (3.1%) at a detection threshold of 20%. A total of 1184 mutations in Gag were detected, of which 51 have been associated with resistance to PI, most of them were detected at a threshold of 20%. Follow-up clinical data was available for 79 PLWH at 6 months post-ART initiation, seven PLWH failed their first ART regimen; however no major PI mutations were identified in these individuals at baseline. CONCLUSIONS: The frequency of DRM in the HIV protease was 7.3% at a detection threshold of 1% and 3.1% at a detection threshold of 20%. NGS-based HIV drug resistance genotyping provide improved detection of DRMs. Viral load was used to monitor ARV response and treatment failure was 8.9%.

Using data mining techniques to isolate chemical intrusion in water distribution systems.

The security of water distribution systems has become the subject of an increasing volume of research over the last decade. Data analysis and machine learning are linked to hydraulic and quality modeling for improving the capacity of water utilities to save lives when faced with the contamination of water networks. This research applies k-nearest neighbor and random forest algorithms to estimate the location of contamination sources at near-real time. Epanet and Epanet-MSX software are used to simulate intrusions of pesticide into water distribution system and the interaction with compounds already present in water bulk. Different pesticide concentrations are considered in the simulations, and chlorine monitoring occurs through placed quality sensors. The results show that random forest can localize [Formula: see text] of contamination scenarios, while the KNN algorithm found [Formula: see text]. Finally, an assessment of contamination spread is made for a better understanding of the impacts of non-localized contamination.

Dificuldades percebidas por trabalhadores com deficiência no cotidiano do trabalho / Difficulties perceived by workers with disabilities in the routine of their work / Dificultades percebidas por los trabajadores con discapacidades en la rutina de su trabajo

Este estudo teve como objetivo investigar, junto a trabalhadores com deficiência, as principais dificuldades enfrentadas os primeiros meses de trabalho. Trata-se de pesquisa qualitativa com 16 trabalhadores com deficiência, numa empresa privada de ensino superior e médio no noroeste do estado do Rio Grande do Sul. A coleta dos dados se deu mediante entrevista estruturada e análise de conteúdo em agosto 2014. Foi possível elencar duas categorias: a primeira inerente às dificuldades enfrentadas pelos trabalhadores com deficiência, e a segunda, às (in)satisfações e contribuições do trabalhador para a melhoria do processo de trabalho. Identificou-se que a maioria dos entrevistados não enfrentou dificuldades, contudo em alguns relatos, foi possível apreender alguma discriminação e dificuldades de adaptação. Algumas ações da empresa foram facilitadoras do processo de inserção do trabalhador com deficiência. Considera-se que a inclusão do enfermeiro, dentro das empresas, possa contribuir para uma melhor integração destes trabalhadores (AU).

This study aimed to investigate, with disabled workers, the main difficulties faced by these in their first months at work. It is qualitative research with 16 disabled workers, in a private company providing teaching services at a high school and higher education level, in the northwest of the Brazilian state of Rio Grande do Sul. Data collection took place through a structured interview and content analysis, in August 2014. It was possible to list two categories: the first, inherent to the difficulties faced by the disabled workers, and the second, to the worker's (dis-)satisfactions and contributions to improving the work process. It was identified that the majority of the interviewees did not face difficulties ­ however, in some reports, it was possible to learn some instances of discrimination, and difficulties in adapting. Some of the company's actions facilitated the process of the disabled worker's insertion. It is considered that the inclusion of the nurse, within companies, may contribute to the better integration of these workers (AU).

El objetivo de este estudio fue investigar, con trabajadores discapacitados, las principales dificultades a las que se enfrentan en sus primeros meses de trabajo. Se trata de una investigación cualitativa con 16 trabajadores discapacitados, en una empresa privada que presta servicios de enseñanza en una escuela secundaria y superior, en el noroeste del estado brasileño de Rio Grande do Sul. La recolección de datos se realizó mediante una entrevista estructurada y un análisis de contenido, en agosto de 2014. Se pudo enumerar dos categorías: la primera, inherente a las dificultades de los trabajadores discapacitados, y la segunda a las (des) satisfacciones y Contribuciones para mejorar el proceso de trabajo. Se identificó que la mayoría de los entrevistados no se enfrentaban a dificultades; sin embargo, en algunos informes se pudo conocer algunos casos de discriminación y dificultades de adaptación. Algunas de las acciones de la empresa facilitaron el proceso de inserción del trabajador discapacitado. Se considera que la inclusión de la enfermera, dentro de las empresas, puede contribuir a la mejor integración de estos trabajadores (AU).

Newborn physiological responses to noise in the neonatal unit, / Respostas fisiológicas de neonatos frente a ruídos em unidade neonatal

ABSTRACT INTRODUCTION: The incorporation of technologies in the care of infants has contributed to increased survival; however, this has turned neonatal unit into a noisy environment. OBJECTIVE: To evaluate the physiological and functional effects resulting from the exposure to noise on low-weight newborns in incubators in a neonatal unit. METHODS: Prospective, observational, quantitative, exploratory, descriptive study. The adopted statistical method included tables of frequency, descriptive statistics, and Student's t-test, with a 0.05 level of significance. As data collection tools, the environmental noise and the noise inside of the incubator were evaluated, and the Assessment of Preterm Infant Behavior scale was used to assess premature newborn behavior and projected specifically to document the neurobehavioral functioning of preterm infants. The data collection occurred from September of 2012 to April of 2013; 61 low-weight newborns admitted in the neonatal unit and in incubators were observed. RESULTS: Significant differences in the variables heart rate and oxygen saturation were noted when newborns were exposed to noise. CONCLUSION: Low-weight neonates in incubators present physiological alterations when facing discomfort caused by environmental noise in neonatal units.

Resumo INTRODUÇÃO: A incorporação de tecnologias no cuidado dos recém-nascidos contribui para o aumento da sobrevivência, porém, transformou as unidades neonatais em locais muito ruidosos. OBJETIVO: Avaliar os efeitos fisiológicos e funcionais decorrentes de exposição a ruídos em uma unidade neonatal em recém-nascidos de baixo peso em incubadora. MÉTODO: Estudo prospectivo, de caráter observacional, de abordagem quantitativa e natureza descritiva exploratória. O método estatístico utilizado foi o de tabelas de frequência, estatística descritiva e o teste t de student pareado, ao nível de significância de 0,05. Como instrumento de coleta dos dados foi avaliado o ruído ambiental e no interior das incubadoras e utilizada a escala assessment of preterm infant behavior para avaliação do comportamento dos bebês prematuros e projetada especificamente para documentar o funcionamento neurocomporta-mental dos bebês pré-termo. A coleta dos dados aconteceu no período de setembro de 2012 a abril de 2013 e foram observados 61 recém-nascidos de baixo peso em incubadora internados na unidade neonatal. RESULTADOS: Verifica-se a existência de diferenças significativas na variável frequência cardíaca e saturação de oxigênio frente à exposição a ruídos. CONCLUSÃO: Recém-nascidos de baixo peso em incubadora apresentam alterações fisiológicas quando se encontram em desconforto causado pelo ruído ambiente de unidades neonatais.

Newborn physiological responses to noise in the neonatal unit.

INTRODUCTION: The incorporation of technologies in the care of infants has contributed to increased survival; however, this has turned neonatal unit into a noisy environment. OBJECTIVE: To evaluate the physiological and functional effects resulting from the exposure to noise on low-weight newborns in incubators in a neonatal unit. METHODS: Prospective, observational, quantitative, exploratory, descriptive study. The adopted statistical method included tables of frequency, descriptive statistics, and Student's t-test, with a 0.05 level of significance. As data collection tools, the environmental noise and the noise inside of the incubator were evaluated, and the Assessment of Preterm Infant Behavior scale was used to assess premature newborn behavior and projected specifically to document the neurobehavioral functioning of preterm infants. The data collection occurred from September of 2012 to April of 2013; 61 low-weight newborns admitted in the neonatal unit and in incubators were observed. RESULTS: Significant differences in the variables heart rate and oxygen saturation were noted when newborns were exposed to noise. CONCLUSION: Low-weight neonates in incubators present physiological alterations when facing discomfort caused by environmental noise in neonatal units.

Access to hearing health service in Curitiba-PR for the elderly with hearing loss and tinnitus.

OBJECTIVE: To determine the incidence of complaints of hearing loss and tinnitus in a group of seniors and their access to hearing health services in the city of Curitiba. METHOD: 578 elderly, attending general practice clinic of two public hospitals in the city. Three questionnaires were applied: for user identification, to check for hearing loss/tinnitus and on access to hearing health services. RESULTS: Of the 578 subjects, 187 (31%) had hearing complaints and 112 (20%) had tinnitus; of these, 72% have never had an audiological evaluation, 12% received treatment for tinnitus without success, 16% reported having hearing aids, 14% had hearing aid devices managed by SUS; 76% of the sample showed the desire to carry out an assessment and be awarded hearing aids; 37% did not know where to seek help. CONCLUSION: The number of individuals with hearing complaints in the studied group is significant, as is the number of people with hearing complaints such as tinnitus who have never had a hearing examination. The access of people to public programs is deficient in this group.

A percepção dos técnicos de enfermagem em relação aos riscos ocupacionais em salas de vacinas / Nursing technicians' perceptions regarding the occupational risks in vaccination rooms / Percepción de los técnicos de enfermería acerca de los riesgos ocupacionales en salas de vacunas

Estudo descritivo, de abordagem qualitativa, cujo objetivo foi identificar os riscos ocupacionais em salas de vacinas. Participaram da pesquisa 10 técnicos de enfermagem que atuam em cinco salas de vacina de um município no noroeste do Rio Grande do Sul. Os dados foram coletados por meio de uma entrevista semiestruturada e observação simples, e analisados por meio da análise temática no período de março a maio de 2012. Observou-se que as salas de vacinas apresentam inúmeros riscos ocupacionais e que muitos trabalhadores não os percebem, pois havia balcão com pia para lavar as mãos, mas estas tinham altura muito baixa nas cinco salas observadas, além da iluminação deficiente em todas salas. As vacinadoras entendem que os riscos ocupacionais estão relacionados somente aos acidentes de trabalho. A atenção do serviço municipal de promoção à saúde do trabalhador pode conferir valor à qualidade no trabalho destes profissionais.

This descriptive study with a qualitative approach aimed to identify the occupational risks in vaccinations. A total of 10 nursing technicians participated in the research; these worked in five vaccination rooms in a municipality in the North-west of the state of Rio Grande do Sul. The data were collected through semi-structured interviews and simple observation, and were analyzed using thematic analysis in the period March - May 2012. It was observed that the vaccination rooms present innumerable occupational risks - and that many workers do not perceive these. There was a work surface with a basin for handwashing, but these were at a very low height in the five rooms observed, in addition to there being inadequate lighting in all rooms. The vaccinators understand occupational risks as relating only to work accidents. The attention of the municipal service for the promotion of worker's health could add value to the quality in these subjects' work.

Estudio descriptivo, de abordaje cualitativo, cuyo propósito fue identificar los riegos ocupacionales en salas de vacunas. Participaron de la investigación 10 técnicos de enfermería que actúan en cinco salas de vacuna de un municipio del noroeste de Rio Grande do Sul. Los datos fueron obtenidos por medio de una entrevista semiestructurada y de observación simple, y analizados por medio del análisis temático en el periodo de marzo a mayo de 2012. Se observó que las salas de vacunas presentan muchos riegos ocupacionales y que muchos trabajadores no los perciben, pues había local para lavar las manos, pero este presentaba una altura muy baja en las cinco salas observadas, además de la iluminación deficiente en todas las salas. Las personas que aplican las vacunas entienden que los riegos ocupacionales están relacionados solamente a los accidentes de trabajo. La atención del servicio municipal de promoción de la salud del trabajador puede agregar valor a la cualidad en el trabajo de estes sujetos.

Consulta pré-natal: satisfação das usuárias do SUS / Pre-natal check-up: Unified Health System users' satisfaction / Consulta prenatal: satisfación de las usuarias del Sistema Único de Salud

Esse estudo teve como objetivo verificar a satisfação das gestantes nas consultas de pré-natal oferecida na rede básica de um município missioneiro, situado ao noroeste do Estado do Rio Grande do Sul. Na pesquisa, de abordagem qualitativa e caráter descritivo, participaram 10 gestantes que estavam em acompanhamento pré-natal num centro municipal de atendimento à gestantes. Os dados foram coletados por meio de entrevista e a análise foi feita mediante análise do conteúdo. Nessa pesquisa foi possível perceber que as gestantes valorizam o diálogo e orientações, o que possibilita a compreensão do significado do pré-natal. Fortalecer a comunicação com as gestantes, neste período, pode favorecer o acolhimento e a qualidade do cuidado de enfermagem.

This study aimed to check pregnant women's satisfaction with the pre-natal check-ups offered in a basic health network in a missionary town in the north-east of the state of Rio Grande do Sul. Ten mothers-to-be under pre-natal supervision at a town center for pregnancy care participated in the research, which had a qualitative approach and a descriptive character. The data was collected through interviews and analyzed through content analysis. In this research it was possible to notice that the pregnant women valued the dialog and guidance, which makes it possible to understand the meaning of the pre-natal check-up. Strengthening communication with the mothers-to-be in this period can favor the building of the relationship and the quality of nursing care.

Ese estudio tuvo como objetivo verificar la satisfacción de las gestantes en las consultas de prenatal ofrecidas en la red básica de un municipio misionero, ubicado al noroeste del Estado de Rio Grande do Sul. En la investigación, de abordaje cualitativo y carácter descriptivo, participaron 10 gestantes que estaban en acompañamiento prenatal en un centro municipal de atendimiento a gestantes. Los datos fueron recogidos por medio de entrevista y el análisis fue hecho por medio de análisis de contenido. En esa investigación fue posible percibir que las gestantes valoran el diálogo y orientaciones, lo que posibilita la comprensión del significado del prenatal. Fortalecer la comunicación con las gestantes, en este periodo, puede favorecer la acogida y la cualidade del cuidado de enfermería.

Dimensionamento do pessoal de enfermagem em uma unidade clínica / Dimensionamiento del personal de enfermería en la unidad clínica / Sizing of nursing staff in a clinical unit

Realizar o dimensionamento do pessoal de enfermagem segundo o grau de dependência de pacientes de unidade clinica. Método: Pesquisa quantitativa descritiva realizada em uma unidade clínica de um hospital geral de médio porte localizado no interior do estado do Rio Grande do Sul, Brasil, em 2009. Aplicou-se nos pacientes internados o Sistema de Classificação de Pacientes, após foi realizado o cálculo para dimensionamento de pessoal. Respeitaram-se os aspectos éticos. Resultados: Predominaram 60,48 % pacientes em cuidado mínimo, seguido de 25% intermediários, 13,71% semi-intensivos e 0,81% intensivos. O dimensionamento apontou que o número de enfermeiros é insuficiente e o número de técnicos de enfermagem supera discretamente o preconizado. Conclusão: A aplicação do Sistema de Classificação de Pacientes permitiu identificar o perfil assistencial do pacientes internados na unidade clínica. Faz-se necessário o aumento do número de profissionais de acordo com as categorias de cuidado identificadas.

Hacer el dimensionamiento del personal de enfermería de acuerdo con el grado de dependencia de los pacientes de la unidad clínica. Método: Estudio quantitativo descriptivo realizado en una unidad clínica de un hospital en el interior de Rio Grande do Sul, Brasil, en 2009. Se aplicó el Sistema de Clasificación de Pacientes, después se realizó el cálculo del dimensionamiento del personal de enfermería. Sin perjuicio de los aspectos éticos. Resultados: 60,48% pacientes en cuidados mínimos, seguido por un 25% intermedios, 13,71% semi-intensivos e intensivos 0,81%. El dimensionamiento mostró que el número de enfermeras es insuficiente. El número de técnicos es discretamente superior a lo recomendado. Conclusión: La aplicación del Sistema de Clasificación de los Pacientes identifico el perfil asistencial de los pacientes ingresados en la unidad clínica. Es necesario aumentar el número de profesionales de acuerdo en las categorías de atención identificados.

Objectives: To make the sizing of the nursing staffing according to the degree of patient dependence a clinical unit. Method: Quantitative descriptive research held in a clinical unit for a hospital located in the interior of Rio Grande do Sul, Brazil, in 2009. Was applied the Patient Classification System, after the calculation was performed for sizing of staff. Were respected the ethical aspects. Results: Predominated patients in minimal care in 60,48%, followed 25% intermediate, 13,71% semi-intensive and intensive 0,81%. The sizing showed that the number of nurses is insufficient. The technician’s number discreetly exceeded what is recommended. Conclusion: The Patient Classification System identified the care profile of patients admitted to the clinical unit. It’s necessary to increase the number of professionals according to the category of care identified.