Working conditions in COVID-19 hospital units: perceptions of nursing workers.

OBJECTIVE: To know the perceptions of nursing workers about their working conditions in COVID-19 hospital units. METHOD: Qualitative, descriptive, multicenter study, carried out in September 2020 and July 2021 with 35 nursing workers from COVID-19 units of seven hospitals in Rio Grande do Sul, Brazil. Data were produced through semi-structured interviews and submitted to thematic content analysis with the support of NVivo software. RESULTS: The participants reported availability of material resources and personal protective equipment, but perceived a lack of human resources, multiprofessional support and extra absorption of tasks, resulting in the intensification of work and culminating in overload. Professional and institutional aspects were also mentioned, such as fragility in professional autonomy, wage lag, payment delays and little institutional appreciation. CONCLUSION: Nursing workers in the COVID-19 units lived with precarious working conditions, worsened by organizational, professional and financial elements.

Pleasure and suffering of nursing in COVID-19 hospital units: between disenchantment and formation of meanings.

OBJECTIVE: to analyze the experiences of pleasure and suffering of nursing workers in COVID-19 hospital units. METHODS: a multicenter, qualitative study, developed with 35 nursing workers from COVID-19 units in seven hospitals in southern Brazil. Data were produced through semi-structured interviews, submitted to thematic content analysis with the help of NVivo. RESULTS: experiences of pleasure were linked to gratification, identification with work content, positive results in care, recognition, integration with the team and personal overcoming. Suffering was revealed in daily life of deaths and losses, feelings of helplessness, team conflicts, institutional demands, professional devaluation. Workers reported disenchantment, but also strengthening the meaning of their work, highlighting frontline impacts on their mental health. FINAL CONSIDERATIONS: in the dynamics between pleasure and suffering in nursing work in COVID-19 hospital units, elements point to the risk of psychological illness.

Violence in rural areas against disabled people from the perspective of their families.

OBJECTIVES: to know the violence spoken and felt by disabled people, living in rural areas, from the perspective of their families. METHODS: a descriptive-exploratory and qualitative study, carried out in four municipalities in Rio Grande do Sul, Brazil. Twelve family members who lived with disabled people in rural areas participated. Data were collected through semi-structured interviews and analyzed using thematic content analysis. RESULTS: disabled people, living in rural areas, experienced physical, psychological and sexual violence, perpetrated by family members, colleagues, community members and health professionals. Adaptations were mentioned in family dynamics for the care of disabled people, social, financial and leisure impacts, and challenges in access and accessibility to education and health services. FINAL CONSIDERATIONS: violence against this population manifests itself in a reality with socioeconomic and family particularities, marked by exclusion, disrespect and denial of rights and access to fundamental goods and services.

Cotidiano e desafios da enfermagem em unidades hospitalares COVID-19: perspectiva dos profissionais / Daily life and challenges of nursing in COVID-19 hospital units: professionals' perspective

Introdução: O trabalho de enfermagem em unidades hospitalares COVID-19 é complexo, desafiador e repleto de elementos cuja compreensão é importante para o campo da Gestão e Saúde no Trabalho. Objetivo: Compreender o cotidiano e os desafios de trabalhadores de enfermagem na linha de frente do enfrentamento à pandemia em unidades hospitalares COVID-19. Materiais e Métodos: Estudo qualitativo desenvolvido com 35 trabalhadores de enfermagem em unidades COVID-19 de sete hospitais do Sul do Brasil, por meio de entrevistas semiestruturadas. O software NVivo auxiliou no tratamento dos dados a partir da análise temática de conteúdo. Resultados: Da análise dos dados emergiram duas categorias analíticas: Desafios do cotidiano de enfermagem nas unidades COVID-19: complexidade e demandas da assistência; e Desafios de ser um trabalhador de enfermagem da linha de frente: desdobramentos no bem-estar profissional e na vida pessoal. Discussão: Pode-se considerar que a complexidade e intensificação do trabalho na linha de frente causou impactos que podem conduzir os trabalhadores de enfermagem ao adoecimento. São importantes ações de promoção à visibilidade profissional junto à sociedade para desmistificar a imagem romantizada sobre a profissão e problematizar a importância da enfermagem no enfrentamento da pandemia e os impactos sofridos por estes trabalhadores. Conclusão: Trabalhadores de enfermagem de unidades COVID-19 vivenciam desafios complexos, com repercussões em sua experiência laboral e em sua vida.

Introduction: The nursing work in COVID-19 hospital units is complex, challenging, and full of elements whose understanding is important for the field of Management and Health at Work. Objective: To understand the daily life and challenges of nursing workers in the front line of confronting the pandemic in COVID-19 hospital units. Materials and Methods: Qualitative study developed with 35 nursing workers in COVID-19 units from seven hospitals in southern Brazil, through semi-structured interviews. The NVivo software helped in the data treatment from the thematic content analysis. Results: Two analytical categories emerged from data analysis: Challenges of nursing daily life in COVID-19 units: complexity and demands of assistance; and Challenges of being a frontline nursing worker: unfolding in professional well-being and personal life. Discussion: It can be considered that the complexity and intensification of frontline work caused impacts that can lead nursing workers to illness. Actions to promote professional visibility in society are important, to demystify the romanticized image about the profession, and to problematize the importance of nursing in facing the pandemic and the impacts suffered by these workers. Conclusion: Nursing workers in COVID-19 units experience complex challenges, with repercussions on their work experience and their lives.

Introducción: El trabajo de enfermería en las unidades hospitalarias COVID-19 es complejo, desafiante y lleno de elementos cuya comprensión es importante para el campo de la Gestión y Salud Ocupacional. Objetivo: comprender el cotidiano y los desafíos de los trabajadores de enfermería en la primera línea de enfrentamiento a la pandemia en las unidades hospitalarias de la COVID-19. Materiales y Métodos: estudio cualitativo desarrollado con 35 trabajadores de enfermería en unidades de COVID-19 de siete hospitales del sur de Brasil, a través de entrevistas semiestructuradas. El software NVivo ayudó en el procesamiento de datos basado en el análisis de contenido temático. Resultados: del análisis de los datos surgieron dos categorías analíticas: Desafíos cotidianos de la enfermería en las unidades de COVID-19: complejidad y demandas asistenciales; y Desafíos de ser un trabajador de enfermería de primera línea: desarrollos en el bienestar profesional y personal. Discusión: se puede considerar que la complejidad e intensificación del trabajo en primera línea provocó impactos que podrían llevar a los trabajadores de enfermería a la enfermedad. Las acciones de promoción de la visibilidad profesional en la sociedad son importantes para desmitificar la imagen romantizada de la profesión y discutir la importancia de la enfermería en el enfrentamiento de la pandemia y los impactos sufridos por estos trabajadores. Conclusión: los trabajadores de enfermería de las unidades de COVID-19 viven desafíos complejos, con repercusiones en su experiencia laboral y en su vida.

Working conditions in COVID-19 hospital units: perceptions of nursing workers / Condiciones laborales en unidades hospitalarias COVID-19: percepciones de los trabajadores de enfermería / Condições de trabalho em unidades hospitalares COVID-19: percepções de trabalhadores de enfermagem

ABSTRACT Objective: To know the perceptions of nursing workers about their working conditions in COVID-19 hospital units. Method: Qualitative, descriptive, multicenter study, carried out in September 2020 and July 2021 with 35 nursing workers from COVID-19 units of seven hospitals in Rio Grande do Sul, Brazil. Data were produced through semi-structured interviews and submitted to thematic content analysis with the support of NVivo software. Results: The participants reported availability of material resources and personal protective equipment, but perceived a lack of human resources, multiprofessional support and extra absorption of tasks, resulting in the intensification of work and culminating in overload. Professional and institutional aspects were also mentioned, such as fragility in professional autonomy, wage lag, payment delays and little institutional appreciation. Conclusion: Nursing workers in the COVID-19 units lived with precarious working conditions, worsened by organizational, professional and financial elements.

RESUMEN Objetivo: Conocer las percepciones de los trabajadores de enfermería sobre sus condiciones de trabajo en unidades hospitalarias COVID-19. Método: Estudio cualitativo, descriptivo, multicéntrico, realizado en septiembre de 2020 y julio de 2021 con 35 trabajadores de enfermería de unidades COVID-19 en siete hospitales de Rio Grande do Sul, Brasil. Los datos fueron producidos a través de entrevistas semiestructuradas y sometidos al análisis de contenido temático con la ayuda del software NVivo. Resultados: Los participantes mencionaron la disponibilidad de recursos materiales y equipos de protección personal, pero percibieron falta de recursos humanos, apoyo multidisciplinario y absorción extra de tareas, lo que resultó en la intensificación del trabajo y culminó en la sobrecarga. También se mencionaron aspectos profesionales e institucionales, como fragilidad en la autonomía profesional, brecha salarial, retrasos en los pagos y poca valorización institucional. Conclusión: Los trabajadores de enfermería de las unidades COVID-19 vivían con la precariedad de las condiciones de trabajo, agravada por elementos organizativos, profesionales y económicos.

RESUMO Objetivo: Conhecer as percepções de trabalhadores de enfermagem acerca de suas condições de trabalho em unidades hospitalares COVID-19. Método: Estudo qualitativo, descritivo, multicêntrico, realizado setembro de 2020 e julho de 2021 com 35 trabalhadores de enfermagem de unidades COVID-19 de sete hospitais do Rio Grande do Sul, Brasil. Os dados foram produzidos por meio de entrevistas semiestruturadas e submetidos à análise temática de conteúdo com auxílio do software NVivo. Resultados: Os participantes referiram disponibilidade de recursos materiais e equipamentos de proteção individual, mas percebiam carências de recursos humanos, de suporte multiprofissional e absorção extra de tarefas, resultando na intensificação do trabalho e culminando em sobrecarga. Aspectos profissionais e institucionais também foram referidos, como fragilidade na autonomia profissional, defasagem salarial, atrasos nos pagamentos e pouca valorização institucional. Conclusão: Os trabalhadores de enfermagem das unidades COVID-19 conviveram com a precarização das condições de trabalho, agravadas por elementos organizacionais, profissionais e financeiros.

Atenção à saúde de idosos com deficiências residentes em cenário rural: perspectiva de agentes comunitários / Atención a la salud de las personas mayores con discapacidad residentes en el entorno rural: perspectiva de los agentes comunitarios / Health care of elderly people with disabilities living in rural settings: perspective of community agents

RESUMO Objetivo: apreender a perspectiva dos Agentes Comunitários sobre a atenção à saúde de idosos com deficiências residentes em cenário rural. Método: estudo quanti-qualitativo, cuja coleta de dados, inicialmente, foi realizada com 276 pessoas com deficiência residentes em cenário rural, através de questionários aplicados de agosto de 2018 a julho de 2019. Deste total, foram selecionadas apenas as pessoas idosas para fazer parte do recorte desta pesquisa, totalizando uma amostra de 54 indivíduos. Após análise dos dados quantitativos por meio de programa estatístico, foram entrevistados 18 Agentes Comunitários de Saúde que assistiam estes idosos em suas micro áreas rurais. As entrevistas foram realizadas de julho a agosto de 2021, analisadas pela Análise de Conteúdo Temática. Resultados: pôde-se constatar a presença de doenças crônicas nos idosos, além da dependência de serviços públicos de saúde, distantes das residências. Os Agentes Comunitários de Saúde relataram suas ações de atenção aos idosos com deficiência, destacando a importância da colaboração da equipe multiprofissional para atender esta população. Conclusão: verifica-se que o atendimento a esse estrato populacional, em comunidades rurais, centra-se no Agente Comunitário de Saúde, indicando a necessidade de novas pesquisas sobre o tema.

RESUMEN Objetivo: comprender la perspectiva de los Agentes Comunitarios sobre la atención a la salud de personas mayores con discapacidades residentes en el entorno rural. Método: estudio cuanti-cualitativo, cuya recopilación de datos, inicialmente, fue realizada con 276 personas con discapacidad residentes en ambiente rural, a través de cuestionarios aplicados de agosto de 2018 a julio de 2019. De este total, fueron seleccionados solo los ancianos para formar parte del recorte de esta investigación, totalizando una muestra de 54 individuos. Tras el análisis de los datos cuantitativos por medio de programa estadístico, fueron entrevistados 18 Agentes Comunitarios de Salud que asistían a estos ancianos en sus micro áreas rurales. Las entrevistas fueron realizadas de julio a agosto de 2021, analizadas por el Análisis de Contenido Temático. Resultados: se pudo constatar la presencia de enfermedades crónicas en las personas mayores, además de la dependencia de servicios públicos de salud, lejanos a las residencias. Los Agentes Comunitarios de Salud relataron sus acciones de atención a los ancianos con discapacidad, destacando la importancia de la colaboración del equipo multiprofesional para atender a esta población. Conclusión: se verifica que la atención a ese grupo poblacional, en comunidades rurales, se centra en el Agente Comunitario de Salud, indicando la necesidad de nuevas investigaciones sobre el tema.

ABSTRACT Objective: to apprehend the perspective of Community Agents on health care of elderly people with disabilities living in rural settings. Method: quantitative-qualitative study, whose data collection was initially performed with 276 people with disabilities living in rural settings, through questionnaires applied from August 2018 to July 2019. From this total, only the elderly were selected to be part of the cut of this research, totaling a sample of 54 individuals. After analyzing the quantitative data through a statistical program, 18 Community Health Agents who assisted these elderly in their micro rural areas were interviewed. The interviews were conducted from July to August 2021, analyzed by the Thematic Content Analysis. Results: it was possible to verify the presence of chronic diseases in the elderly, in addition to dependence on public health services, far from homes. The Community Health Agents reported their actions of attention to the elderly with disabilities, highlighting the importance of the collaboration of the multidisciplinary team to meet this population. Conclusion: it appears that the care to this population stratum, in rural communities, focuses on the Community Health Agent, indicating the need for new research on the subject.

Pleasure and suffering of nursing in COVID-19 hospital units: between disenchantment and formation of meanings / Placer y sufrimiento de enfermería en unidades hospitalarias COVID-19: entre el desencanto y la formación de sentidos / Prazer e sofrimento de enfermagem em unidades hospitalares COVID-19: entre desencantos e formação de sentidos

ABSTRACT Objective: to analyze the experiences of pleasure and suffering of nursing workers in COVID-19 hospital units. Methods: a multicenter, qualitative study, developed with 35 nursing workers from COVID-19 units in seven hospitals in southern Brazil. Data were produced through semi-structured interviews, submitted to thematic content analysis with the help of NVivo. Results: experiences of pleasure were linked to gratification, identification with work content, positive results in care, recognition, integration with the team and personal overcoming. Suffering was revealed in daily life of deaths and losses, feelings of helplessness, team conflicts, institutional demands, professional devaluation. Workers reported disenchantment, but also strengthening the meaning of their work, highlighting frontline impacts on their mental health. Final considerations: in the dynamics between pleasure and suffering in nursing work in COVID-19 hospital units, elements point to the risk of psychological illness.

RESUMEN Objetivo: analizar las experiencias de placer y sufrimiento de trabajadores de enfermería en unidades hospitalarias COVID-19. Métodos: estudio multicéntrico, cualitativo, desarrollado con 35 trabajadores de enfermería de unidades COVID-19 de siete hospitales del sur de Brasil. Los datos fueron producidos a través de entrevistas semiestructuradas, sometidas al análisis de contenido temático con el auxilio del software NVivo. Resultados: las experiencias de placer se vincularon a la gratificación, identificación con el contenido del trabajo, resultados positivos en el cuidado, reconocimiento, integración con el equipo y superación personal. El sufrimiento se reveló en el cotidiano de muertes y pérdidas, sentimientos de impotencia, conflictos de equipo, exigencias institucionales, desvalorización profesional. Los trabajadores informaron desencanto, pero también fortalecieron el significado de su trabajo, destacando los impactos de primera línea en su salud mental. Consideraciones finales: en la dinámica entre placer y sufrimiento en el trabajo de enfermería en unidades hospitalarias COVID-19, elementos apuntan para el riesgo de enfermedad psíquica.

RESUMO Objetivo: analisar as vivências de prazer e sofrimento de trabalhadores de enfermagem em unidades hospitalares COVID-19. Métodos: estudo multicêntrico, qualitativo, desenvolvido com 35 trabalhadores de enfermagem de unidades COVID-19 de sete hospitais do Sul do Brasil. Os dados foram produzidos por meio de entrevistas semiestruturadas, submetidos à análise temática de conteúdo com auxílio do software NVivo. Resultados: vivências de prazer estavam vinculadas à gratificação, identificação com o conteúdo do trabalho, resultados positivos na assistência, reconhecimento, integração com a equipe e superações pessoais. O sofrimento se relevou no cotidiano de mortes e perdas, sentimento de impotência, conflitos na equipe, cobranças institucionais, desvalorização profissional. Os trabalhadores relataram desencantos, mas também fortalecimento dos sentidos do seu trabalho, ressaltando impactos da linha de frente em sua saúde mental. Considerações finais: na dinâmica entre prazer e sofrimento no trabalho de enfermagem em unidades hospitalares COVID-19, elementos sinalizam para o risco de adoecimento psíquico.

Common mental disorders and associated factors in nursing workers in COVID-19 units.

OBJECTIVE: To analyze the interfaces between mental illness, based on common mental disorder screening, and sociodemographic, health and life habits aspects of nursing workers at COVID-19 units. METHOD: A mixed methods study, carried out with 327 nursing workers from COVID-19 units of seven public and philanthropic, medium and large hospitals in Brazil. The collection included a socio-employment, health and lifestyle questionnaire, the Self-Reporting Questionnaire, and interviews. chi-square and Fisher's exact tests were applied to quantitative data and thematic content analysis, with the help of NVivo in the qualitative ones. RESULTS: Common mental disorders were screened in 35.5% of the sample and were associated with female sex (p = 0.004), age up to 40 years (p = 0.003), nurse (p = 0.014), reporting previous illness (p = 0.003), using psychoactive drugs (p < 0.001), medication that was not used before the pandemic (p < 0.001) and reporting poor sleep/eating quality (p < 0.001). The impacts of the pandemic on social and family life presented interfaces with mental illness. CONCLUSION: The presence of psychological illness is suggested, possibly associated with the repercussions of the pandemic on work and personal life.

Prazer e sofrimento no trabalho de enfermagem em urgência e emergência / El placer y el sufrimiento en el trabajo de enfermería en urgencia y emergência / Pleasure and suffering in urgent and emergency nursing work

RESUMO Objetivo: conhecer as vivências de prazer e sofrimento de trabalhadores de Enfermagem de serviços de urgência e emergência. Metodologia: pesquisa qualitativa descritiva. Foram entrevistados trabalhadores de Enfermagem de uma unidade de urgência e emergência de um hospital filantrópico e do Serviço de Atendimento Móvel de Urgência de uma cidade do Sul do Brasil. O material foi submetido à análise temática de conteúdo. Resultados: as vivências de prazer se relacionaram à identificação com o trabalho, à satisfação frente aos resultados exitosos, ao reconhecimento, ao trabalho em equipe e ao fortalecimento do sentido do trabalho. Já as vivências de sofrimento foram atribuídas ao contato com a morbimortalidade da população, aos conflitos e à precarização do trabalho. Conclusão: as vivências de prazer coexistem com as de sofrimento no cotidiano do trabalho de Enfermagem em urgência e emergência, sendo importantes espaços de fala e escuta para a ressignificação dos sentimentos e proteção à saúde mental no trabalho.

RESUMEN Objetivo: conocer las experiencias de placer y sufrimiento de los trabajadores de enfermería en los servicios de urgencia y emergencia. Metodología: investigación descriptiva cualitativa. Entrevistamos a trabajadores de enfermería de una unidad de urgencias y emergencias de un hospital filantrópico y del Servicio de Atención Móvil de Urgencias de una ciudad del sur de Brasil. El material se sometió a un análisis de contenido temático. Resultados: las vivencias de los trabajadores se relacionaron con la identificación con el trabajo, la satisfacción frente a los resultados exitosos, la reconciliación, el trabajo en equipo y el fortalecimiento del sentido del trabajo. Las experiencias de sufrimiento se atribuyeron al contacto con la morbilidad y la mortalidad de la población, los conflictos y la inseguridad laboral. Conclusión: las experiencias de placer conviven con las de sufrimiento en el trabajo diario de la enfermería en las urgencias y emergencias, siendo importantes espacios de palabra y escucha para la resignificación de los sentimientos y la protección de la salud mental en el trabajo.

ABSTRACT Objective: to know the experiences of pleasure and suffering of Nursing workers in urgent and emergency services. Methodology: descriptive qualitative research. Nursing workers from an urgency and emergency unit of a philanthropic hospital and from the Mobile Emergency Care Service of a city in southern Brazil were interviewed. The material was submitted to thematic content analysis. Results: the experiences of pleasure were related to identification with work, satisfaction with successful results, recognition, teamwork and strengthening the meaning of work. The experiences of suffering were attributed to the contact with the population's morbidity and mortality, to conflicts and to the precariousness of work. Conclusion: the experiences of pleasure coexist with those of suffering in the daily work of Nursing in urgency and emergency, being important spaces of speech and listening for the resignification of feelings and protection of mental health at work.

Dietary interventions in mice affect oxidative stress and gene expression of the Prlr and Esr1 in the adipose tissue and hypothalamus of dams and their offspring

Maternal diet is key to the progeny’s health since it may impact on the offspring’s adult life. In this study, mice dams received standard (CONT), restrictive (RD), or hypercaloric (HD) diets during mating, pregnancy, and lactation. Male offspring of each group of dams also received these diets: CONT, RD, HD. Aiming to evaluate the oxidative stress in the adipose tissue, reactive oxygen species (ROS) production, catalase (CAT), and superoxide dismutase (SOD) activities were analyzed in dams and offspring. In the adipose tissue and hypothalamus, gene expression of prolactin (Prlr) and estrogen alpha (Esr1) receptors was performed in dams and offspring. Protein expression of Stat5 was evaluated in the adipose tissue of the offspring from RD-fed dams. HD-fed dams increased triglycerides and leptin serum concentrations, and decreased SOD activity in the adipose tissue. In the offspring’s adipose tissue, we observed a maternal diet effect caused by HD, with increased ROS production and SOD and CAT activities. Gene expression of Prlr and Esr1 in the offspring’s adipose tissue was decreased due to maternal RD. Mice from HD-fed dams showed higher Stat5 expression compared to the offspring from CONT and RD dams in the adipose tissue. In the hypothalamus, we found decreased expression of Prlr in RD and HD dams, compared to CONT; and a maternal diet effect on Prlr and Esr1 gene expression in the offspring. In conclusion, we can affirm that maternal nutrition impacts the redox state and influences the gene expression of Prlr and Esr1, which are involved in energy metabolism, both peripherally and centrally in the adult life of the female offspring. (AU)

Routine of the unpredictable: workloads and health of urgent and emergency nursing workers.

OBJECTIVE: To know the perceptions of nursing professionals in urgent and emergency services regarding workloads and the relationship with their health. METHOD: Descriptive qualitative study carried out in two urgent and emergency sectors in southern Brazil. 16 nursing professionals were interviewed. The data were subjected to thematic content analysis. RESULTS: The first thematic category highlighted the workloads in the daily lives of professionals, highlighting Covid-19 as an element recently incorporated into the perception of biological load. The psychic load is enhanced by stress and suffering in the face of deaths, in addition to adverse working conditions. The second category showed the interface between the loads, the overload and the workers' health, highlighting the importance of the psychic load in mental health. CONCLUSION: Workloads are enhanced by working conditions and the relationship with the profession's work object, generating overload and risk of mental illness.

Dietary interventions in mice affect oxidative stress and gene expression of the Prlr and Esr1 in the adipose tissue and hypothalamus of dams and their offspring.

Maternal diet is key to the progeny's health since it may impact on the offspring's adult life. In this study, mice dams received standard (CONT), restrictive (RD), or hypercaloric (HD) diets during mating, pregnancy, and lactation. Male offspring of each group of dams also received these diets: CONT, RD, HD. Aiming to evaluate the oxidative stress in the adipose tissue, reactive oxygen species (ROS) production, catalase (CAT), and superoxide dismutase (SOD) activities were analyzed in dams and offspring. In the adipose tissue and hypothalamus, gene expression of prolactin (Prlr) and estrogen alpha (Esr1) receptors was performed in dams and offspring. Protein expression of Stat5 was evaluated in the adipose tissue of the offspring from RD-fed dams. HD-fed dams increased triglycerides and leptin serum concentrations, and decreased SOD activity in the adipose tissue. In the offspring's adipose tissue, we observed a maternal diet effect caused by HD, with increased ROS production and SOD and CAT activities. Gene expression of Prlr and Esr1 in the offspring's adipose tissue was decreased due to maternal RD. Mice from HD-fed dams showed higher Stat5 expression compared to the offspring from CONT and RD dams in the adipose tissue. In the hypothalamus, we found decreased expression of Prlr in RD and HD dams, compared to CONT; and a maternal diet effect on Prlr and Esr1 gene expression in the offspring. In conclusion, we can affirm that maternal nutrition impacts the redox state and influences the gene expression of Prlr and Esr1, which are involved in energy metabolism, both peripherally and centrally in the adult life of the female offspring.

Immediate analgesic effect of two modes of short-wave diathermy application in chronic low back pain: study protocol for a randomized controlled trial.

The aim of this study is to evaluate and compare the immediate analgesic effects of two applications of short-wave diathermy (SWD) in individuals with chronic low back pain. Randomized, controlled, double-blind clinical trial. A total of 159 participants with chronic low back pain will be randomized in three groups: pulsed mode SWD, continuous mode SWD and placebo. SWD will be applied only once for 30 min. The primary outcomes: intensity and quality of pain. Secondary outcomes: depression and anxiety; perception of global improvement; patient satisfaction; disability and influence of psychosocial factors, strength of the lower limbs and the mobility of the posterior chain. Patients will be evaluated before and after the session and 1 week after. Trial registration number: RBR-2k58f5h Brazilian Registry of Clinical Trials (ReBEC).

Lay abstract Aim : Low back pain is one of the main health problems in the world. Short-wave diathermy (SWD) is a physiotherapy device that can be used to treat low back pain, but its scientific effectiveness is uncertain. Objective: To evaluate and compare the effects of pain reduction immediately after application of the device (SWD) in two different application methods in individuals with chronic low back pain. Materials & methods: Clinical trial in which 159 individuals will be selected and randomly allocated into three groups: pulsed short-wave diathermy group, n = 53; continuous short-wave diathermy group, n = 53 and placebo group, n = 53. The technique will only be applied once for 30 min. The main result analyzed will be pain. Other results that will also be evaluated are perception of global improvement and treatment satisfaction, functionality (ability to perform daily tasks), leg strength and trunk mobility. It will also be verified the presence of depression, anxiety, psychological and social factors that may influence the response to treatment. Individuals will be evaluated before the first session, immediately after the application of the device and 1 week later. Conclusion: It is expected to verify the decrease in pain soon after the application of the device in the chronic low back pain and find out if there is any difference in this outcome according to the application method.

Common mental disorders and associated factors in nursing workers in COVID-19 units / Trastornos mentales comunes y factores asociados en trabajadores de enfermería en unidades de COVID-19 / Transtornos mentais comuns e fatores associados em trabalhadores de enfermagem de unidades COVID-19

ABSTRACT Objective: To analyze the interfaces between mental illness, based on common mental disorder screening, and sociodemographic, health and life habits aspects of nursing workers at COVID-19 units. Method: A mixed methods study, carried out with 327 nursing workers from COVID-19 units of seven public and philanthropic, medium and large hospitals in Brazil. The collection included a socio-employment, health and lifestyle questionnaire, the Self-Reporting Questionnaire, and interviews. chi-square and Fisher's exact tests were applied to quantitative data and thematic content analysis, with the help of NVivo in the qualitative ones. Results: Common mental disorders were screened in 35.5% of the sample and were associated with female sex (p = 0.004), age up to 40 years (p = 0.003), nurse (p = 0.014), reporting previous illness (p = 0.003), using psychoactive drugs (p < 0.001), medication that was not used before the pandemic (p < 0.001) and reporting poor sleep/eating quality (p < 0.001). The impacts of the pandemic on social and family life presented interfaces with mental illness. Conclusion: The presence of psychological illness is suggested, possibly associated with the repercussions of the pandemic on work and personal life.

RESUMEN Objetivo: Analizar las interfaces entre la enfermedad mental, a partir del tamizaje de los trastornos mentales comunes, y aspectos sociodemográficos, de salud y de hábitos de vida de trabajadores de enfermería en unidades de COVID-19. Método: Estudio de métodos mixtos, realizado con 327 trabajadores de enfermería de unidades COVID-19 de siete hospitales públicos y filantrópicos, medianos y grandes de Brasil. La recogida incluyó un cuestionario sociolaboral, de salud y de estilo de vida, el Self-Reporting Questionnaire y entrevistas. Para los datos cuantitativos y análisis de contenido temático se aplicaron las pruebas Chi-Cuadrado y Exacto de Fisher, con la ayuda del software NVivo en los cualitativos. Resultados: Los trastornos mentales comunes fueron tamizados en el 35,5% de la muestra y se asociaron al sexo femenino (p = 0,004), edad hasta 40 años (p = 0,003), enfermero (p = 0,014), relatar enfermedad previa (p = 0,003), usar psicofármacos (p < 0,001), medicación que no se usaba antes de la pandemia (p < 0,001) y referir mala calidad del sueño/alimentación (p < 0,001). Los impactos de la pandemia en la vida social y familiar presentaron interfaces con la enfermedad mental. Conclusión: Se sugiere la presencia de enfermedad psíquica, posiblemente asociada a las repercusiones de la pandemia en la vida laboral y personal.

RESUMO Objetivo: Analisar as interfaces entre o adoecimento mental, a partir do rastreamento de transtornos mentais comuns, e aspectos sociodemográficos, de saúde e hábitos de vida de trabalhadores de enfermagem de unidades COVID-19. Método: Estudo de métodos mistos, realizado com 327 trabalhadores de enfermagem de unidades COVID-19 de sete hospitais do Brasil, públicos e filantrópicos, de médio e grande porte. A coleta incluiu um questionário sociolaboral, de saúde e hábitos de vida, o Self-Reporting Questionnaire, e entrevistas. Foram aplicados Testes Qui-Quadrado e Exato de Fisher nos dados quantitativos e análise temática de conteúdo, com auxílio do software NVivo nos qualitativos. Resultados: Os transtornos mentais comuns foram rastreados em 35,5% da amostra e se associaram ao sexo feminino (p = 0,004), idade de até 40 anos (p = 0,003), enfermeiro (p = 0,014), relatar doença prévia (p = 0,003), usar psicoativos (p < 0,001), medicamentos que não utilizava antes da pandemia (p < 0,001) e relatar má qualidade do sono/alimentação (p < 0,001). Os impactos da pandemia na vida social e familiar apresentaram interfaces com o adoecimento mental. Conclusão Sugere-se a presença de adoecimento psíquico, possivelmente associado às repercussões da pandemia no trabalho e na vida pessoal.

Routine of the unpredictable: workloads and health of urgent and emergency nursing workers / Rutina de lo imprevisible: cargas de trabajo y salud para los trabajadores de enfermeira de emergência / Rotina do imprevisível: cargas de trabalho e saúde de trabalhadores de enfermagem de urgência e emergência

ABSTRACT Objective: To know the perceptions of nursing professionals in urgent and emergency services regarding workloads and the relationship with their health. Method: Descriptive qualitative study carried out in two urgent and emergency sectors in southern Brazil. 16 nursing professionals were interviewed. The data were subjected to thematic content analysis. Results: The first thematic category highlighted the workloads in the daily lives of professionals, highlighting Covid-19 as an element recently incorporated into the perception of biological load. The psychic load is enhanced by stress and suffering in the face of deaths, in addition to adverse working conditions. The second category showed the interface between the loads, the overload and the workers' health, highlighting the importance of the psychic load in mental health. Conclusion: Workloads are enhanced by working conditions and the relationship with the profession's work object, generating overload and risk of mental illness.

RESUMEN Objetivo: Conocer las cargas de trabajo percibidas por los profesionales de enfermería en los servicios de urgencias y emergencias y su relación con su salud. Método: Estudio descriptivo cualitativo realizado en dos sectores de urgencias y emergencias del sur de Brasil. Se entrevistó a 16 profesionales de enfermería. Los datos se sometieron a análisis de contenido temático. Resultados: La primera categoría temática destacó las cargas de trabajo en el día a día de los profesionales, destacando el Covid-19 como un elemento recientemente incorporado a la percepción de carga biológica. La carga psíquica se vio reforzada por el estrés y el sufrimiento ante las muertes, además de las condiciones laborales adversas. La segunda categoría mostró la interfaz entre las cargas, la sobrecarga y la salud de los trabajadores, destacando la importancia de la carga psíquica en la salud mental. Conclusión: Las cargas de trabajo se ven potenciadas por las condiciones laborales y la relación con el objeto de trabajo de la profesión, generando sobrecarga y riesgo de enfermedad mental.

RESUMO Objetivo: Conhecer as percepções dos profissionais de enfermagem de serviços de urgência e emergência quanto às cargas de trabalho e a relação com sua saúde. Método: Estudo qualitativo descritivo realizado em dois setores de urgência e emergência do Sul do Brasil. Foram entrevistados 16 profissionais de enfermagem. Os dados foram submetidos à análise temática de conteúdo. Resultados: A primeira categoria temática evidenciou as cargas de trabalho no cotidiano dos profissionais, destacando Covid-19 como elemento recentemente incorporado à percepção da carga biológica. A carga psíquica é potencializada pelo estresse e sofrimento frente aos óbitos, além das condições laborais adversas. A segunda categoria evidenciou a interface entre as cargas, a sobrecarga e a saúde dos trabalhadores, destacando a importância da carga psíquica na saúde mental. Conclusão: As cargas de trabalho são potencializadas pelas condições laborais e pela relação com o objeto de trabalho da profissão, gerando sobrecarga e risco de adoecimento psíquico.

Necessidades de cuidadores de crianças com transtorno de neurodesenvolvimento: overview / Necessities of caregivers of children with neurodevelopmental disorder: an overview

Objetivo: analisar estratégias de como o sistema de saúde e outras redes de apoio podem prover suporte de saúde de famílias/cuidadores de crianças com transtorno de neurodesenvolvimento (TND). Métodos: trata-se de um overviewde revisões estruturada de acordo com o checklist PRISMA e registrada na plataforma PROSPERO CRD42018102193. Buscas foram realizadas em dez bases da literatura com descritores padronizados MESH. A análise narrativa foi realizada para sistematizar elementos das estratégias, aspectos de implementação e equidade. Resultados: foram triados 3215 títulos e resumos, após retirada de duplicidades e leitura de título e resumo, 127 foram para leitura completa e 11 atenderam aos critérios. Quatro estratégias abordaram as principais necessidades dos cuidadores: 1. Estimular que as estratégias de atenção integral à saúde sejam centradas na família das crianças com TND, 2. Promover melhores condições de vida para as famílias, por meio de apoio emocional, social e financeiro, 3. Incentivar e fortalecer vínculos afetivos entre os cuidadores e os profissionais da saúde, 4. Promover linhas de cuidado para os cuidadores, centradas na autonomia e no autocuidado. Conclusões: as quatro estratégias abordadas procuram atender às necessidades dos cuidadores de crianças com TND para promover um maior suporte às famílias.

Objective: analyze strategies that can provide health support for families/caregivers of children diagnosed with neurodevelopmental disorders (NDD) by the health system and other support networks.Methods: it is an overview of reviews structured according to the PRISMA checklist and registered on the PROSPERO CRD42018102193 platform. Searches were performed on ten literature databases with standardized MESH descriptors. Narrative analysis was carried out to systematize elements of the strategies, aspects of implementation and equity. Results: 3215 titles and abstracts were screened, after duplicates were removed and the title and abstract were read, 127 were selected for complete reading, and 11 met the eligibility criteria. The caregivers' needs were approached in four strategies: 1. Encourage that health care strategies are centered on the family of children with NDD, 2. Promote better living conditions for families, through emotional, social and financial support, 3. Encourage strengthening affective bonds between caregivers and health professionals, 4. Promote lines of care for caregivers, centered on autonomy and self-care. Conclusions: The four strategies addressed seek tomeet the needs of caregivers of children with NDD to promote greater support for families. They are independent but complementary, and the four pillars must be present for quality support.

Recyclable waste pickers: life and work in light of the social determinants of health.

OBJECTIVES: to know how the social determinants of health relate to the context of life and work of recyclable waste pickers. METHODS: a qualitative study, derived from Convergent-Care Research, conducted with waste pickers from two recycling associations in the South of Brazil. We used systematic participant observation, semi-structured interviews, and convergence groups. The analysis followed the steps of Seizure, Synthesis, Theorization, and Transfer. RESULTS: advanced age, precarious self-care, gender inequalities, violence, and family conflicts have shown to be elements linked to the individual, behavioral, and social network determinants. Determinants connected to living and working conditions were related to poor access to education and formal work, as well as to the daily occupational risks in recycling. The lack of labor rights and public policies represented macro-determinants. Final. CONSIDERATIONS: social and economic deficiencies are potentiated in the context of life and work of waste pickers, strongly related to their determinants.

Recyclable waste pickers: life and work in light of the social determinants of health / Segregadores de residuos sólidos: vida y trabajo a la luz de los determinantes sociales de la salud / Catadores de material reciclável: vida e trabalho à luz dos determinantes sociais de saúde

ABSTRACT Objectives: to know how the social determinants of health relate to the context of life and work of recyclable waste pickers. Methods: a qualitative study, derived from Convergent-Care Research, conducted with waste pickers from two recycling associations in the South of Brazil. We used systematic participant observation, semi-structured interviews, and convergence groups. The analysis followed the steps of Seizure, Synthesis, Theorization, and Transfer. Results: advanced age, precarious self-care, gender inequalities, violence, and family conflicts have shown to be elements linked to the individual, behavioral, and social network determinants. Determinants connected to living and working conditions were related to poor access to education and formal work, as well as to the daily occupational risks in recycling. The lack of labor rights and public policies represented macro-determinants. Final Considerations: social and economic deficiencies are potentiated in the context of life and work of waste pickers, strongly related to their determinants.

RESUMEN Objetivos: conocer como los determinantes sociales de la salud se relacionan con el contexto de vida y trabajo de segregadores de residuos sólidos. Métodos: estudio cualitativo, oriundo de una Investigación Convergente-Asistencial, realizado con segregadores de residuos sólidos de dos asociaciones de reciclaje del Sur Brasileño. Utilizadas observación sistemática participante, entrevistas semiestructuradas y equipos de convergencia. Análisis siguió los pasos: Aprehensión, Síntesis, Teorización y Transferencia. Resultados: edad avanzada, autocuidado deficitario, iniquidades de género, violencia y conflictos familiares se evidenciaron como elementos enlazados a determinantes individuales, comportamentales y de redes sociales. Determinantes adscritos a condiciones de vida y trabajo se mostraron relacionados al poco acceso a educación y trabajo formal, bien como al cotidiano de riesgos ocupacionales en reciclaje. Carencia de derechos laborales y de políticas públicas representó macrodeterminantes. Consideraciones Finales: carencias sociales y económicas son potenciadas en el contexto de vida y trabajo de los segregadores de residuos sólidos, relacionándose fuertemente a sus determinantes.

RESUMO Objetivos: conhecer como os determinantes sociais de saúde se relacionam com o contexto de vida e trabalho dos catadores de material reciclável. Métodos: estudo qualitativo, oriundo de uma Pesquisa Convergente-Assistencial, realizado com catadores de duas associações de reciclagem do Sul do Brasil. Foram utilizadas observação sistemática participante, entrevistas semiestruturadas e grupos de convergência. A análise seguiu os passos: Apreensão, Síntese, Teorização e Transferência. Resultados: idade avançada, autocuidado deficitário, iniquidades de gênero, violência e conflitos familiares se evidenciaram como elementos atrelados aos determinantes individuais, comportamentais e de redes sociais. Determinantes adstritos às condições de vida e trabalho se mostraram relacionados ao pouco acesso à educação e trabalho formal, bem como ao cotidiano de riscos ocupacionais na reciclagem. Carência de direitos trabalhistas e de políticas públicas representou macrodeterminantes. Considerações Finais: carências sociais e econômicas são potencializadas no contexto de vida e trabalho dos catadores, relacionando-se fortemente aos seus determinantes.

Acolhimento na Estratégia Saúde da Família: perspectivas das pessoas com deficiência no contexto rural / Acogimiento en la Estrategia de Salud Familiar: perspectivas de las personas con discapacidad en el contexto rural / Welcoming in the Family Health Strategy: perspectives of people with disabilities in the rural context

Objetivo: analisar as percepções das pessoas com deficiência física que residem no contexto rural acerca do acolhimento prestado pelas equipes da Estratégia Saúde da Família. Método: estudo qualitativo, desenvolvido em seis municípios do Rio Grande do Sul, Brasil, cujos participantes foram treze pessoas com deficiência física. A produção das informações ocorreu de janeiro a maio de 2019 por entrevistas semiestruturadas, analisadas pela modalidade temática. Resultados: o acolhimento foi relacionado ao carinho, afeto, relação de confiança, diálogo e proximidade com os profissionais, bem como à resolutividade das demandas ou encaminhamento para outros serviços. Contudo, elencaram dificuldades quanto à disponibilidade de medicações, exames, atendimento médico e agendamento do atendimento. Conclusão: apesar do esforço dos profissionais das equipes em acolher as pessoas com deficiência física residentes no contexto rural e atender suas demandas, revela-se a centralização do cuidado nas questões biológicas e as limitações de acessibilidade e acesso aos serviços de saúde.

Objective: to analyze the perceptions of people with physical disabilities living in the rural context about the welcoming provided by the Family Health Strategy teams. Method: qualitative study, developed in six cities in Rio Grande do Sul, Brazil, whose participants were 13 people with physical disabilities. The production of information took place from January to May 2019 through semi-structured interviews, analyzed by thematic modality. Results: welcoming was related to fondness, affection, relationship of trust, dialogue and closeness with professionals, as well as resolvability of demands or referral to other services. Nevertheless, they listed difficulties regarding the availability of medications, exams, medical care and scheduling of care. Conclusion: despite the efforts of the professionals working in the teams to welcome people with physical disabilities living in the rural context and meet their demands, the centralization of care in biological issues and the limitations of accessibility and access to health services are revealed.

Objetivo: analizar las percepciones de las personas con discapacidad física que viven en el contexto rural sobre la acogida brindada por los equipos de la Estrategia de Salud Familiar. Método: estudio cualitativo, desarrollado en seis ayuntamientos de Rio Grande do Sul, Brasil, cuyos participantes fueron 13 personas con discapacidad física. La producción de la información tuvo lugar de enero a mayo de 2019 mediante entrevistas semiestructuradas, analizadas por modalidad temática. Resultados: el acogimiento se relacionó con el cariño, el afecto, la relación de confianza, el diálogo y la cercanía con los profesionales, así como la resolución de demandas o la referencia a otros servicios. Sin embargo, enumeraron dificultades con respecto a la disponibilidad de medicamentos, exámenes, atención médica y programación de la atención. Conclusión: a pesar del esfuerzo de los profesionales de estos equipos para acoger a las personas con discapacidad física que viven en el contexto rural y atender sus demandas, se revela la centralización de la atención en cuestiones biológicas y las limitaciones de accesibilidad y acceso a los servicios de salud.

Antinociceptive and anti-inflammatory effects of cellular and extracellular extracts from microalga Chlamydomonas pumilioniformis on mice

Microalga species have attracted interest as a source of bioactive compounds with several pharmacological activities. Previous studies reported that microalgae from the genus Chlamydomonas have anti-inflammatory and antioxidant properties. In this study, antinociceptive and anti-inflammatory activities of two extracts from microalga Chlamydomonas pumilioniformis were investigated. Cellular and extracellular extracts were prepared from a 14 day-batch culture in WC medium at the end of exponential growth and their carbohydrate contents were determined. Antinociceptive effects of extracts were evaluated by writhing and formalin-induced nociception tests, while the anti-inflammatory activity was analyzed by formalin-induced paw edema in mice. The analysis of dissolved carbohydrates detected amounts of 90 and 20 µg mL-1 of total carbohydrate in cellular and extracellular extracts, respectively. Cellular extract was mainly composed of glucose, but with significant proportions of arabinose, galactose and mannose and/or xylose and minor ones of fucose, rhamnose, amino sugars and uronic acids. Extracellular extract was composed of a similar proportion of glucose, galactose and mannose/xylose, besides significant ones of arabinose, fucose and galacturonic acid. Intraperitoneal administration of extracts significantly reduced writhing response in mice. In the formalin test, the extracellular extract inhibited both formalin phases, while the cellular extract was only effective in the late phase. Furthermore, extracts reduced the formalin-induced paw edema. In sum, we showed, for the first time, that C. pumilioniformis can be an important source of polysaccharides with anti-inflammatory and antinociceptive effects.