Association between burnout syndrome and obesity: A cross-sectional population-based study.

BACKGROUND: Burnout Syndrome (BS) is a response of organism against long-lasting exposure to occupational stressors. Those affected usually have comorbidities, as well as cardiovascular and metabolic problems. OBJECTIVE: Estimating the association between BS and obesity in primary health care nurses of in the state of Bahia, Brazil. METHODS: Population-analytical, cross-confirmatory, integrated and multicenter study, conducted with a random sample of primary health care nursing professionals in 43 municipalities from 07 mesoregions of Bahia, Brazil. This study was funded by the Brazilian Board for Scientific and Technological Development. The independent variable (BS) was evaluated by using the Maslach Burnout Inventory (MBI) scale, and the dependent one (obesity) was based on the Body Mass Index (BMI)≥30. Effect modification and confounding factors were verified by crude, stratified, and multivariate analysis. RESULTS: The prevalence of BS and obesity was 17.7% and 12.7%, respectively. BS was statistically associated with obesity, even after adjustment (RPa: 1.85; CI 95% 1.11-3.06) per gender, age, physical activity, healthy eating, satisfaction with occupation, another job, night shift, primary health care (PHC) time, and working conditions. Effect-modifying variables were not identified. CONCLUSIONS: The specialized literature points out a path to the association identified here. New studies on the subject are relevant and should have more robust methodologies so that the path of causality is better clarified. In addition, occupational health programs become an alternative to control stress and, therefore, its complications, such as burnout and other health aggravations.

Mental health of nursing professionals: Internet-based interventions.

This study aimed to analyze published evidence about how the Internet is used in mental health interventions for nurses. This integrative literature review searched MEDLINE (PubMed), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados em Enfermagem (BDENF), and the Web of Science. Data was collected in July 2020. Six articles addressed the research question - "What Internet-based mental health interventions exist for nurses?" -, of which five were randomized clinical trials (2 protocols and 3 completed trials) and 1 was a cohort study. Identified intervention programs consisted of 4 interactive webpages and 2 smartphone apps, based on cognitive behavioral and holistic approaches. The intervention programs were effective in reducing stress, anxiety, and depression among nurses; however, there was a lack of scientific evidence on the subject and a research gap regarding other approaches.

Este estudo objetivou analisar as evidências científicas encontradas na literatura sobre como se configuram as intervenções na saúde mental dos enfermeiros baseadas na utilização da internet. Tratou-se de revisão integrativa da literatura, conduzida nas bases de dados MEDLINE (PubMed), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados em Enfermagem (BDENF) e Web of Science. A coleta de dados foi realizada em julho de 2020. Foram identificados seis artigos, por meio dos quais foi possível responder à pergunta de investigação: "Quais são as intervenções na saúde mental de enfermeiros baseadas na utilização da internet?". Identificaram-se cinco ensaios clínicos randomizados (dois protocolos e três ensaios realizados) e um estudo de coorte. Os programas identificados consistiram em quatro páginas interativas virtuais e dois aplicativos para smartphones, com abordagens cognitivo-comportamentais e holísticas. Os programas de intervenção foram eficazes na redução do estresse, ansiedade e depressão em enfermeiros; contudo, notou-se escassez de evidências científicas sobre a temática, além de uma lacuna atinente a outras vertentes de abordagem.

Distribution and spatial density of viral hepatitis cases in Brazil due to occupational accidents.

Introduction: Viral hepatitis, an infectious disease endemic to Brazil, can be transmitted by occupational accident. Objectives: To analyze the distribution and spatial density of viral hepatitis due to occupational accidents in Brazil from 2007 to 2014. Methods: This ecological study of multiple groups used data from the Brazilian Sistema de Informação de Agravos de Notificação (Disease Information Notification System). Spatial analysis of cluster detection and point density was performed using kernel techniques and estimates. Results: The recorded cases were concentrated in the southeastern (40.6%) and southern regions (28.1%), and a small increase occurred between 2011 and 2014 (53.9%). The etiological classification was predominantly hepatitis C virus (45.3%) and B virus (45.1%). Conclusions: Reports of viral hepatitis due to occupational accidents have increased in Brazil in recent years, with a higher density in the southeastern and southern regions, especially viruses B and C. Thus, occupational health surveillance must be intensified, including vaccination cards for worker admission to the public or private companies.

Prevalence and Factors Associated with Metabolic Syndrome in Patients at a Psychosocial Care Center: A Cross-Sectional Study.

BACKGROUND: Metabolic syndrome (MS) is associated with greater risk of morbimortality and it has high prevalence in people with mental illness. OBJECTIVE: Estimate the prevalence of Metabolic Syndrome (MS) and its associated factors in the patients of a Psychosocial Care Center (CAPS in Brazilian Portuguese) in the city of Salvador, state of Bahia, Brazil. METHOD: Cross-sectional study set at CAPS in the city of Salvador-Bahia between August 2019 and February 2020. MS was evaluated according to the National Cholesterol Education Program's Adult Treatment Panel III. In addition to descriptive statistics, gross and adjusted prevalence ratios were described. RESULTS: MS was found in 100 (35.2%) individuals, 116 (40.9%) were obese and 165 (58.1%) had increased waist circumference. Polypharmacy was identified in 63 (22.3%) patients and 243 (85.9%) used antipsychotics. Under gross evaluation, women (PR = 1.88; 95%CI: 1.35-2.63) and those who used antidepressants (PR = 1.41; 95%CI: 1.05-1.88) showed an association with MS. After logistic regression, depression (PR = 1.86; 95%CI: 1.38-2.51), acanthosis (PR = 1.50; 95%CI: 1.18-1.90), use of antipsychotics (PR = 1.88; 95%CI: 1.13-2.75), and hypertriglyceridemic waist (PR = 3.33; 95%CI: 2.48-4.46) were associated with MS. CONCLUSION: The prevalence of MS signals multimorbidity among individuals with mental disorders and suggests a need for clinical screening.

Association between Metabolic Syndrome and professional category: a cross-sectional study with Nursing professionals. / Associação entre síndrome metabólica e categoria profissional: estudo transversal com profissionais de Enfermagem.

OBJECTIVE: to evaluate the association of Metabolic Syndrome and its components among Primary Health Care Nursing professionals in the state of Bahia, Brazil, according to professional category. METHOD: a cross-sectional, population-based and multicenter study conducted with 1,125 Nursing professionals. The independent variable was the professional category, dichotomized into technical and higher education levels. The outcome was Metabolic Syndrome following criteria from the National Cholesterol Education Program Adult Treatment Panel III based on anthropometric measurements and blood samples. The statistical analysis was performed by calculating the prevalence ratios and using Pearson's Chi-square test. RESULTS: the prevalence of Metabolic Syndrome was higher in the technical level category (PR=1.64; CI=1.29 - 2.06; p≤0.01). When compared to Nurses, these professionals were older, had lower incomes, worked more on duty and performed less physical activity on a regular basis. Among the Nurses, the most prevalent component was altered cholesterol (40.5%) and among the Nursing Technicians/Assistants, it was abdominal obesity (47.3%). CONCLUSION: the association between the Nursing category and Metabolic Syndrome was evident, with higher occurrence among technical level professionals.

Interaction between Work and Metabolic Syndrome: A Population-Based Cross-Sectional Study.

Metabolic syndrome (MS) is a clinical condition and a relevant risk factor in the development of cardiovascular diseases; it occurs as a result of lifestyle factors, e.g., work. The aim of this research was to estimate the interaction between work and MS among primary health care (PHC) nursing professionals in the state of Bahia, Brazil. A sectional multicentered study carried out in 43 municipalities in Bahia, whose study population consisted of nursing professionals. The exposure variables were occupation, professional exhaustion, and working time, and the outcome variable was MS. Interaction measures based on the additivity criteria were verified by calculating the excess risks due to the interactions and according to the proportion of cases attributed to the interactions and the synergy index. The global MS prevalence is 24.4%. There was a greater magnitude in the exposure group regarding the three investigated factors (average level occupation, professional exhaustion, and working time in PHC for more than 5 years), reaching an occurrence of 44.9% when compared to the prevalence of 13.1% in the non-exposure group (academic education, without professional burnout, and working time in PHC for up to 5 years). The study's findings showed a synergistic interaction of work aspects for MS occurrence among PHC nursing professionals.

Anxiety and dyslipidemia among primary health care professionals: A Cross-sectional study.

BACKGROUND: Cross-sectional studies point out important evidence between anxiety and dyslipdemic disorders in health workers. OBJECTIVE: Our main objective was to estimate the association between anxiety and dyslipidemia in Primary Health Care (PHC) nursing professionals in Feira de Santana, Bahia, Brazil. METHODS: A confirmatory cross-sectional study involving 376 PHC nursing professionals. Data collection occurred through the application of a questionnaire containing sociodemographic, labor and lifestyle issues, and the Beck Inventory for anxiety; to evaluate the lipid profile, the HDL-c, LDL-c, and triglycerides markers were evaluated. Descriptive, bivariate analysis and Logistic Regression were performed. RESULTS: The estimated prevalence of moderate/severe anxiety corresponded to 26.1% and dyslipidemia was 54.8%, with a statistically significant association between both of variables stratified by physical activity (PR = 2.69; 95% CI = 1.87-3.85) and (PR = 1.87; 95% CI = 1.53-2.28). CONCLUSIONS: There is a positive association between anxiety and dyslipidemia in Primary Health Care nursing professionals.

Effect of immunonutrition on serum levels of C-reactive protein and lymphocytes in patients with COVID-19: a randomized, controlled, double-blind clinical trial.

INTRODUCTION: Introduction: patients with COVID-19 undergo changes in leukocyte count, respiratory disorders, and an increase in inflammatory substances. To improve the inflammatory condition, some nutrients can be used, including arginine, omega-3 fatty acids and nucleotides. This study aims to evaluate how oral immunonutrient supplements affects serum C-reactive protein (CRP) levels and lymphocyte count in patients with COVID-19. Methods: in this double-blind clinical trial, we randomized 43 adult patients with COVID-19 to receive a standard high-protein normocaloric supplement (control) or an immunonutrient-enriched supplement (experiment) for 7 days. The primary outcome was to evaluate changes in total lymphocyte count and serum level of CRP. The assessment of risk and nutritional status of these patients was also performed. Results: forty-three patients with mean age of 41.5 (± 1.8) years were followed up, 39.5 % of them women. The mean body mass index was 27.6 (± 0.8) kg/m² and 58.1 % had low nutritional risk. In the experiment group, there was a CRP reduction of 23.6 (± 7.5) mg/L, while in the control branch the decrease was 14.8 (± 12.1) mg/L (p = 0.002). There was an increase in lymphocytes in the experiment group (+367.5 ± 401.8 cells/mm³) and a reduction in the control group (-282.8 ± 327.8 cells/mm³), although there was no statistical significance (p = 0.369). Relative risk (RR) of treatment in reducing CRP by 30 % or more was 4.45 (p < 0.001; 95 % CI, 1.79-11.07). RR in increasing lymphocyte count by 30 % or more was 1.28 (p = 0.327; 95 % CI, 0.67-2.45). Conclusion: we conclude that immunonutrient supplements seem to reduce CRP levels more than standard high-protein normocaloric supplements.

INTRODUCCIÓN: Introducción: los pacientes con COVID-19 sufren cambios en el recuento de leucocitos, trastornos respiratorios y aumento de sustancias inflamatorias. Para mejorar la condición inflamatoria se pueden usar algunos nutrientes, como la arginina, los ácidos grasos omega-3 y los nucleótidos. Este estudio tiene como objetivo evaluar cómo los suplementos de inmunonutrientes orales afectan a los niveles séricos de proteína C-reactiva (PCR) y al recuento de linfocitos en pacientes con COVID-19. Métodos: en este ensayo clínico doble ciego, aleatorizamos a 43 pacientes adultos con COVID-19 para recibir un suplemento normocalórico estándar alto en proteínas (control) o un suplemento enriquecido con inmunonutrientes (experimento) durante 7 días. El resultado primario fue evaluar los cambios en el recuento total de linfocitos y el nivel sérico de PCR. También se realizó la evaluación del riesgo y el estado nutricional de estos pacientes. Resultados: cuarenta y tres pacientes con edad media de 41,5 (± 1,8) años fueron seguidos, el 39,5 % de ellos mujeres. El índice de masa corporal medio fue de 27,6 (± 0,8) kg/m² y el 58,1 % tenían bajo riesgo nutricional. En el grupo experimental hubo una reducción de la PCR de 23,6 (± 7,5) mg/L, mientras que en la rama de control la disminución fue de 14,8 (± 12,1) mg/L (p = 0,002). Hubo un aumento de linfocitos en el grupo experimental (+367,5 ± 401,8 células/mm³) y una reducción en el grupo de control (-282,8 ± 327,8 células/mm³), aunque no hubo significación estadística (p = 0,369). El riesgo relativo (RR) del tratamiento para reducir la PCR en un 30 % o más fue de 4,45 (p < 0,001; IC 95 %: 1,79-11,07). El RR en el aumento del recuento de linfocitos en un 30 % o más fue de 1,28 (p = 0,327; IC 95 %: 0,67-2,45). Conclusión: se concluye que los suplementos de inmunonutrientes parecen reducir los niveles de PCR más que los suplementos normocalóricos estándar altos en proteína.

Viral hepatitis caused by occupational accidents: distribution of cases in Brazil, 2007-2014 / Hepatites virais por acidentes de trabalho: distribuição dos casos no Brasil, 2007-2014 / Hepatitis viral por accidentes de trabajo: distribución de casos en Brasil, 2007-2014

Background and Objectives: to analyze the distribution of cases of viral hepatitis due to occupational accidents in Brazil from 2007 to 2014. Methods: this is an ecological study of a descriptive nature of notifications of viral hepatitis registered in the Information System for Notifiable Diseases. Results: they point out that the mean incidence of viral hepatitis due to occupational accidents in Brazil was 2 cases/1,000,000 of the economically active and employed population. There was an increasing trend in the Midwest region (p=0.02), among women (p=0.01) and those aged 38 to 49 years and 50 and older (p=0.01). The decreasing time trend was observed among those up to 37 years old and for non-black race/skin color (p=0.04). Conclusion: the temporal distribution was stationary in most regions and states in Brazil, increasing among female workers over 38 years old and decreasing among non-black women and under 37 years old.(AU)

Justificativa e Objetivos: analisar a distribuição dos casos de hepatites virais por acidentes de trabalho no Brasil de 2007 a 2014. Métodos: trata-se de um estudo ecológico de natureza descritiva das notificações de hepatites virais registradas no Sistema de Informação de Agravos de Notificação. Resultados: apontam que a incidência média de hepatites virais por acidentes de trabalho no Brasil foi de 2 casos/1.000.000 da população economicamente ativa e ocupada. Houve tendência de aumento na região Centro-Oeste (p=0,02), entre as mulheres (p=0,01) e entre 38 a 49 anos e 50 anos ou mais (p=0,01). A tendência temporal decrescente foi observada entre aqueles com até 37 anos e para raça/cor da pele não preta (p=0,04). Conclusão: a distribuição temporal foi estacionária na maioria das regiões e estados do Brasil, aumentando entre as trabalhadoras acima de 38 anos e diminuindo entre as mulheres não negras e com menos de 37 anos.(AU)

Justificación y Objetivos: analizar la distribución de los casos de hepatitis viral por accidentes de trabajo en Brasil de 2007 a 2014. Métodos: se trata de un estudio ecológico de carácter descriptivo de las notificaciones de hepatitis viral registradas en el Sistema de Información de Enfermedades de Declaración Obligatoria. Resultados: señalan que la incidencia media de hepatitis viral por accidente de trabajo en Brasil fue de 2 casos/1.000.000 de población económicamente activa y ocupada. Hubo una tendencia creciente en la región del Medio Oeste (p=0,02), entre las mujeres (p=0,01) y las de 38 a 49 años y 50 y más (p=0,01). La tendencia temporal decreciente se observó entre los de hasta 37 años y para raza/color de piel no negra (p=0,04). Conclusión: la distribución temporal fue estacionaria en la mayoría de las regiones y estados de Brasil, aumentando entre las trabajadoras mayores de 38 años y disminuyendo entre las mujeres no negras y menores de 37 años.(AU)

The Prevalence of Abdominal Adiposity among Primary Health Care Physicians in Bahia, Brazil: An Epidemiological Study.

BACKGROUND: Labor activities are demanding for workers and can induce occupational stress. Primary health care (PHC) workers have faced problems that can lead to the development of stress and abdominal obesity. The aim of this study was to estimate the prevalence of abdominal adiposity among primary health care physicians in the metropolitan mesoregion of Salvador, Bahia. METHODS: This is a cross-sectional study conducted with physicians from the family health units (FHUs) of the metropolitan mesoregion of Salvador, Bahia, Brazil. The number of FHUs corresponded to 41 teams (52 physicians). Anamnesis was performed and a questionnaire was applied. The clinical examination consisted of measuring waist circumference (WC), blood pressure levels (BP), and body mass index (BMI), as well as examining for acanthosis nigricans. Blood samples were collected for biochemical dosages. The data obtained were analyzed by SPSS version 22.0. RESULTS: The sample included 41 physicians (response rate: 78.8%), of which 18 were women (44.0%). The percentage of overweight participants represented by BMI was 31.7%. The hypertriglyceridemia prevalence was 29.2%. HDL-c was low in 48.7% of the participants. The waist circumference measurement revealed a prevalence of abdominal adiposity of 38.8% (women) and 34.8% (men). CONCLUSIONS: Medical professionals in PHC are more susceptible to having higher abdominal adiposity, especially female physicians.

Analysis of the socio-environmental vulnerability of black and Caucasian pregnant women in Salvador, Bahia, Brazil to the occurrence of microcephaly associated with the congenital syndrome of zika virus.

To understand the occurrence of the Congenital Zika Syndrome (CZS), the living conditions of pregnant individuals must be considered in order to identify factors and areas of risk. An intersectional approach provides an understanding of the vulnerabilities to which Black women are subjected. To that end, we present an overview of the spatio-temporal distribution of confirmed cases of microcephaly associated with CZS during the 2015-2016 period in Salvador, Bahia, Brazil based on a survey of Black and Caucasian, pregnant women seen through the intersectional lens of race and class. To consider the confirmed cases of microcephaly and other neurological anomalies associated with CZS, a Living Condition Index (LCI) was utilized to rate the socio-environmental vulnerability of pregnant women. There was less information in the notification records with regard to Black, pregnant women resulting in fewer examinations. Twelve, highrisk areas for Black, pregnant women were identified but only two for Caucasian women. CZS cases referred to Black, pregnant women were found to be concentrated in census sectors with a low (31.6%) and very low (34.5%) LCI, while those referred to Caucasian, pregnant women were concentrated in areas with a high (35.6%) and intermediate (29.4%) LCI. The study concludes that inequities in health expose different population groups to different forms of illnesses, and institutional racism solidifies scenarios of exclusion. In this sense, Black women experiences manifest directly in their health. Confrontation with arboviruses requires the implementation of inter-institutional policies aimed at overcoming discriminatory practices of exposure.

Evidências científicas sobre a associação entre burnout e síndrome metabólica: revisão integrativa / Evidencias científicas sobre la asociación entre el burnout y el síndrome metabólico: revisión integradora / Scientific evidence on the association between burnout and metabolic syndrome: integrative review

Resumo Objetivo Avaliar as evidências científicas disponíveis na literatura sobre a associação entre Síndrome de Burnout e Síndrome Metabólica. Métodos Revisão integrativa da literatura, com buscas nas bases de dados do Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online e Springer Link. Os artigos selecionados foram analisados de acordo com a Agency for Healthcare Research and Quality. Resultados A maioria (80%) dos 5 artigos que atenderam aos critérios de seleção estava na língua inglesa e indexada nas bases de dados Web of Science e Scopus. Dentre os trabalhos, 80% tinham médicos como autores principais. O continente asiático (Israel, Japão e China) concentrou a maior parte de produção. Não ocorreu predominância de desenho de estudo. A área financeira correspondeu a 60% do público pesquisado. Conclusão As evidências disponíveis na literatura são incipientes, apenas 20% dos artigos elegíveis apresentou associação entre as síndromes estudadas e os demais, indicam associação entre Burnout e componentes da SM separadamente.

Resumen Objetivo evaluar las evidencias científicas disponibles en la literatura sobre la asociación entre el síndrome de burnout y el síndrome metabólico. Métodos revisión integradora de la literatura, con búsquedas en las bases de datos del Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online y Springer Link. Los artículos seleccionados fueron analizados de acuerdo con la Agency for Healthcare Research and Quality. Resultados la mayoría (80%) de los cinco artículos que cumplieron los criterios de selección estaba en inglés e indexada en las bases de datos Web of Science y Scopus. Entre los trabajos, 80% tenía médicos como autores principales. El continente asiático (Israel, Japón y China) concentró la mayor parte de la producción. No ocurrió predominio de diseño de estudio. El área financiera correspondió al 60% del público investigado. Conclusión las evidencias disponibles en la literatura son incipientes, solo el 20% de los artículos elegibles presentó asociación entre los síndromes estudiados y los demás indican asociación entre burnout y componentes del SM separadamente.

Abstract Objective To evaluate the scientific evidence available in the literature on the association between Burnout Syndrome and Metabolic Syndrome. Methods Integrative literature review, searching the databases of the Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine, National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online and Springer Link. The selected articles were analyzed according to the Agency for Healthcare Research and Quality. Results Most (80%) of the 5 studies that met the selection criteria were in English language and indexed in the Web of Science and Scopus databases. Among the studies, 80% had physicians as the main authors. The Asian continent (Israel, Japan and China) concentrated the majority of production. There was no predominance of study design. The financial area corresponded to 60% of the study participants. Conclusion The available evidence in the literature is incipient, only 20% of the eligible articles showed association between the syndromes studied and the others, indicate association between Burnout and MS components separately.

Metabolic Syndrome Among Primary Health Care Nursing Professionals: A Cross-Sectional Population-Based Study.

This research aims at evaluating prevalence and factors associated with metabolic syndrome (MS) in primary health care (PHC) nursing professionals. A multicenter, population-based and cross-sectional study was conducted in a team-tested sample of 1125 PHC nurses in the state of Bahia, Brazil. Sociodemographic, labor, lifestyle and human biology variables were investigated by mean of anamnesis. MS was evaluated according to the criteria of the first Brazilian Guideline for Metabolic Syndrome, which fully adopts the criteria of the National Cholesterol Education Program's Adult Treatment Panel III. MS-associated factors were tested by using robust Poisson Regression. The prevalence of MS found was 24.4%; low High Density Lipoprotein (HDL) cholesterol was the most prevalent component of the syndrome. In the multivariate analysis, physical inactivity (PR = 1.25, 95% CI = 1.02-1.53), alcohol use (PR = 1.84, 95% CI = 1.22-2.77), acanthosis nigricans (PR = 3.23, 95% CI = 2.65-3.92), burnout syndrome (PR = 1.45, 95% CI = 1.17-1.81), (PR = 1.37, 95% CI = 1.12-1.69), working as a nursing technician (PR = 1.43, 95% CI = 1.14-1.80), were associated to MS. It was found that the prevalence of MS was high, which evidences the need for interventions in the PHC environment, improvement of working conditions, monitoring of worker safety and health, diet programs and physical activity.

Factors associated with occupational and non-occupational viral hepatitis infections in Brazil between 2007-2014.

INTRODUCTION AND OBJECTIVES: Viral hepatitis is an endemic and epidemic disease of relevance in public health. This study estimated the frequency of viral hepatitis by occupational and non-occupational infections and analyzed the factors associated with case notifications in Brazil from 2007 to 2014. MATERIAL AND METHODS: This was an exploratory epidemiological study using the Notifiable Diseases Information System database. Descriptive and multivariate analyses were performed. RESULTS: The frequency of viral hepatitis by occupational infections was 0.7%, of which 1.3% were due to hepatitis A virus (HAV), 45.1% hepatitis B virus (HBV), and 45.3% hepatitis C virus (HCV). There was a significant association of the disease with female sex [AOR=1.31; P=0.048], schooling [AOR=1.71; P<0.001], occupation [AOR=2.74; P<0.001], previous contact with an HBV or HCV-infected patient [AOR=5.77; P<0.001], exposure to accidents with biological materials [AOR=99.82; P<0.001], and hepatitis B vaccination [AOR=0.73; P=0.033]. CONCLUSION: While there was a low frequency of viral hepatitis by occupational infections in Brazil from 2007 to 2014, these findings might be underreported and have been associated with individual and occupational characteristics. This reinforces the need for the adoption of prevention strategies in the workplace and for completeness of case notifications.

Data quality of the reporting of viral hepatitis caused by work-related accidents, Brazil. / Qualidade dos dados das notificações de hepatites virais por acidentes de trabalho, Brasil.

OBJECTIVE: To assess the completeness and consistency of reports describing viral hepatitis caused by work-related accidents in Brazil between 2007 and 2014. METHODS: This is an analytical, epidemiological study evaluating the quality of data from the Information System for Notifiable Diseases (Sistema de Informação de Agravos de Notificação). Data were analyzed using absolute and relative frequencies, proportional percentage variation, and a linear χ2 test. RESULTS: The majority of mandatory and essential variables were classified with good completeness, despite growth during the study period. The occupation and clinical form variables were classified as normal when they had less than 25.1% incomplete data. Inconsistency was considered high among different variables above 15.0%, including, for example, serologic markers with the types of viral hepatitis and age with occupation and date of birth. CONCLUSIONS: We need to evaluate data quality periodically, in addition to train health professionals on the adequate way to completely fill out reports, because this contributes to the establishment of an efficient surveillance of communicable diseases and improves the population's quality of life.

Notificações da Hepatite B no Estado da Bahia, Brasil / Notification Hepatitis B in the state of Bahia, Brazil

Introdução: a Hepatite B é um problema de saúde pública no Brasil por ser prevenível. Objetivou-se analisar as associações entre as características individuais, sócio demográficas e os comportamentos de risco com os casos de Hepatite B no estado da Bahia. Metodologia: estudo epidemiológico de corte transversal exploratório. Todos os casos de VHB, notificados em 2014 no Sistema de Informação de Agravos de Notificação (SINAN), foram analisados com testes estatísticos para verificar as associações entre as variáveis. Resultados: a prevalência do VHB, em relação às outras hepatites, foi de 32,6%, atingindo pessoas, principalmente, com média de 37+13,92 anos de idade. Apresentou associação estatisticamente significante com a Hepatite B: o sexo masculino, a escolaridade com ensino médio completo, todas as faixas etárias, vacinação incompleta e não vacinados, fonte de infecção sexual e vertical, exposição a múltiplos parceiros e drogas injetáveis. Conclusão: a Hepatite B esteve associada a fatores individuais, sociodemográficos e comportamentos de risco entre a população estudada. Diante dos resultados percebe-se a necessidade de medidas de prevenção para o VHB, orientações acerca da doença e dos principais meios de infecção, diagnóstico precoce oportuno e a vacinação contra hepatite B em vários ambientes comunitários. É preciso capacitação dos profissionais de saúde para notificação adequada e completa, assim como a vigilância desta infecção para facilitar o planejamento de medidas adequadas de controle e prevenção.

Introduction: Hepatitis B is a major public health problem in Brazil because it is preventable. This study aimed to examine the associations between individual characteristics, socio-demographic and the risk behavior with the cases of Hepatitis B in the state of Bahia. Methodology: epidemiological study of exploratory cross-section. All cases of HBV reported in 2014 in the Notifiable Diseases Information System (SINAN) were analyzed with statistical tests to verify the associations between variables. Results: the prevalence of HBV in relation to other hepatitis, was 32.6%, reaching people, mainly with mean 37 + 13.92 years old. Showed a statistically significant association with hepatitis B: male, education with high school education, all age groups, incompletely vaccinated and unvaccinated, sexual and vertical infection source, exposure to multiple partners and injecting drugs. Conclusion: Hepatitis B has been associated with individual factors, sociodemographic and risk behavior among the study population. Based on the results we see the need for prevention measures for HBV, guidelines about the disease and the main means of infection, appropriate early diagnosis and vaccination against hepatitis B in various community settings. It takes training of health professionals for proper and complete notification and the monitoring of this infection to facilitate the planning of appropriate measures for control and prevention

Qualidade dos dados das notificações de hepatites virais por acidentes de trabalho, Brasil / Data quality of the reporting of viral hepatitis caused by work-related accidents, Brazil

RESUMO: Objetivo: Avaliar a completitude e a consistência das notificações de hepatites virais por acidentes de trabalho no Brasil entre 2007 e 2014. Métodos: Trata-se de um estudo epidemiológico analítico de avaliação da qualidade dos dados do Sistema de Informação de Agravos de Notificação. Os dados foram analisados pelas frequências absoluta e relativa, variação percentual proporcional e pelo teste do χ2 linear. Resultados: A maior parte das variáveis obrigatórias e essenciais foi classificada em boa completitude, apesar de crescimento no período em estudo. A ocupação e a forma clínica foram classificadas como regular, com mais de 25,1% dos dados incompletos. A inconsistência foi considerada alta entre diferentes variáveis, superior a 15,0%, como por exemplo os marcadores sorológicos com os tipos de hepatites virais; e a idade com a ocupação e data de nascimento. Conclusões: Conclui-se que se faz necessária a avaliação da qualidade dos dados periodicamente, assim como a capacitação dos profissionais de saúde quanto ao preenchimento adequado e completo das notificações, o que contribui para atuação eficiente da vigilância das doenças transmissíveis e melhoria da qualidade de vida da população.

ABSTRACT: Objective: To assess the completeness and consistency of reports describing viral hepatitis caused by work-related accidents in Brazil between 2007 and 2014. Methods: This is an analytical, epidemiological study evaluating the quality of data from the Information System for Notifiable Diseases (Sistema de Informação de Agravos de Notificação). Data were analyzed using absolute and relative frequencies, proportional percentage variation, and a linear χ2 test. Results: The majority of mandatory and essential variables were classified with good completeness, despite growth during the study period. The occupation and clinical form variables were classified as normal when they had less than 25.1% incomplete data. Inconsistency was considered high among different variables above 15.0%, including, for example, serologic markers with the types of viral hepatitis and age with occupation and date of birth. Conclusions: We need to evaluate data quality periodically, in addition to train health professionals on the adequate way to completely fill out reports, because this contributes to the establishment of an efficient surveillance of communicable diseases and improves the population's quality of life.

Prevalência da Síndrome de Burnout em profissionais de enfermagem da atenção básica à saúde / Prevalencia del Síndrome de Burnout en profesionales de enfermería de atención de la salud básica / Prevalence of Burnout Syndrome in nursing professionals of basic health care

Objective: to estimate the prevalence of Burnout Syndrome among the Primary Health Care nurses in a city of Bahia Southwest. Methods: Cross-sectional study, conducted with 60 nursing professionals of primary care. We used a sociodemographic and occupational questionnaire, and the Maslach Burnout Inventory. Data were tabulated using SPSS, version 22.0, and analyzed using descriptive statistics. Results: The prevalence of burnout syndrome was 58.3% according to the criteria of Grunfeld et al, and 16.7% according to Ramirez et al., they have found high levels in the dimension depersonalization (48.3%) and low job satisfaction (56.6%). The prevalence of burnout syndrome in the study population was high, as was the high rate predisposition to develop this syndrome. Conclusions: The study pointed out the need to implement preventive and interventional measures to ensure a beneficial and promising health work environment.

Objetivo: estimar a prevalência da Síndrome de Burnout entre profissionais de enfermagem da Atenção Básica à Saúde de um município do sudoeste baiano. Método: Estudo de corte transversal, realizado com 60 profissionais de enfermagem da Atenção Básica. Utilizou-se um questionário sociodemográfico e laboral, e o Maslach Burnout Inventory. Os dados foram tabulados no SPSS versão 22.0 e analisados segundo estatística descritiva. Resultados: A prevalência de Síndrome de Burnout foi de 58,3%, de acordo os critérios de Grunfeld et al., e de 16,7% segundo Ramirez et al. Encontraram-se altos níveis na dimensão despersonalização (48,3%) e baixa realização profissional (56,6%). A prevalência da Síndrome de Burnout na população estudada foi alta, assim como foi alto o índice de predisposição para desenvolver esta síndrome. Conclusões: O estudo apontou a necessidade de implementação de medidas preventivas e interventivas para garantir um ambiente de trabalho benéfico e promissor de saúde.

Objetivo: estimar la prevalencia del Síndrome de Burnout entre las enfermeras de Atención Primaria de la Salud en la ciudad de Bahía Suroeste. Métodos: Estudio transversal, realizado con 60 profesionales de atención primaria. Se utilizó un cuestionario sociodemográfico ocupacional y el Maslach Burnout Inventory. Los datos fueron tabulados mediante el programa SPSS, versión 22.0, y analizados mediante estadística descriptiva. Resultados: La prevalencia del Síndrome de Burnout fue del 58,3%, según los criterios de Grunfeld et al., y el 16,7%, de acuerdo a los altos niveles de Ramírez et al. Ellos han encontrado en la despersonalización dimensión (48,3%) y la satisfacción laboral bajo (56,6%). La prevalencia del síndrome en la población de estudio fue alta, al igual que la predisposición tasa alta de desarrollar este síndrome. Conclusiones: El estudio señala la necesidad de implementar medidas de prevención y de intervención para garantizar un ambiente de trabajo de salud beneficioso prometedor.

Association between severe asthma and changes in the stomatognathic system / Associação entre asma grave e alterações do sistema estomatognático

ABSTRACT Objective: To describe orofacial muscle function in patients with severe asthma. Methods: This was a descriptive study comparing patients with severe controlled asthma (SCA) and severe uncontrolled asthma (SUA). We selected 160 patients, who completed a sociodemographic questionnaire and the 6-item Asthma Control Questionnaire (ACQ-6), as well as undergoing evaluation of orofacial muscle function. Results: Of the 160 patients evaluated, 126 (78.8%) and 34 (21.2%) presented with SCA and SUA, respectively, as defined by the Global Initiative for Asthma criteria. Regardless of the level of asthma control, the most frequent changes found after evaluation of muscle function were difficulty in chewing, oronasal breathing pattern, below-average or poor dental arch condition, and difficulty in swallowing. When the sample was stratified by FEV1 (% of predicted), was significantly higher proportions of SUA group patients, compared with SCA group patients, showed habitual open-mouth chewing (24.8% vs. 7.7%; p < 0.02), difficulty in swallowing water (33.7% vs. 17.3%; p < 0.04), and voice problems (81.2% vs. 51.9%; p < 0.01). When the sample was stratified by ACQ-6 score, the proportion of patients showing difficulty in swallowing bread was significantly higher in the SUA group than in the SCA group (66.6% vs. 26.6%; p < 0.01). Conclusions: The prevalence of changes in the stomatognathic system appears to be high among adults with severe asthma, regardless of the level of asthma control. We found that some such changes were significantly more common in patients with SUA than in those with SCA.

RESUMO Objetivo: Descrever os achados da avaliação miofuncional orofacial em pacientes com asma grave. Métodos: Estudo descritivo comparando pacientes com asma grave controlada (AGC) e asma grave não controlada (AGNC). Foram selecionados 160 participantes, que responderam a um questionário sociodemográfico e o Asthma Control Questionnaire com seis questões (ACQ-6) e realizaram avaliação miofuncional orofacial. Resultados: Na amostra estudada, 126 (78,8%) e 34 (21,2%) pacientes, respectivamente, apresentavam AGC e AGNC segundo os critérios da Global Initiative for Asthma. Independentemente do nível de controle da asma grave, as alterações mais frequentes observadas na avaliação miofuncional foram problemas de mastigação, padrão de respiração oronasal, estado de conservação da arcada dentária médio ou ruim e problemas na deglutição. Quando a amostra foi estratificada pelo VEF1 (% do previsto), os resultados foram significativamente maiores no grupo AGNC que no grupo AGC quanto a mastigação habitual com boca aberta (24,8% vs. 7,7%; p < 0,02), deglutição de água com dificuldade (33,7% vs. 17,3%; p < 0,04) e problemas de voz (81,2% vs. 51,9%; p < 0,01). Quando estratificada pelo ACQ-6, os resultados do grupo AGNC foram significativamente maiores que no grupo AGC quanto à deglutição de pão com dificuldade (66,6% vs. 26,6%; p < 0,01). Conclusões: A prevalência de alterações do sistema estomatognático parece ser alta em adultos com asma grave independentemente do nível de controle da doença. No grupo AGNC, algumas dessas alterações foram significativamente mais frequentes que no grupo AGC.

Burnout syndrome and abdominal adiposity among primary health care nursing professionals

Background: Accumulation of abdominal adiposity (AA) constitutes a risk factor for heart and coronary diseases and for metabolic complications. Research suggests that stress is related to adipogenesis. The burnout syndrome (BS) is linked to stress due to the chronicity of work stress. The objective of this study is to estimate the association between BS and AA in Primary Health Care (PHC) nursing practitioners. Methods: This is confirmatory cross-sectional study with 189 workers from nine municipalities in Bahia, Brazil. The dependent variable was AA, measured by waist circumference. The independent variable was the BS, diagnosed by the Maslach Burnout Inventory (MBI). Sociodemographic and job characteristics, lifestyle, and human biology were taken as covariates and were evaluated as modifiers or confounders by the homogeneity tests and by comparison with the adjusted Mantel-Haenszel test, respectively. Logistic regression was employed to evaluate the association between BS and AA, adjusted for covariates. The adequacy of the final regression model was evaluated by the model's goodness of fit test and the area under the ROC curve. Results: BS prevalence was 10.6% and AA 54%. The variables age, education, hypertension, diabetes, working time, and high emotional exhaustion were associated with AA. An association was found between BS and AA (1.63 adjusted prevalence ratios; 95% CI, 1.29 to 2.06) even after age and working time adjustment. Conclusion: The results suggest an association between BS and AA in the analyzed professionals. A significant prevalence of burnout and AA is highlighted. (AU)