Working Conditions and Health of Prison Officers in Paraná (Brazil).

OBJECTIVES: This cross-sectional study was carried out to identify the associations between working and health conditions among prison officers at a state prison in Paraná, Brazil. MATERIAL AND METHOD: A proportional and stratified random sample of 125 individuals was used. The participants, who were not identified, completed a self-administered questionnaire. RESULTS: The results showed a prevalence of minor psychiatric disorders (MPD) of 30.4% (95%CI: 22.4-39.2). A total of 17.9% of the respondents had persistent stress (95%CI: 12.2-25.2), 66.4 had up to five health-related complaints (95%CI: 58.4-75.2) and 9.6% had scores that indicated higher risk for alcohol abuse and/or dependance (95%CI:4.8-16.0). Multivariate analyses showed that with an MPD outcome, health problems (p<0.01), physical environment (p=0.013) and organizational risks (p<0.01) were significant predictors. Persistent stress was predicted by age (p=0.031), health problems (p<0.01) and organizational risks (p=0.023), while health complaints were associated with health problems (p<0.01) and physical environment (p<0.01). There were no significant predictors for higher risk for alcohol abuse and/or dependance. DISCUSSION: In general, the results demonstrate the precarious nature of the work of prison officers, and reveal the importance of further studies to evaluate whether this is a specific reality of the unit that was investigated, or whether these results are common in other prison environments.

Seroprevalence and factors associated with hepatitis B virus exposure in the incarcerated population from southern Brazil.

Hepatitis B viral infection (HBV) in prisons poses serious public health challenges because it significantly contributes to the increase in both morbidity and mortality indicators worldwide. Research has shown high HBV prevalence among inmates when compared to the general population. In this study, we estimated the prevalence of HBV exposure and its risk factors among 1,132 inmates detained in high security institutions. A cross-sectional, epidemiological study was carried out in 11 male-only prisons in the State of Paraná, Brazil, between May 2015 to December 2016. HBV exposure was explored using a variety of methods, including HBsAg, anti-HBs, and total anti-HBc. Data were analyzed using univariate and multivariate techniques. The overall prevalence of HBV exposure was 11.9% (95% CI: 10.9-12.8), totaling 135 individuals. In the multivariate analyses, risk factors that remained statistically significant were related to the penitentiary location (Francisco Beltrão; OR = 5.59; 95% CI: 3.32-9.42), age (over 30 years; OR = 5.78; 95% CI: 3.58-9.34), undergoing tattooing procedures in prison (OR = 1.64; 95% CI: 1.03-2.60), self-reported sexual activities with a known drug user (OR = 1.67; 95% CI: 1.12-2.48) and having a history of previous history of hepatitis B or C infection (OR = 2.62; 95% CI: 1.48-4.64). The findings indicate that public policies-including vaccination, early diagnosis, harm reduction strategies, and adequate treatment-should be designed and delivered in the same way for both the incarcerated and the general population in order to reduce the prevalence of HBV and its associated consequences.

Cross-sectional study for COVID-19-related mortality predictors in a Brazilian state-wide landscape: the role of demographic factors, symptoms and comorbidities.

OBJECTIVE: The Brazilian state of Paraná has suffered from COVID-19 effects, understanding predictors of increased mortality in health system interventions prevent hospitalisation of patients. We selected the best models to evaluate the association of death with demographic characteristics, symptoms and comorbidities based on three levels of clinical severity for COVID-19: non-hospitalised, hospitalised non-ICU ward and ICU ward. DESIGN: Cross-sectional survey using binomial mixed models. SETTING: COVID-19-positive cases diagnosed by reverse transcription-PCR of municipalities located in Paraná State. PATIENTS: Cases of anonymous datasets of electronic medical records from 1 April 2020 to 31 December 2020. PRIMARY AND SECONDARY OUTCOME MEASURES: The best prediction factors were chosen based on criteria after a stepwise analysis using multicollinearity measure, lower Akaike information criterion and goodness-of-fit χ2 tests from univariate to multivariate contexts. RESULTS: Male sex was associated with increased mortality among non-hospitalised patients (OR 1.76, 95% CI 1.47 to 2.11) and non-ICU patients (OR 1.22, 95% CI 1.05 to 1.43) for symptoms and for comorbidities (OR 1.89, 95% CI 1.59 to 2.25, and OR 1.30, 95% CI 1.11 to 1.52, respectively). Higher mortality occurred in patients older than 35 years in non-hospitalised (for symptoms: OR 4.05, 95% CI 1.55 to 10.54; and for comorbidities: OR 3.00, 95% CI 1.24 to 7.27) and in hospitalised over 40 years (for symptoms: OR 2.72, 95% CI 1.08 to 6.87; and for comorbidities: OR 2.66, 95% CI 1.22 to 5.79). Dyspnoea was associated with increased mortality in non-hospitalised (OR 4.14, 95% CI 3.45 to 4.96), non-ICU (OR 2.41, 95% CI 2.04 to 2.84) and ICU (OR 1.38, 95% CI 1.10 to 1.72) patients. Neurological disorders (OR 2.16, 95% CI 1.35 to 3.46), neoplastic (OR 3.22, 95% CI 1.75 to 5.93) and kidney diseases (OR 2.13, 95% CI 1.36 to 3.35) showed the majority of increased mortality for ICU as well in the three levels of severity jointly with heart disease, diabetes and CPOD. CONCLUSIONS: These findings highlight the importance of the predictor's assessment for the implementation of public healthcare policy in response to the COVID-19 pandemic, mainly to understand how non-pharmaceutical measures could mitigate the virus impact over the population.

Alterações oftalmológicas em pacientes com COVID-19: revisão narrativa de estudos e séries de casos / Ophthalmic changes in patients with COVID-19: narrative review of studies and case series

O objetivo deste trabalho é descrever casos clínicos e séries de casos relacionados a alterações oftalmológicas em pacientes com diagnóstico de COVID-19. Foi realizada uma revisão narrativa/descritiva de casos clínicos e série de casos. A partir das buscas de dados com descritores pré-definidos, foram integrados na revisão, 17 estudos. Dentre os principais temas identificados, destacam-se: alterações conjuntivais, alterações retinianas e oftalmoparesias. O quadro de alterações da conjuntiva foi prevalente em relação aos demais. Essa revisão incluiu não apenas afecções oculares em adultos, mas também, em crianças e adolescentes. O estudo chama atenção para o fato de que as alterações oculares foram descritas como alteração isolada, alteração precipitante e alteração simultânea ao quadro respiratório. Conclui-se que as afecções oculares vão além de alterações conjuntivais, embora sejam essas preponderantes, havendo ainda alterações retinianas, quadro de oftalmoparesia e ainda a incomum síndrome de Miller Fisher. Novos ensaios irão poder avaliar, qual é de fato, a representatividade dos problemas oculares na cadeia epidemiológica da COVID-19. [au]

The objective of this work is to describe clinical cases and case series related to ophthalmological changes in patients diagnosed with COVID-19. A narrative/descriptive review of clinical cases and case series was performed. Based on data searches with pre-defined descriptors, 17 studies were integrated in the review. Among the main themes identified, the following stand out: conjunctival changes, retinal changes and ophthalmoparesis. The picture of changes in the conjunctiva was prevalent in relation to the others. This review included not only eye disorders in adults, but also in children and adolescents. The study draws attention to the fact that the ocular changes were described as isolated alteration, precipitating alteration and simultaneous alteration to the respiratory condition. It is concluded that ocular conditions go beyond conjunctival alterations, although these are predominant, with retinal alterations, ophthalmoparesis and the unusual Miller Fisher syndrome. New trials will be able to assess, in fact, the representativeness of eye problems in the epidemiological chain of COVID-19. [au]

Epidemiological profile of suicide attempts in a municipality in southwest Paraná, from 2017 to 2020.

OBJECTIVE: This study aimed to analyze the epidemiological profile and psychological disorder of the suicide attempt cases in Francisco Beltrão, Paraná. METHODS: This is an epidemiological descriptive/qualitative study of suicide attempts conducted between 2017 and 2020. This study used data from the Brazilian Information system for notifications involving suicide attempts (Sistema de Informação de Agravos de Notificação, SINAN) and 447 notifications were obtained. An analysis of the electronic medical record of these patients was performed in order to investigate the mental disorders, using a questionnaire. RESULTS: Of the 447 notifications, 382 were eligible for the study. Using the 95% confidence interval, there was a higher frequency of females with 71.7% aged between 18 and 35 years representing 48.4%, with 77.2% white race/color, the singles appeared in the majority with 47.6% with a history of previous suicide attempts, using exogenous intoxication as a method in the attempt with 67.5%. Regarding mental health, 66.5% of the patients had some mental disorders, with the highest prevalence of recurrent depressive disorder found in 40.6%. CONCLUSION: It was observed that there is a need for training of health professionals and implementation of programs and preventive measures aimed primarily at females aged between 18 and 35 years with mental disorders, especially with recurrent depressive disorder and with a history of previous suicide attempt.

Epidemiological profile of suicide attempts in a municipality in southwest Paraná, from 2017 to 2020

SUMMARY OBJECTIVE: This study aimed to analyze the epidemiological profile and psychological disorder of the suicide attempt cases in Francisco Beltrão, Paraná. METHODS: This is an epidemiological descriptive/qualitative study of suicide attempts conducted between 2017 and 2020. This study used data from the Brazilian Information system for notifications involving suicide attempts (Sistema de Informação de Agravos de Notificação, SINAN) and 447 notifications were obtained. An analysis of the electronic medical record of these patients was performed in order to investigate the mental disorders, using a questionnaire. RESULTS: Of the 447 notifications, 382 were eligible for the study. Using the 95% confidence interval, there was a higher frequency of females with 71.7% aged between 18 and 35 years representing 48.4%, with 77.2% white race/color, the singles appeared in the majority with 47.6% with a history of previous suicide attempts, using exogenous intoxication as a method in the attempt with 67.5%. Regarding mental health, 66.5% of the patients had some mental disorders, with the highest prevalence of recurrent depressive disorder found in 40.6%. CONCLUSION: It was observed that there is a need for training of health professionals and implementation of programs and preventive measures aimed primarily at females aged between 18 and 35 years with mental disorders, especially with recurrent depressive disorder and with a history of previous suicide attempt.

Condiciones de trabajo y salud de los funcionarios de prisiones en Paraná (Brasil) / Working conditions and health of prison officers in Paraná (Brazil)

Objetivos: Este estudio transversal fue realizado para identificar las asociaciones y las condiciones de trabajo y salud entre losagentes penitenciarios en una prisión estatal de Paraná, Brasil.Material y método: Se utilizó una muestra aleatoria proporcional y estratificada de 125 individuos. Los participantes respondieron, de forma anónima, un cuestionario autoadministrado.Resultados: Los resultados mostraron prevalencia de trastornos psiquiátricos menores (TPM) de 30,4% (intervalo de confianza[IC] del 95%: 22,4-39,2); el 17,9% presentaron estrés persistente (IC del 95%: 12,2-25,2); el 66,4% presentaron hasta cincoquejas relacionadas con la salud (IC del 95%: 58,4-75,2); y el 9,6% tenían un mayor riesgo de abuso y/o dependencia del alcohol (IC del 95%: 4,8-16,0). Los análisis multivariantes mostraron que, con el resultado de los TPM, los problemas de salud (p<0,01), el ambiente físico (p <0,013) y los riesgos organizacionales (p <0,01) fueron factores predictores significativos. El estréspersistente fue un predictor con la edad (p = 0,031), los problemas de salud (p <0,01) y los riesgos organizacionales (p = 0,023);mientras que las quejas de salud se asociaron con problemas de salud (p <0,01) y el entorno físico (p <0,01). No había predictores significativos para riesgos de abuso y/o dependencia del alcohol.Discusión: En general, los resultados demostraron la naturaleza precaria del trabajo del agente penitenciario, revelan la importancia de la realización de nuevos estudios para evaluar si se trata de una realidad específica de la unidad investigada o si estosresultados son comunes en otros entornos penitenciarios. (AU)

Objectives: This cross-sectional study was carried out to identify the associations between working and health conditionsamong prison officers at a state prison in Paraná, Brazil. Material and method: A proportional and stratified random sample of 125 individuals was used. The participants, who werenot identified, completed a self-administered questionnaire.Results: The results showed a prevalence of minor psychiatric disorders (MPD) of 30.4% (95%CI: 22.4-39.2). A total of 17.9%of the respondents had persistent stress (95%CI: 12.2-25.2), 66.4 had up to five health-related complaints (95%CI: 58.4-75.2)and 9.6% had scores that indicated higher risk for alcohol abuse and/or dependance (95%CI:4.8-16.0). Multivariate analyses showed that with an MPD outcome, health problems (p<0.01), physical environment (p=0.013) and organizational risks(p<0.01) were significant predictors. Persistent stress was predicted by age (p=0.031), health problems (p<0.01) and organizational risks (p=0.023), while health complaints were associated with health problems (p<0.01) and physical environment (p<0.01).There were no significant predictors for higher risk for alcohol abuse and/or dependance.Discussion: In general, the results demonstrate the precarious nature of the work of prison officers, and reveal the importanceof further studies to evaluate whether this is a specific reality of the unit that was investigated, or whether these results arecommon in other prison environments. (AU)

Dexamethasone for treating SARS-CoV-2 infection: a systematic review and meta-analysis

ABSTRACT BACKGROUND: Considering the disruptions imposed by lockdowns and social distancing recommendations, coupled with overwhelmed healthcare systems, researchers worldwide have been exploring drug repositioning strategies for treating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVE: To compile results from randomized clinical trials on the effect of dexamethasone, compared with standard treatment for management of SARS-CoV-2. DESIGN AND SETTING: We conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in a Brazilian public university. METHODS: We sought to compile data from 6724 hospitalized patients with confirmed or suspected SARS-CoV-2 infection. RESULTS: Treatment with dexamethasone significantly reduced mortality within 28 days (risk ratio, RR: 0.89; 95% confidence interval, CI: 0.82-0.97). Dexamethasone use was linked with being discharged alive within 28 days (odds ratio, OR: 1.20; 95% CI: 1.07-1.33). CONCLUSIONS: This study suggests that dexamethasone may significantly improve the outcome among hospitalized patients with SARS-CoV-2 infection and associated severe respiratory complications. ­Further studies need to consider both dose-dependent administration and outcomes in early and later stages of the disease. PROSPERO platform: CRD42021229825.

Correction: Seroprevalence and associated factors of HIV and Hepatitis C in Brazilian high-security prisons: A state-wide epidemiological study.

[This corrects the article DOI: 10.1371/journal.pone.0255173.].

Dexamethasone for treating SARS-CoV-2 infection: a systematic review and meta-analysis.

BACKGROUND: Considering the disruptions imposed by lockdowns and social distancing recommendations, coupled with overwhelmed healthcare systems, researchers worldwide have been exploring drug repositioning strategies for treating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVE: To compile results from randomized clinical trials on the effect of dexamethasone, compared with standard treatment for management of SARS-CoV-2. DESIGN AND SETTING: We conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in a Brazilian public university. METHODS: We sought to compile data from 6724 hospitalized patients with confirmed or suspected SARS-CoV-2 infection. RESULTS: Treatment with dexamethasone significantly reduced mortality within 28 days (risk ratio, RR: 0.89; 95% confidence interval, CI: 0.82-0.97). Dexamethasone use was linked with being discharged alive within 28 days (odds ratio, OR: 1.20; 95% CI: 1.07-1.33). CONCLUSIONS: This study suggests that dexamethasone may significantly improve the outcome among hospitalized patients with SARS-CoV-2 infection and associated severe respiratory complications. -Further studies need to consider both dose-dependent administration and outcomes in early and later stages of the disease. PROSPERO PLATFORM: CRD42021229825.

Sleep quality and common mental disorder in the hospital Nursing team.

OBJECTIVE: to determine the prevalence of sleep quality and common mental disorder in Nursing professionals and factors associated with sleep change. METHOD: a cross-sectional, analytical and quantitative study developed with 196 Nursing professionals of a public hospital and a mixed one. Data was collected by means of an instrument of sociodemographic characterization, by the Self-Report Questionnaire 20 and Pittsburgh Sleep Quality Index and were analyzed by descriptive and inferential statistics to identify possible factors associated with sleep changes. RESULTS: sleep changes were identified among the Nursing professionals with a frequency of 76.5% (70.4-82.1). Sleep quality was classified as poor in 41.8% (41.8-55.6) and sleep disorder in 27.6%. (21.4-34.2). The prevalence of common mental disorder was identified in 36.7% (30.1-43.9). The main factor for poor sleep quality was the presence of common mental disorder (Odds Ratio: 5.15; p<0.001). CONCLUSION: sleep changes were prevalent and the characteristics of the work environment and the presence of mental disorder showed relevance in the changes.

Sociodemographic, behavioral, and geriatric characteristics in older adults with and without HIV: A case-control study.

ABSTRACT: Older adults with human immunodeficiency virus (HIV) have higher risks for early manifestations of age-related disabilities. The objective of this study was to compare HIV-positive and HIV-negative adults aged ≥50 years in relation to sociodemographic, behavioral, and geriatric characteristics. A case-control study was conducted with a >90% estimated statistical power. A total of 52 individuals living with HIV were matched by age, sex, and neighborhood of residence with 104 community controls. Age-related disabilities were assessed throughout a comprehensive geriatric assessment. Review of medical records and interviews were used to obtain behavioral and clinical covariates. No statistical differences on clinically significant age-related disabilities were found. However, multivariate regression analyses, controlling for education and income, revealed that behavioral (use of condom [odds ratio {OR}: 7.03; 95% confidence intervals {CI}: 2.80-7.65] and number of medical visits [OR: 1.25; 95%CI: 1.09-1.43]), along with faster gait speed (OR: 17.68; 95%CI: 2.55-122.85) and lower body and muscle mass indexes were independently associated with HIV (OR: .88; 95%CI: .79-.98 and OR: .72; 95%CI: .54-.97, respectively). In summary, results on age-related disabilities between groups could mean that public policies on HIV might be contributing to patients' positive outcomes regardless of the effects of aging, albeit gait speed, body and muscle mass indexes were independently associated with HIV. Screenings for age-related disabilities in specialized HIV services are recommended.

Seroprevalence and associated factors of HIV and Hepatitis C in Brazilian high-security prisons: A state-wide epidemiological study.

The prevalence of hepatitis C virus (HCV) and the acquired immunodeficiency virus (HIV) is much higher in prisons than in community settings. Some explanatory factors for this burden include putative aspects of the prison environment, such as unprotected sexual relations and sexual violence, use of injectable drugs and syringe sharing. Nonetheless, efforts in better understanding the dynamics of both HCV and HIV are scarce in developing countries such as Brazil, which poses a risk not only to the inmates but to the community as well. In this investigation, we sought to determine the seroprevalence and sociodemographic and behavioral risk factors associated with HIV and anti-HCV antibodies among men detained at high-security institutions. This is an epidemiological, proportionally stratified observational study including 1,132 inmates aged 18 to 79 years-old (Mage = 32.58±10.18) from eleven high-security prisons located in the State of Paraná, Brazil. We found that HIV and anti-HCV prevalence were 1.6% (95% CI: 1.0-2.5) and 2.7% (95% CI: 1.0-2.5), respectively. Risk factors associated with HIV included not receiving intimate visits (OR = 8.80, 95% CI: 1.15-66.88), already having another sexually transmitted infection (OR = 3.89, 95% CI: 1.47-10.29), and reporting attendance in HIV preventive campaigns (OR = 4.24, 95% CI: 1.58-11.36). Moreover, anti-HCV seroprevalence was associated with higher age (OR = 4.03, 95% CI: 1.61-10.07), criminal recidivism (OR = 2.58, 95% CI 1.02-6.52), and the use of injectable drugs (OR = 7.32, 95% CI 3.36-15.92). Although prisons might increase the risk for acquiring and transmitting HIV and HCV, the adoption of permanent epidemiological surveillance programs could help reducing the circulation of viruses, involving strategies focusing on screening, treating, and preventing infections to assure proper prisoner health. Moreover, these policies need to take place inside and outside the prison environment to offer continued assistance to former prisoners once they leave the institution.

Associated factors of Acinetobacter baumannii complex in hospitalized patients: A case-control study.

INTRODUCTION: Acinetobacter baumannii complex are microorganisms of critical priority of resistance, being associated with higher costs and negative outcomes for hospitalized patients. Thus, the study aimed to analyse the factors associated with A. baumannii complex infection in various hospital sectors. METHODOLOGY: This is a case-control study that included patients hospitalized from January 2017 to June 2019. Demographic, microbiological and clinical variables were collected from each patient. All cases had positive culture results for A. baumannii complex resistant to more than three classes of antimicrobials. Carbapenem-resistance was examined by the disk diffusion test, while the broth microdilution method was used to determine the susceptibility to colistin. RESULTS: A. baumannii complex infection was mostly present in ICU (74.2%) than in other hospital areas. The bacteria was also linked with the length of hospitalization until the results for the culture (OR = 1.13; 95% CI: 1.06 - 1.21; p < 0.001) and with pneumonia associated with mechanical ventilation (OR = 4.48; 95% CI: 1.55 - 13.00; p = 0.006). Moreover, patients exposed to infection with multidrug-resistant A. baumannii complex had higher risks of death (OR = 3.25; 95% CI: 1.06 - 9.91; p = 0.039). CONCLUSIONS: This study provides evidence that A. baumannii complex infection is associated with the number of days of hospitalization up to culture positivity, pneumonia associated with the use of mechanical ventilation and death. Infections appear to be more critical in ICU when compared to other areas. Taken together, these findings could support hospital infection surveillance programs, as well as prevention measures to reduce mortality rates and other complications.

Cytotoxicity and mutagenicity of the waters of the Marrecas River (Paraná, Brazil) to bullfrogs (Lithobates catesbeianus).

Animals have a long history of assessing ecosystem responses to environmental disturbances, and amphibians stand out for presenting themselves as good animal model and bioindicators of environmental quality. The main purpose of the present work was to investigate the cellular effects of contamination of waters of the Marrecas River, located in the southwest of the state of Paraná, Brazil. Therefore, the objective of the present study was to investigate and monitor the cytotoxic and mutagenic effect, with bullfrog tadpoles, and to discuss these effects with land use along this hydrographic basin. Mutagenic effects were determined by micronucleus assay, and cytotoxicity by other nuclear changes, such as segmented cells, binucleated cells, cells with buds and reniform cells. Water samples were obtained at nine sites along the Marrecas River, covering areas with rural and urban hydrological contribution. For each site, four samples were collected, along the years 2017 and 2018, encompassing the four seasons (summer, autumn, winter, and spring). The results showed mutagenic and cytotoxic effect in four sampling sites, and only cytotoxic effect in other four sites. These effects may be due, possibly, to the use of different agrochemicals across the hydrographic basin region, which have predominant hydrological contributions from crops. Data of this study indicate the presence of cytotoxic and mutagenic contaminants in the waters of the Marrecas River, which can generate environmental problems on the river fauna/flora, and can also affect the local population health.

Burnout Syndrome in Brazilian Medical Doctors: A Cross-Sectional Examination of Risk and Protective Factors.

Objectives: This investigation sought to identify the prevalence of Burnout Syndrome (BS) among Brazilian medical doctors (BS) and the associations with risk factors and protective factors. Methods: Out of 206 registered MD from a medium-sized municipality, 121 were enrolled in this cross-sectional study. Convenience sampling was used. Based on Cohen's f 2, a power of 98% and a 0.05 alpha was achieved. MD responded to sociodemographic questions and to the Portuguese-version of the Maslach Burnout Inventory-Human Services Survey (MBI). Risk and protective factors linked with BS were examined with regression analyses. Results: The age of the participants ranged from 25 to 69 years (M = 40.89; SD = 10.13) and 73.6% were male. The prevalence of BS was 7.5%. Differential aspects were related to BS. For instance, while not reporting satisfaction with the institution (ß = 16.16, p < 0.001) and not practicing physical exercise (ß = 7.39, p = 0.014) were associated with higher scores in the BS composite score, those who did not intend to change their careers (ß = -17.15, p < 0.001) and participants who saw mental health specialists (ß = -8.99, p = 0.007) scored lower, accounting for nearly a half of the BS composite score (R 2 = 46%). Conclusion: The prevalence of BS in this study falls within the range previously reported among healthcare professionals (i.e., 2.6-11.8%). Moreover, data suggested that commitment with the occupation and with the participant's own mental health could boost reactions against the deleterious effects of the BS. In this sense, organizations can develop strategies for preventing BS, a process that is known to be chronic and, to some extent, preventable.

COVID-19: The question of genetic diversity and therapeutic intervention approaches.

Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China's Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients' overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.

Sleep quality and common mental disorder in the hospital Nursing team / Qualidade do sono e transtorno mental comum em equipe de enfermagem hospitalar / Calidad del sueño y trastorno mental común en un equipo de enfermería de un hospital

Objective: to determine the prevalence of sleep quality and common mental disorder in Nursing professionals and factors associated with sleep change. Method: a cross-sectional, analytical and quantitative study developed with 196 Nursing professionals of a public hospital and a mixed one. Data was collected by means of an instrument of sociodemographic characterization, by the Self-Report Questionnaire 20 and Pittsburgh Sleep Quality Index and were analyzed by descriptive and inferential statistics to identify possible factors associated with sleep changes. Results: sleep changes were identified among the Nursing professionals with a frequency of 76.5% (70.4-82.1). Sleep quality was classified as poor in 41.8% (41.8-55.6) and sleep disorder in 27.6%. (21.4-34.2). The prevalence of common mental disorder was identified in 36.7% (30.1-43.9). The main factor for poor sleep quality was the presence of common mental disorder (Odds Ratio: 5.15; p<0.001). Conclusion: sleep changes were prevalent and the characteristics of the work environment and the presence of mental disorder showed relevance in the changes.

Objetivo: determinar a prevalência da qualidade do sono e do transtorno mental comum em profissionais de enfermagem e os fatores associados à alteração do sono. Método: estudo transversal, analítico e quantitativo desenvolvido com 196 profissionais de enfermagem de um hospital público e um misto. Os dados foram coletados por meio de instrumento de caracterização sociodemográfica, do Self-Report Questionnaire 20 e do Índice de Qualidade de Sono de Pittsburgh e foram analisados por estatística descritiva e inferencial para identificar possíveis fatores associados com a alteração no sono. Resultados: a alteração do sono foi identificada entre os profissionais de enfermagem numa frequência de 76,5% (70,4-82,1). A qualidade do sono foi classificada como ruim em 41,8% (41,8-55,6) e o distúrbio do sono em 27,6% (21,4-34,2). Identificou-se uma prevalência de transtorno mental comum em 36,7% (30,1-43,9). O principal fator para a má qualidade do sono foi a presença de transtorno mental comum (Odds ratio: 5,15 p<0,001). Conclusão: as alterações de sono foram prevalentes e as características do ambiente de trabalho e a presença de transtorno mental comum apresentaram relevância com as alterações.

Objetivo: determinar la prevalencia de la calidad del sueño y del trastorno mental común en los profesionales de enfermería y factores asociados a los trastornos del sueño. Método: se trata de un estudio transversal, analítico y cuantitativo desarrollado con 196 profesionales de enfermería de un hospital público y otro mixto. Los datos se recolectaron mediante un instrumento de caracterización sociodemográfica, utilizando el Self-Report Questionnaire 20 y el Índice de Calidad de Sueño de Pittsburgh y se analizaron utilizando estadísticas descriptivas e inferenciales para identificar posibles factores asociados con trastornos del sueño. Resultados: se identificaron trastornos del sueño entre los profesionales de enfermería con una frecuencia del 76,5% (70,4-82,1). La calidad del sueño se clasificó como mala en el 41,8% (41,8-55,6) y trastorno del sueño en el 27,6% (21,434,2). Se identificó una prevalencia de trastorno mental común en el 36,7% (30,1-43,9). El factor principal de la mala calidad del sueño fue la presencia de trastorno mental común (Odds ratio: 5,15 p<0,001). Conclusión: los trastornos del sueño fueron prevalentes y las características del entorno laboral y la presencia de trastorno mental común fueron relevantes para los trastornos del sueño.

Programa Cuide-se Mais: impacto na prevenção e rastreamento do câncer no Paraná / Take More Care Program: impact on cancer prevention and tracking in Paraná

O aumento da incidência de câncer na população brasileira alerta para a necessidade de implantação de medidas de rastreamento baseadas na busca ativa de novos casos. Neste sentido, o presente trabalho avaliou o impacto de um programa itinerante de rastreamento dos cânceres de mama, colo de útero, próstata e pele realizado pelo Serviço Social da Indústria (Sesi) no período de 1 ano, em 22 municípios do estado do Paraná. O estudo é descritivo, com banco de dados secundários e abordagem quantitativa, referente ao programa Cuide-se Mais do Sesi Paraná. Através de uma unidade móvel, foram realizadas análises da superfície da pele, coleta de Papanicolau em mulheres de 25 a 69 anos, mamografia em mulheres com idade entre 40 e 69 anos e dosagem de Antígeno Prostático Específico (PSA) em homens de 45 a 69 anos de 22 municípios do Paraná. Foram atendidos 4679 trabalhadores paranaenses em 202 empresas, realizadas 4120 palestras de orientações e 1346 oficinas de prevenção. As lesões avaliadas em pele suspeitas para câncer corresponderam a 3,4% do total de 3054 exames. Foram realizadas 873 mamografias, e encaminhados 11 casos de lesões suspeitas no exame de Papanicolau de um total de 2073 coletas. O PSA esteve alterado em 8 homens de um total de 1308 exames. A instalação da unidade móvel dentro da empresa quebra duas barreiras de impedimento dos trabalhadores realizarem seus exames preventivos: a sociocultural e a institucional. Desta forma, programas e ações de rastreamento do câncer podem contribuir para o diagnóstico precoce desta patologia, especialmente na população em idade economicamente produtiva.(AU)

The increased incidence of cancer in the Brazilian population urges the need of implementing screening measures based on the active search for new cases. In this sense, the present work presents the results of the Take More Care disease-screening program. With a mobile unit, analyzes of the skin surface, Pap smear collection in women aged 25 to 69 years, mammography in women aged 40 to 69 years and specific prostatic antigen (SPA) in men aged 45 to 69 were performed in 22 municipalities of Paraná state. 4679 workers from Paraná were attended in 202 companies, 4120 orientation lectures and 1346 prevention workshops were given. Suspected skin lesions for skin cancer corresponded to 3.4% from 3054 skin assessment tests. 873 mammograms were performed, and 11 cases of suspected lesions were referred to the Pap smear, from 2073 collections. The SPA was altered in 8 men, in a total of 1308 tests performed. The installation of the mobile unit inside the company breaks two barriers preventing workers from carrying out their preventive exams: the sociocultural and the institutional. Thus, cancer screening programs and actions can contribute to the early diagnosis of this pathology, especially in the population of economically productive age.(AU)

Characteristics associated with anti-HCV serological markers in prisoners in the state of Paraná, Brazil: a case-control study.

BACKGROUND: The prison system in Paraná, Brazil, is experiencing serious problems related to the increasing number of prisoners. Control of hepatitis C virus (HCV) has become more intense because the incarcerated population is considered a high-risk group for contagious diseases due to the favorable conditions found in prisons for the spread of these morbidities. The objective of this study was to identify features associated with hepatitis C infection among male prisoners in correctional institutions of Paraná state, Brazil. METHODS: This was a case-control study (27 cases and 54 controls) of men incarcerated in 11 penitentiaries in Paraná, Brazil. Information was obtained through a questionnaire in a cross-sectional epidemiological survey on HCV infection during the period from May 2015 to December 2016. Eligible men were recruited after testing positive for anti-HCV antibodies. Cases and controls were selected based on serological results of enzyme-linked immunosorbent assays and were matched by age, location of the penitentiary, and time in prison. Logistic regression analysis was used to identify risk factors for HCV seropositivity. RESULTS: The main significant independent risk factor for the acquisition of HCV infection was the use of injectable drugs (OR = 4.00; 95%CI:1.41-11.35; p < 0.001). CONCLUSIONS: This study provides evidence that HCV infection is associated with drug use by this population. This information is pivotal for tailoring prevention programs and guiding specific socioeducational measures that aim to reduce or prevent HCV transmission within the prison setting.