Prenatal care for pregnant women diagnosed with syphilis according to primary health care nurses / Assistência pré-natal às gestantes com diagnóstico de sífilis segundo os enfermeiros da atenção primária à saúde

Objective: to analyze how prenatal care to pregnant women diagnosed with syphilis is provided by nurses working in primary health care, in a health region of the interior of the State of São Paulo. Method: non-experimental, cross-sectional, descriptive correlational research with a quantitative approach. Results: it was possible to observe that 29.6% of nurses reported not performing subsequent prenatal consultations, and also an important association where most nurses who performed the subsequent consultations based their care on municipal protocol (P=0.000). Among the results, 30.4% of nurses did not prescribe benzylpenicillin benzathine for pregnant women who were reagent to syphilis, and 22.7% did not administer it without the presence of a physician in the unit. Another result that deserves attention is the prescription of a single treatment protocol for pregnant women regardless of the stage of syphilis. Conclusion: There are gaps between the protocols for the care of pregnant women diagnosed with syphilis and the care provided by nurses in primary health care. It is expected that the actions evidenced in this study will promote improvements in the practice of nurses and that they will contribute to reaching the goal recommended by the World Health Organization for congenital syphilis in Brazil.

Objetivo: analisar como ocorre a assistência pré-natal às gestantes com diagnóstico de sífilis pelos enfermeiros que atuam na atenção primária à saúde, em uma regional de saúde do interior do Estado de São Paulo. Método: pesquisa de delineamento não experimental, transversal, do tipo correlacional descritiva e de abordagem quantitativa. Resultados: foi possível observar que 29,6% dos enfermeiros referiram não realizar consultas subsequentes de pré-natal, e ainda uma associação importante onde a maioria dos enfermeiros que realizaram as consultas subsequentes baseava sua assistência em protocolo municipal (P=0,000). Destaca-se entre os resultados que 30,4% dos enfermeiros não cumpriram a prescrição de benzilpenicilina benzatina para as gestantes reagentes à sífilis e 22,7% não administraram a mesma sem a presença do médico na unidade. Outro resultado que merece atenção, é a prescrição de protocolo único de tratamento para gestantes independentemente do estágio da sífilis. Conclusão: Há lacunas entre os protocolos para a assistência às gestantes com diagnóstico de sífilis e a assistência prestada pelos enfermeiros da atenção primária à saúde. Espera-se que as ações evidenciadas neste estudo promovam melhorias para a prática dos enfermeiros e que contribua para atingir no Brasil a meta preconizada pela Organização Mundial de Saúde para a sífilis congênita.

Sleep quality and perception of quality of life of undergraduate nursing students / Calidad del sueño y la percepcion de la calidad de vida de estudiantes de graduaci´ón en enfermería / Qualidade do sono e percepção da qualidade de vida de estudantes de graduação em enfermagem

During graduation, students face several situations that, although promoting personal growth, can compromise well-being, sleep, health and quality of life. This study aimed to analyze the relationship between individual characteristics, sleep quality and the perception of quality of life of undergraduate nursing students. This is a cross-sectional study with a quantitative, analytical and comparative approach, carried out with 187 nursing students at a private institution in the city of Poços de Caldas, Minas Gerais, Brazil. The data collection instruments were an individual characterization questionnaire, the Pittsburgh Sleep Quality Index and the WHOQOL-Bref instrument for quality of life analysis. There was a predominance of women, adults, young, without children, who worked, and who did not practice physical activity. Work, cost of study and female gender were associated with shorter sleep duration and worse quality of life. The worst perception in the physical domain of quality of life was related to the worst quality of sleep. Bad sleep quality was obtained for all years of the course, sleep duration of less than 7 hours a day and complaints of daytime sleepiness. Therefore, sleep alterations with impairments in quality of life were observed. Educational strategies are suggested for sleep hygiene and stimulation of health-promoting behaviors to improve general health, academic health and quality of life in this population.

Durante la graduación, los estudiantes enfrentan varias situaciones que, sin embargo promueven el crecimiento personal, pueden comprometer el bienestar, el sueño, la salud y la calidad de vida. Este estudio tuvo como objetivo analizar la relación entre las características individuales, la calidad del sueño y la percepción de la calidad de vida de los estudiantes de graduación en enfermería. Se trata de un estudio transversal con enfoque cuantitativo, analítico y comparativo, realizado con 187 estudiantes de enfermería de una institución privada de la ciudad de Poços de Caldas, Minas Gerais, Brasil. Los instrumentos de recolección de datos fueron un cuestionario de caracterización individual, el Índice de Calidad del Sueño de Pittsburgh y el instrumento de calidad de vida WHOQOL-Bref. Hubo predominio de mujeres, adultas, jóvenes, sin hijos, que trabajaban y que no practicaban actividad física. El trabajo, el costo de los estudios y el género femenino se asociaron con menor duración del sueño y peor calidad de vida. La peor percepción en el dominio físico de la calidad de vida se relacionó con la peor calidad del sueño. Se obtuvo mala calidad del sueño para todos los años del curso, duración del sueño inferior a 7 horas diarias y quejas de somnolencia diurna. Por lo tanto, se observaron alteraciones del sueño con deterioro de la calidad de vida. Se sugieren estrategias educativas para la higiene del sueño y la estimulación de conductas promotoras de salud para mejorar la salud académica y general, y la calidad de vida de esta población.

Durante a graduação, os estudantes enfrentam diversas situações que, embora, promovam o crescimento pessoal, podem comprometer o bem-estar, o sono, a saúde e a qualidade de vida. Este estudo objetivou analisar a relação entre as características individuais, a qualidade do sono e a percepção da qualidade de vida de estudantes de graduação em enfermagem. Trata-se de um estudo transversal de abordagem quantitativa, analítica e comparativa, desenvolvido com 187 graduandos de enfermagem numa instituição particular, na cidade de Poços de Caldas, Minas Gerais, Brasil. Os instrumentos de coleta de dados foram um questionário de caracterização individual, o Índice de Qualidade do Sono de Pittsburgh e o instrumento para análise de qualidade de vida WHOQOL-Bref. Houve predomínio de mulheres, adultas, jovens, sem filhos, que trabalhavam, e que não praticavam atividade física. Trabalho, custeio dos estudos e gênero feminino associaram-se à menor duração do sono e pior qualidade de vida. A pior percepção no domínio físico da qualidade de vida esteve relacionada à pior qualidade do sono. Obteve-se qualidade de sono ruim para todos os anos do curso, duração do sono inferior a 7h por dia e queixas de sonolência diurna. Constatou-se, portanto, alterações do sono com prejuízos na qualidade de vida. Sugere-se estratégias educativas para a higiene do sono e estímulo de comportamentos promotores de saúde para melhorias na saúde geral, acadêmica e de qualidade de vida nesta população.

Professores de ensino médio, características do sono e sinais de burnout: revisão integrativa / High school teachers, sleep characteristics and burnout signs: integrative review / Profesores de secundaria, características del sueño y signos del burnout: revisión integradora

Objetivo: identificar estudos que avaliaram alterações do sono e Burnout em professores de ensino médio. Método: revisão integrativa, com busca de artigos em português, inglês e espanhol, publicados nas bases de dados National Library of Medicine (PubMed), Biblioteca Virtual em Saúde (BVS), Scopus, Web of Science e EBSCOHOST, utilizando os descritores Sleep, Burnout Psychological e School Teachers, e seus sinônimos. A busca e seleção de evidências científicas foi realizada por três revisores, de forma simultânea. Resultados: foram selecionados três artigos que avaliaram sono e Burnout para docentes, realizados no continente europeu (66,7%) e Estados Unidos, publicados a partir de 2018, que utilizaram três instrumentos distintos para avaliação de variáveis relacionadas ao sono e Burnout. Conclusão: Esgotamento, fadiga, carga de trabalho, comprometimento excessivo, podem ser fontes geradoras de alterações de sono e presença de Burnout na profissão docente, justificando a implementação de programas que promovam a promoção da saúde dessa classe. (AU).

Objective: identifing studies that evaluated sleep disorders and burnout in high school teachers. Method: integrative review, with search for articles in Portuguese, English and Spanish, published in the National Library of Medicine (PubMed), the Virtual Health Library (VHL), Scopus, Web of Science and EBSCOHOST databases, using the descriptors Sleep, Burnout, Psychological and School Teachers, and their synonyms. The search and selection of scientific evidence was carried out by three reviewers, simultaneously. Results: three articles were selected that evaluated sleep and Burnout for teachers, carried out in the European continent (66.7%) and the United States, published from 2018 onwards, which used three different instruments to assess variables related to sleep and Burnout. Conclusion: Exhaustion, fatigue, workload, excessive commitment, can be sources of sleep alterations and the presence of Burnout in the teaching profession, justifying the implementation of programs that promote the health promotion of this class. (AU).

Objetivo: identificar estudios que evaluaron alteraciones del sueño y Burnout en docentes de enseñanza media. Método: revisión integradora, búsqueda de artículos en portugués, inglés y español, publicados en las bases de datos de la Biblioteca Nacional de Medicina (PubMed), Biblioteca Virtual en Salud (BVS), Scopus, Web of Science y EBSCOHOST, utilizando los descriptores Sueño, Burnout Psicológico y Escolar Maestros, y sus sinónimos. La búsqueda y selección de evidencia científica fue realizada por tres revisores, simultáneamente. Resultados: se seleccionaron tres artículos que evaluaron el sueño y el Burnout para docentes, realizados en el continente europeo (66,7%) y Estados Unidos, publicados a partir de 2018, que utilizaron tres instrumentos diferentes para evaluar variables relacionadas con el sueño y el Burnout. Conclusión: El agotamiento, la fatiga, la carga de trabajo, el compromiso excesivo, pueden ser fuentes de alteraciones del sueño y la presencia de Burnout en la profesión docente, justificando la implementación de programas que promuevan la promoción de la salud de esta classe. (AU).

Psychological stress factors and salivary cortisol in nursing students throughout their training.

OBJECTIVE: to analyze psychological stress factors and salivary cortisol concentration in nursing undergraduates throughout their training. METHOD: a cross-sectional, analytical, and comparative study carried out in an evening course using a sociodemographic questionnaire, an Instrument to Assess Stress in Nursing Students, and salivary cortisol analysis. The study included descriptive and comparative analyses and a multiple linear regression model. RESULTS: 187 participants answered the questionnaires, and 129 had their cortisol quantified. The domains Practical Activities Execution, Professional Communication, and Professional Training represented the stress factors with the highest mean values for 3rd, 4th, and 5th-year students compared to 1st and 2nd year. For the 5th year, it was the domains Professional Communication and Professional Training compared to the 3rd year and Environment compared to the 1st and 3rd year. A significant result was obtained between the times of cortisol collections for males (p < 0.0001), females (p < 0.0001), and for 1st (p = 0.0319) 2nd (p = 0.0245), and 5th (p < 0.0001) years. CONCLUSION: Students in years 3 through 5 had higher exposure to stressors, and there were adjustments in cortisol production rhythmicity for students in years 1, 2, and 5.

What Do Physicians Think About the Use of Telemedicine to Recruit and Assess Participants in mHealth-Related Clinical Studies as a Consequence of the COVID-19 Pandemic?

Objectives: To evaluate physician's opinion and availability to participate in mHealth-related clinical studies with patient recruitment and assessment via telemedicine and to identify characteristics associated with the willingness to participate. Methods: Cross-sectional, observational study, based on an anonymous web survey conducted in May-Jun of 2020 to 237 physicians, from Portugal and Spain that collaborated with an asthma mHealth project (INSPIRERS). Results: Response rate was 51% (n = 120). Most (74%, n = 89) physicians were available to participate in such studies, but 62% anticipated lower recruiting capacity and 40% increased difficulty in obtaining quality data. Physicians aged ≤40 years, from secondary care (vs. general practitioners) and that used apps in personal life or clinical practice were more likely to be available. Conclusions: Three-quarters of the physicians were available to participate in mHealth-related clinical studies with patient recruitment and assessment through telemedicine. Age group, medical specialty, and app use were associated with the willingness to participate.

Psychological stress factors and salivary cortisol in nursing students throughout their training / Factores de estrés psicológico y cortisol salivar en alumnos de enfermería a lo largo de la formación / Fatores de estresse psicológico e cortisol salivar em alunos de enfermagem ao longo da formação

ABSTRACT Objective: to analyze psychological stress factors and salivary cortisol concentration in nursing undergraduates throughout their training. Method: a cross-sectional, analytical, and comparative study carried out in an evening course using a sociodemographic questionnaire, an Instrument to Assess Stress in Nursing Students, and salivary cortisol analysis. The study included descriptive and comparative analyses and a multiple linear regression model. Results: 187 participants answered the questionnaires, and 129 had their cortisol quantified. The domains Practical Activities Execution, Professional Communication, and Professional Training represented the stress factors with the highest mean values for 3rd, 4th, and 5th-year students compared to 1st and 2nd year. For the 5th year, it was the domains Professional Communication and Professional Training compared to the 3rd year and Environment compared to the 1st and 3rd year. A significant result was obtained between the times of cortisol collections for males (p < 0.0001), females (p < 0.0001), and for 1st (p = 0.0319) 2nd (p = 0.0245), and 5th (p < 0.0001) years. Conclusion: Students in years 3 through 5 had higher exposure to stressors, and there were adjustments in cortisol production rhythmicity for students in years 1, 2, and 5.

RESUMEN Objetivo: analizar los factores de estrés psicológico y la concentración de cortisol salivar de estudiantes de enfermería a lo largo de su formación. Método: es un estudio transversal, analítico y comparativo realizado en un curso nocturno mediante cuestionario sociodemográfico, Instrumento para Evaluación del Estrés en Estudiantes de Enfermería y análisis del cortisol salivar. Se llevaron a cabo diversos análisis descriptivos, comparativos y modelo de regresión linear múltiple. Resultados: 187 respondieron a los cuestionarios y a 129 se les cuantificó el cortisol. Los dominios Realización de Actividades Prácticas, Comunicación Profesional y Formación Profesional representaron los factores de estrés con los valores medios más altos en los estudiantes de 3er, 4º y 5º año en comparación con los de 1er y 2º año. Para el 5º año fueron los dominios Comunicación Profesional y Formación Profesional en comparación con el 3er año y Medio Ambiente en comparación con el 1er y 3er año. Se obtuvo un resultado significativo entre los momentos de las recogidas de cortisol de los hombres (p < 0,0001), de las mujeres (p < 0,0001), y del 1er (p = 0,0319), 2º (p = 0,0245) y 5º (p < 0,0001) año. Conclusión: los alumnos de 3er a 5º año tuvieron una mayor exposición a los estresores y hubo ajustes en la ritmicidad de la producción de cortisol en los alumnos de 1er, 2º y 5º año.

RESUMO Objetivo: analisar os fatores de estresse psicológico e a concentração de cortisol salivar de graduandos de Enfermagem ao longo da formação. Método: estudo transversal, analítico e comparativo realizado em curso noturno por meio de questionário sociodemográfico, Instrumento para Avaliação de Estresse em Estudantes de Enfermagem e análise do cortisol salivar. Foram feitas análises descritivas, comparativas e modelo de regressão linear múltipla. Resultados: um total de 187 responderam aos questionários, e 129 tiveram o cortisol quantificado. Os domínios Realização das Atividades Práticas, Comunicação Profissional e Formação Profissional representaram os fatores de estresse com os maiores valores médios para alunos do 3º, 4º e 5º anos em comparação ao 1º e 2º anos. Para o 5º ano, foram os domínios Comunicação Profissional e Formação Profissional em relação ao 3º ano e Ambiente em comparação ao 1º e 3º anos. Obteve-se resultado significativo entre os horários das coletas de cortisol para homens (p < 0,0001), mulheres (p < 0,0001) e para o 1º (p = 0,0319) 2º (p = 0,0245) e 5º (p < 0,0001) anos. Conclusão alunos do 3º ao 5º ano tiveram maior exposição aos fatores de estresse, e houve ajustes na ritmicidade de produção do cortisol para alunos do 1º, 2º e 5º anos.

Determinants of the Use of Health and Fitness Mobile Apps by Patients With Asthma: Secondary Analysis of Observational Studies.

BACKGROUND: Health and fitness apps have potential benefits to improve self-management and disease control among patients with asthma. However, inconsistent use rates have been reported across studies, regions, and health systems. A better understanding of the characteristics of users and nonusers is critical to design solutions that are effectively integrated in patients' daily lives, and to ensure that these equitably reach out to different groups of patients, thus improving rather than entrenching health inequities. OBJECTIVE: This study aimed to evaluate the use of general health and fitness apps by patients with asthma and to identify determinants of usage. METHODS: A secondary analysis of the INSPIRERS observational studies was conducted using data from face-to-face visits. Patients with a diagnosis of asthma were included between November 2017 and August 2020. Individual-level data were collected, including age, gender, marital status, educational level, health status, presence of anxiety and depression, postcode, socioeconomic level, digital literacy, use of health services, and use of health and fitness apps. Multivariate logistic regression was used to model the probability of being a health and fitness app user. Statistical analysis was performed in R. RESULTS: A total of 526 patients attended a face-to-face visit in the 49 recruiting centers and 514 had complete data. Most participants were ≤40 years old (66.4%), had at least 10 years of education (57.4%), and were in the 3 higher quintiles of the socioeconomic deprivation index (70.1%). The majority reported an overall good health status (visual analogue scale [VAS] score>70 in 93.1%) and the prevalence of anxiety and depression was 34.3% and 11.9%, respectively. The proportion of participants who reported using health and fitness mobile apps was 41.1% (n=211). Multivariate models revealed that single individuals and those with more than 10 years of education are more likely to use health and fitness mobile apps (adjusted odds ratio [aOR] 2.22, 95%CI 1.05-4.75 and aOR 1.95, 95%CI 1.12-3.45, respectively). Higher digital literacy scores were also associated with higher odds of being a user of health and fitness apps, with participants in the second, third, and fourth quartiles reporting aORs of 6.74 (95%CI 2.90-17.40), 10.30 (95%CI 4.28-27.56), and 11.52 (95%CI 4.78-30.87), respectively. Participants with depression symptoms had lower odds of using health and fitness apps (aOR 0.32, 95%CI 0.12-0.83). CONCLUSIONS: A better understanding of the barriers and enhancers of app use among patients with lower education, lower digital literacy, or depressive symptoms is key to design tailored interventions to ensure a sustained and equitable use of these technologies. Future studies should also assess users' general health-seeking behavior and their interest and concerns specifically about digital tools. These factors may impact both initial engagement and sustained use.

Feasibility and Acceptability of an Asthma App to Monitor Medication Adherence: Mixed Methods Study.

BACKGROUND: Poor medication adherence is a major challenge in asthma, and objective assessment of inhaler adherence is needed. The InspirerMundi app aims to monitor adherence while providing a positive experience through gamification and social support. OBJECTIVE: This study aimed to evaluate the feasibility and acceptability of the InspirerMundi app to monitor medication adherence in adolescents and adults with persistent asthma (treated with daily inhaled medication). METHODS: A 1-month mixed method multicenter observational study was conducted in 26 secondary care centers from Portugal and Spain. During an initial face-to-face visit, physicians reported patients' asthma therapeutic plan in a structured questionnaire. During the visits, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients registered the intake (inhaler, blister, or other drug formulation) by using the image-based medication detection tool. At 1 month, patients were interviewed by phone, and app satisfaction was assessed on a 1 (low) to 5 (high) scale. Patients were also asked to point out the most and least preferred app features and make suggestions for future app improvements. RESULTS: A total of 107 patients (median 27 [P25-P75 14-40] years) were invited, 92.5% (99/107) installed the app, and 73.8% (79/107) completed the 1-month interview. Patients interacted with the app a median of 9 (P25-P75 1-24) days. At least one medication was registered in the app by 78% (77/99) of patients. A total of 53% (52/99) of participants registered all prescribed inhalers, and 34% (34/99) registered the complete asthma therapeutic plan. Median medication adherence was 75% (P25-P75 25%-90%) for inhalers and 82% (P25-P75 50%-94%) for other drug formulations. Patients were globally satisfied with the app, with 75% (59/79) scoring ≥4,; adherence monitoring, symptom monitoring, and gamification features being the most highly scored components; and the medication detection tool among the lowest scored. A total of 53% (42/79) of the patients stated that the app had motivated them to improve adherence to inhaled medication and 77% (61/79) would recommend the app to other patients. Patient feedback was reflected in 4 major themes: medication-related features (67/79, 85%), gamification and social network (33/79, 42%), symptom monitoring and physician communication (21/79, 27%), and other aspects (16/79, 20%). CONCLUSIONS: The InspirerMundi app was feasible and acceptable to monitor medication adherence in patients with asthma. Based on patient feedback and to increase the registering of medications, the therapeutic plan registration and medication detection tool were redesigned. Our results highlight the importance of patient participation to produce a patient-centered and engaging mHealth asthma app.

Profiling Persistent Asthma Phenotypes in Adolescents: A Longitudinal Diagnostic Evaluation from the INSPIRERS Studies.

We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13-17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.

Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies.

Background: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support. Objective: We assessed the medium-term feasibility of the InspirerMundi app to monitor inhaler adherence in real-world patients with persistent asthma (treated with daily inhaled medication). In addition, we attempted to identify the characteristics of the patients related to higher app use. Methods: Two real-world multicenter observational studies, with one initial face-to-face visit and a 4-month telephone interview, were conducted in 29 secondary care centers from Portugal. During an initial face-to-face visit, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients took a photo of the medication (inhaler, blister, or others) using the image-based medication detection tool. Medication adherence was calculated as the number of doses taken as a percentage of the number scheduled. Interacting with the app ≥30 days was used as the cut-off for higher app use. Results: A total of 114 patients {median 20 [percentile 25 to percentile 75 (P25-P75) 16-36] years, 62% adults} were invited, 107 (94%) installed the app and 83 (73%) completed the 4-month interview. Patients interacted with the app for a median of 18 [3-45] days, translated on a median use rate of 15 [3-38]%. Median inhaler adherence assessed through the app was 34 [4-73]% when considering all scheduled inhalations for the study period. Inhaler adherence assessed was not significantly correlated with self-reported estimates. Median adherence for oral and other medication was 41 [6-83]% and 43 [3-73]%, respectively. Patients with higher app use were slightly older (p = 0.012), more frequently taking medication for other health conditions (p = 0.040), and more frequently prescribed long-acting muscarinic antagonists (LAMA, p = 0.024). After 4 months, Control of Allergic Rhinitis and Asthma Test (CARAT) scores improved (p < 0.001), but no differences between patients interacting with the app for 30 days or less were seen. Conclusions: The InspirerMundi app was feasible to monitor inhaler adherence in patients with persistent asthma. The persistent use of this mHealth technology varies widely. A better understanding of characteristics related to higher app use is still needed before effectiveness studies are undertaken.

Integration of mandarin (Citrus reticulata) cytogenetic map with its genome sequence.

Citrus is an extremely important genus in terms of world fruit production. Despite its economic importance and the small genome sizes of its species (2n = 18, 1C = 430 ± 68 Mbp), entire genomic assemblies have only recently become available for some of its representatives. Together with the previous CMA/DAPI banding and fluorescence in situ hybridization (FISH) in the group, these data are important for understanding the complex relationships between its species and for assisting breeding programs. To anchor genomic data with the cytogenetic map of mandarin (Citrus reticulata), the parental species of several economically important hybrids such as sweet orange and clementine, 18 BAC (bacterial artificial chromosome) clones were used. Eleven clementine BACs were positioned by BAC-FISH, doubling the number of chromosome markers so far available for BAC-FISH in citrus. Additionally, six previously mapped BACs were end-sequenced, allowing, together with one BAC previously sequenced, their assignment to scaffolds and the subsequent integration of chromosomes and the genome assembly. This study therefore established correlations between mandarin scaffolds and chromosomes, allowing further structural genomic and comparative study with the sweet orange genome, as well as insights into the chromosomal evolution of the group.

Stress factors of nursing students in their final year.

OBJECTIVE: To identify the stress factors of the university environment and the repercussions on the quality of sleep and life of students in their last year of undergraduate nursing. METHOD: A cross-sectional, comparative, quantitative study conducted with students in their last year of undergraduate nursing in a private institution in the south of Minas Gerais. The Instrument for the Assessment of Stress in Nursing Students (ASNS), the Pittsburgh Sleep Quality Index (PSQI), the WHOQOL-Bref quality of life questionnaire and the sociodemographic characterization questionnaire were applied for data collection; association, comparison and correlation coefficient tests and descriptive statistics were performed for data analysis. RESULTS: The sample consisted of 55 participants. There was a strong correlation between Time Management of stress with sleep and the physical, psychological and environmental domains of quality of life, in addition to the significant association for insomnia and some sociodemographic variables. CONCLUSION: Stress factors were associated with poor quality sleep and changes in quality of life. Time Management was the factor with the greatest potential for stress. The ninth semester had greater exposure to stressors, worse quality of sleep and life.

Profile of nursing students: quality of life, sleep and eating habits.

OBJECTIVE: to profile and analyze sleep quality, quality of life and eating habits of nursing students. METHODS: a cross-sectional, comparative and correlational study with the following variables: sociodemographic characteristics, Pittsburgh sleep quality index, quality of life and eating habits. One hundred ninety-five students participated in the study. RESULTS: participants were on average 24 years old. Results showed that females were prevalent (87.1%); 71.0% of the students had poor sleep quality; 98.9% used electronic devices before bedtime. Self-perception of quality of life was indifferent (38.3%), and self-perception of general health, 36.9% expressed satisfaction. Among the participants, 45.13% consumed one portion of fruit and 40.66% two to three portions of vegetables daily. CONCLUSION: the study allowed the profile of these students, sedentary, overweight and poor sleep quality young students who studied and worked.

Profile of nursing students: quality of life, sleep and eating habits / Perfil de los estudiantes de enfermería: calidad de vida, sueño y hábitos alimentícios / Perfil dos estudantes que cursam enfermagem: qualidade de vida, sono e hábitos alimentares

ABSTRACT Objective: to profile and analyze sleep quality, quality of life and eating habits of nursing students. Methods: a cross-sectional, comparative and correlational study with the following variables: sociodemographic characteristics, Pittsburgh sleep quality index, quality of life and eating habits. One hundred ninety-five students participated in the study. Results: participants were on average 24 years old. Results showed that females were prevalent (87.1%); 71.0% of the students had poor sleep quality; 98.9% used electronic devices before bedtime. Self-perception of quality of life was indifferent (38.3%), and self-perception of general health, 36.9% expressed satisfaction. Among the participants, 45.13% consumed one portion of fruit and 40.66% two to three portions of vegetables daily. Conclusion: the study allowed the profile of these students, sedentary, overweight and poor sleep quality young students who studied and worked.

RESUMEN Objetivo: identificar lo perfil y analizar la calidad del sueño, la calidad de vida y los hábitos alimenticios de los estudiantes de enfermería. Métodos: estudio transversal, comparativo y correlacional con las siguientes variables: características sociodemográficas, índice de calidad del sueño de Pittsburgh, calidad de vida y hábitos alimenticios. 195 estudiantes participaron en el estudio. Resultados: los participantes tenían en promedio 24 años de edad. Los resultados mostraron que las mujeres eran prevalentes (87.1%); El 71.0% de los estudiantes tenían mala calidad del sueño; El 98.9% usó dispositivos electrónicos antes de acostarse. La autopercepción de la calidad de vida fue indiferente (38.3%), y la autopercepción de la salud general, 36.9% expresó satisfacción. Entre los participantes, el 45.13% consumió una porción de fruta y el 40.66% dos o tres porciones de vegetales diariamente. Conclusión: el estudio permitió el perfil de estos estudiantes, estudiantes sedentarios, con sobrepeso y con poca calidad del sueño que estudiaron y trabajaron.

RESUMO Objetivo: traçar o perfil e analisar a qualidade do sono, qualidade de vida e hábitos alimentares dos estudantes de enfermagem. Métodos: estudo transversal, comparativo e correlacional com as seguintes variáveis: características sociodemográficas, índice de qualidade de sono de Pittsburgh, qualidade de vida e hábitos alimentar. 195 estudantes participaram do estudo. Resultados: os participantes tinham em média 24 anos. Os resultados demonstraram que o sexo feminino foi prevalente (87,1%); 71,0% dos estudantes apresentaram qualidade de sono ruim; 98,9% faziam uso de aparelhos eletrônicos antes de dormir. A autopercepção da qualidade de vida foi indiferente (38,3%) e quanto à autopercepção de saúde geral, 36,9% expressaram-se satisfeitos. Dentre os participantes, 45,13% consumiam uma porção de fruta e 40,66% duas a três porções de verduras e legumes, diariamente. Conclusão: o estudo permitiu traçar o perfil desses estudantes, jovens que estudavam e trabalhavam, sedentários, acima do peso e com qualidade de sono ruim.

Stress factors of nursing students in their final year / Los factores de estrés en estudiantes del último año de enfermeira / Fatores de estresse em estudantes do último ano da graduação em enfermagem

Abstract Objective: To identify the stress factors of the university environment and the repercussions on the quality of sleep and life of students in their last year of undergraduate nursing. Method: A cross-sectional, comparative, quantitative study conducted with students in their last year of undergraduate nursing in a private institution in the south of Minas Gerais. The Instrument for the Assessment of Stress in Nursing Students (ASNS), the Pittsburgh Sleep Quality Index (PSQI), the WHOQOL-Bref quality of life questionnaire and the sociodemographic characterization questionnaire were applied for data collection; association, comparison and correlation coefficient tests and descriptive statistics were performed for data analysis. Results: The sample consisted of 55 participants. There was a strong correlation between Time Management of stress with sleep and the physical, psychological and environmental domains of quality of life, in addition to the significant association for insomnia and some sociodemographic variables. Conclusion: Stress factors were associated with poor quality sleep and changes in quality of life. Time Management was the factor with the greatest potential for stress. The ninth semester had greater exposure to stressors, worse quality of sleep and life.

Resumen Objetivo: Identificar los factores de estrés del ambiente universitario y las repercusiones en la calidad del sueño y de vida de los estudiantes del ultimo año de la graduación de Enfermeria. Método: Estudio transversal, comparativo, cuantitativo, realizado con estudiantes del ultimo año de la graduación de Enfermeria de una institución particular al sur de Minas Gerais. Se aplicaron para a recolección de datos la Escala para Evaluación del Estrés en Estudiantes de Enfermeria, el Indice de la Calidad del Sueño de Pittsburgh, el Cuestionario de la calidad de vida WHOQOL-bref y el Cuestionario de la caracterización sociodemografica. Para el análisis de los datos fueron realizados testes de asociación, comparación y de coeficiente de correlación y estadística descriptiva. Resultados: Muestra de 55 participantes. Hube correlación fuerte entre la Gestión del Tiempo del estrés con el sueño y los domínios físico, psicologico y del ambiente de la calidad de vida, mas allá de la asociación significante para el insomnio y algunas variables sociodemograficas. Conclusión: Factores de estrés se asociaran al sueño de mala calidad y la alteración de la calidad de vida. La Gestión del Tiempo fue el factor de mayor potencialidad para el estrés. El nono semestre tuve mayor exposición a factores de estrés, peor calidad del sueño e de vida.

Resumo Objetivo: Identificar os fatores de estresse do ambiente universitário e as repercussões na qualidade de sono e de vida de estudantes do último ano da graduação em Enfermagem. Método: Estudo transversal, comparativo, quantitativo, realizado com estudantes do último ano da graduação em Enfermagem de uma instituição particular no sul de Minas Gerais. Aplicaram-se, para a coleta de dados, a Escala para Avaliação de Estresse em Estudantes de Enfermagem, o Índice de Qualidade do Sono de Pittsburgh, o questionário de qualidade de vida WHOQOL-bref e o questionário de caracterização sociodemográfica. Para a análise dos dados, foram realizados testes de associação, comparação e de coeficiente de correlação e estatística descritiva. Resultados: A amostra foi de 55 participantes. Houve correlação forte entre o Gerenciamento do Tempo do estresse com o sono e os domínios físico, psicológico e de ambiente da qualidade de vida, além da associação significante para insônia e algumas variáveis sociodemográficas. Conclusão: Fatores de estresse associaram-se ao sono de má qualidade e a alterações da qualidade de vida. O Gerenciamento de Tempo foi o fator de maior potencialidade para o estresse. O nono semestre teve maior exposição aos fatores de estresse, pior qualidade de sono e de vida.

Instrumentos para a avaliação de estresse em estudantes de enfermagem / Instruments for the evaluation of stress in nursing students

Objetivo: identificar instrumentos para a avaliação do estresse em alunos de graduação em Enfermagem. Método: trata-se de um estudo bibliográfico, tipo revisão integrativa, com buscas de artigos nos idiomas português, inglês e espanhol, publicados entre 2007 e 2017, nas bases de dados LILACS, MEDLINE, BDENF, CINAHL, WEB OF SCIENCE e Scopus. Apresentaram-se os resultados por meio de figuras e uma tabela. Resultados: analisou-se uma amostra de 25 artigos, que identificou 13 instrumentos distintos, sendo os mais utilizados a Escala de Estresse Percebido (PSS), o Questionário KEZKAK, a Escala de Evento de Vida Estressante (SLES), a Escala de Estressores em Estudantes de Enfermagem (SINS), o Índice de Estresse de Estudante de Enfermagem (SNSI) e o Instrumento para a Avaliação de Estresse de Estudantes de Enfermagem (AEEE). Conclusão: obtiveram-se diversos instrumentos validados, capazes de avaliar várias fontes de estresse em estudantes de Enfermagem durante o período da formação acadêmica, sobretudo, nas atividades de prática clínica, por meio de instrumentos psicométricos específicos, os quais podem auxiliar os gestores das instituições acadêmicas no reconhecimento precoce de problemas de saúde potenciais, tornando o período de formação profissional mais produtivo.(AU)

Objective: to identify instruments for the evaluation of stress in nursing undergraduate students. Method: this is a bibliographical study, type integrative, with searches of articles in Portuguese, English and Spanish, published between 2007 and 2017, in the LILACS, MEDLINE, BDENF, CINAHL, WEB OF SCIENCE and Scopus databases. The results were presented by means of figures and a table. Results: a sample of 25 articles was analyzed, which identified 13 different instruments, the most used being the Perceived Stress Scale (PSS), the KEZKAK Questionnaire, the Stressful Life Event Scale (SLES), the Stressors in Nursing Students Scale (SINS), the Student Nurse Stress Index (SNSI) and the Nursing Student Stress Assessment Instrument (NSSAI). Conclusion: several validated instruments have been obtained, capable of evaluating various sources of stress in nursing students during the period of academic training, especially in clinical practice activities, through specific psychometric instruments, which can assist the managers of the institutions early recognition of potential health problems, making the period of professional training more productive.(AU)

Objetivo: identificar instrumentos para la evaluación del estrés en alumnos de graduación en Enfermería. Método: se trata de un estudio bibliográfico, tipo revisión integrativa con las búsquedas de artículos en portugués, inglés y español, publicados entre 2007 y 2017 en las bases de datos LILACS, MEDLINE, BDENF, CINAHL, Web of Science y Scopus. Se presentaron los resultados por medio de figuras y una tabla. Resultados: se analizó una muestra de 25 artículos, que identificó 13 instrumentos distintos, siendo los más utilizados la Escala de estrés percibido (PSS), el Cuestionario KEZKAK, la Escala de Evento de Vida Estresante (SLES), la Escala de Factores de Estrés en los Estudiantes de Enfermería (SINS), el Índice de Estrés de Estudiante de Enfermería (SNSI) y el Instrumento para la Evaluación de Estrés de Estudiantes de Enfermería (AEEE). Conclusión: se obtuvieron diversos instrumentos validados, capaces de evaluar varias fuentes de estrés en estudiantes de Enfermería durante el período de la formación académica, sobre todo, en las actividades de práctica clínica, por medio de instrumentos psicométricos específicos, los cuales pueden auxiliar a los gestores de las instituciones académicas en reconocimiento precoz de problemas de salud potenciales, haciendo el período de formación profesional más productivo.(AU)

Sono e variáveis de saúde de profissionais de enfermagem nos diferentes turnos de trabalho / Sleep and health variables of nursing professionals in the different working shifts / El sueño y las variables de salud de profesionales de enfermería en diferentes turnos laborales

INTRODUÇÃO: a relação entre sincronizadores e a organização temporal interna pode ser perturbada por mudanças causadas pelo trabalho em turnos, manifestando-se como distúrbios cardiovasculares, metabólicos e do sono. OBJETIVO: analisar o padrão de sono, características antropométricas, glicemia e pressão arterial de 88 profissionais de Enfermagem, trabalhadores de turnos diurnos e noturnos fixos. MÉTODOS: estudo descritivo e transversal realizado em serviços públicos de pronto atendimento de um município do estado de Minas Gerais, no qual se utilizaram questionário sociodemográfico e o diário do sono. As medidas realizadas foram glicemia, pressão arterial, índice de massa corporal e circunferência da cintura. RESULTADOS: a duração e a qualidade de sono noturno dos trabalhadores do turno da noite apresentaram-se com média estatisticamente inferior em relação aos funcionários do turno diurno. No entanto, entre as outras variáveis estudadas e turnos não houve diferença estatística significante. CONCLUSÃO: observaram-se sobrepeso e obesidade em 59,09% dos profissionais e alterações da circunferência de cintura em 70,46% deles. O conhecimento dessa realidade pode contribuir para estudos adicionais, com possíveis programas de acompanhamento periódico da saúde do trabalhador.(AU)

The relationship between synchronizers and the internal temporal organization can be disturbed by changes caused by shift work, manifesting as cardiovascular, metabolic, and sleep disorders. Objective: to analyze the sleep pattern, anthropometric characteristics, blood glucose and blood pressure of 88 Nursing professionals, day and night shift workers. Method: a descriptive and cross-sectional study conducted in public emergency services of a city in the state of Minas Gerais, in which a sociodemographic questionnaire and a sleep diary were used. The measurements taken were blood glucose, blood pressure, body mass index and waist circumference. Results: the duration and the quality of the night sleep of the night-shift workers were statistically lower than those of their day-shift peers. However, there was no statistically significant difference between the other studied variables and the shifts. Overweight and obesity were observed in 59.09% of the professionals and waist circumference changes in 70.46% of them. Conclusion: knowledge of this reality may contribute to further studies, with possible programs for periodic monitoring of the workers' health.(AU)

Introducción: la relación entre los sincronizadores y la organización temporal interna puede verse alterada por los cambios causados por el trabajo en turnos, que se manifiestan como trastornos cardiovasculares, metabólicos y del sueño. Objetivo: analizar el patrón de sueño, las características antropométricas, la glucosa en sangre y la presión arterial de 88 profesionales de enfermería, trabajadores de turno diurno y nocturno. Métodos: estudio descriptivo de corte transversal realizado en los servicios públicos de emergencia de una ciudad del estado de Minas Gerais, que utilizó un cuestionario sociodemográfico y un diario del sueño. Las medidas tomadas fueron glucosa en sangre, presión arterial, índice de masa corporal y circunferencia de cintura. Resultados: la duración y la calidad del sueño nocturno de los trabajadores del turno nocturno fueron estadísticamente más bajas que las de los trabajadores del turno diurno. Sin embargo, entre las otras variables estudiadas y turnos no hubo diferencias estadísticamente significativas. Conclusión: se observó sobrepeso y obesidad en el 59,09% de los profesionales y alteración en la circunferencia de cintura en el 70,46% de ellos. El tener conciencia de esta realidad puede contribuir a futuros estudios, con posibles programas para el monitoreo periódico de la salud de los trabajadores.(AU)

Melanin: Quantification and protection against oxidative stress in chromoblastomycosis agents.

Chromoblastomycosis (CBM) is a chronic cutaneous and subcutaneous infection caused by melanized fungal species. We quantified the extractable melanin of 77 strains of CBM agents distributed within five genera. Moreover, resistance to oxidative stress was evaluated in strains exposed or not to the melanin inhibitor tricyclazole. The median percentage of melanin mass extracted from dry fungal mass varied from 0.69 (Rhinocladiella similis) to 3.81 (Phialophora americana). Inhibition of melanin synthesis decreased survival rates to hydrogen peroxide. Together, these data highlight the importance of melanin in CBM agents.

In Vitro Differentiation of Gata2 and Ly6a Reporter Embryonic Stem Cells Corresponds to In Vivo Waves of Hematopoietic Cell Generation.

In vivo hematopoietic generation occurs in waves of primitive and definitive cell emergence. Differentiation cultures of pluripotent embryonic stem cells (ESCs) offer an accessible source of hematopoietic cells for blood-related research and therapeutic strategies. However, despite many approaches, it remains a goal to robustly generate hematopoietic progenitor and stem cells (HP/SCs) in vitro from ESCs. This is partly due to the inability to efficiently promote, enrich, and/or molecularly direct hematopoietic emergence. Here, we use Gata2Venus (G2V) and Ly6a(SCA1)GFP (LG) reporter ESCs, derived from well-characterized mouse models of HP/SC emergence, to show that during in vitro differentiation they report emergent waves of primitive hematopoietic progenitor cells (HPCs), definitive HPCs, and B-lymphoid cell potential. These results, facilitated by enrichment of single and double reporter cells with HPC properties, demonstrate that in vitro ESC differentiation approximates the waves of hematopoietic cell generation found in vivo, thus raising possibilities for enrichment of rare ESC-derived HP/SCs.