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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. [ABSTRACT FROM AUTHOR]

Objective: To identify the scientific evidence available in the literature on the association between Burnout Syndrome (BS) and C-reactive protein levels. Methods: This is an integrative literature review of articles published in Portuguese, Spanish and English, with no date limit, with different study designs, available electronically in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), National Library of Medicine, National Institutes of Health (PubMed), Scopus, Latin American and Caribbean Center on Health Sciences Information (LILACS), Science Direct, and Springer Link databases. The selected articles were analyzed according to the Agency for Healthcare Research and Quality. Results: Seven articles were analyzed. In most studies, there was a positive association between Burnout and high c-reactive protein levels, despite the general results being contradictory. Most articles that met the selection criteria were in English and indexed in the CINAHL database. The European continent concentrated most of studies. There was a predominance of cross-sectional study design. Conclusion: Despite the positive association between Burnout and high c-reactive protein levels, the results of this review suggest that new, more robust studies be carried out in an attempt to explain the relationship between BS and CRP. [ABSTRACT FROM AUTHOR]

The frequency of asymptomatic infection among relatives and neighbors of cases of visceral leishmaniasis (VL) was compared and characterization of the immunological response in these subjects was performed. Cases were from a new endemic area, close to the beach and near Salvador, capital of the State of Bahia, Brazil. The characterization of asymptomatic infection was made using a skin reaction test and detection of antibody to Leishmania chagasi by the ELISA test. To characterize the immunological response of these subjects with asymptomatic L. chagasi infection the cytokines profile and the lymphoproliferative response were determined after stimulation of lymphocytes by L. chagasi antigen. There was no difference in the frequency of L. chagasi infection in relatives (45%) and in neighbors (27%) of cases of VL (P>0.05). The immunological response from these subjects was characterized by high production of IFN-g and a low production of IL-10 and a good lymphoproliferative response to L. chagasi antigen

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. [ABSTRACT FROM AUTHOR]

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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). [ABSTRACT FROM AUTHOR]

The self-perception of the individual in relation to their health, work, and lifestyle is considered as work ability, a concept of various dimensions, characterizing a multidimensional and versatile construct, because it encompasses physical, mental, and social prerequisites. This study aims to identify the factors associated with work capacity among primary health care professionals. An integrative review was conducted from March to June 2020, following this eligibility criteria: studies in Portuguese, Spanish, and English; from 1996, available on PubMed, SciELO, LILACS, and Cochrane databases; longitudinal studies, clinical trials, and crosssectional studies; among primary health care professionals; which used the Work Ability Index. Three articles were found, two in English and one in Portuguese. It was concluded that further studies should be conducted, with primary health care professionals, in order to propose measures that can reduce inadequate capacity rates and better understand the variables associated with work ability., Competing Interests: Conflicts of interest: None

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., Competing Interests: Confilicts of interest: None

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.

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., Competing Interests: Conflicts of interest: None

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.

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.

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.

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.

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.

Men generally have a lower life expectancy and higher mortality than women in nearly all age groups. Military police, whose main activity in Brazil is the maintenance of public order and the prevention of crimes and transgressions of the laws, is mostly composed of men; it is also a risky and stressful profession generally related to poor quality of life. Considering that risk factors for disease and death from cardiovascular causes--including the multiple risk factor metabolic syndrome-are mostly related to lifestyle and associated with impaired quality of life, this study aims to provide a theoretical basis for other studies about the prevalence of metabolic syndrome among police officers. In a theoretical study, the authors present an interdisciplinary review based on studies on the health and quality of life of men in general and policemen in their specificity; published studies were selected according to the key words: men, health, quality of life, police, metabolic syndrome; they should also have been published in the past 15 years and available in the Scientific Electronic Library Online--SciELO--and in the Public Medline--PubMed. In conclusion, military policemen have a risky profession, whose conditions may contribute to low quality of life, illness, and mortality from cardiovascular causes; these conditions indicate a need for the characterization of metabolic syndrome in this population as an important element for promotion of health. Studying these conditions may contribute to the adoption of comprehensive and continuing care for military policemen's integral health., (© The Author(s) 2014.)

Purpose: The aims of this paper were to quantify the heavy metals (HM) in the air of different sites in Rio de Janeiro (RJ) and Salvador (SA) using Tillandsia usneoides (Bromeliaceae) as a biomonitor, and to study the morphology and elemental composition of the air particulate matter (PM) retained on the Tillandsia surface., Methods: Tillandsia samples were collected in a noncontaminated area and exposed to the air of five sites in RJ State and seven in SA for 45 days, in two seasons. Samples were prepared to HM quantification by flame atomic absorption spectrophotometry, while morphological and elemental characterizations were studied by using scanning electron microscopy., Results: HM concentrations were significantly higher when compared to control sites. We found an increasing metal concentration as follows: Cd < Cr < Pb < Cu < Zn. PM exhibited a morphology varying from amorphous- to polygonal-shaped particles. Size measurements indicated that more than 80% of particles were less than 10 μm. PM contained aluminosilicates iron-rich particles, but Zn, Cu, Cr, and Ba were also detected., Conclusion: HM input in the atmosphere was mainly associated with anthropogenic sources such as vehicle exhaust. Elemental analysis detected HM in the inhalable particles, indicating that those HMs may intensify the toxic effects of PM on human health. Our results indicated T. usneoides as an adequate biomonitor of HM in the PM belonging to the inhalable fraction.

Objective: To evaluate whether the Portuguese version of the Asthma Control Questionnaire (ACQ) is a valid instrument to measure asthma control in adult outpatients in Brazil., Methods: We selected 278 outpatients diagnosed with asthma. All of the patients completed the questionnaire, underwent spirometry and were clinically evaluated by a physician in order to characterize the control of the disease in the first visit. The questionnaire was evaluated in three versions, with 5, 6 and 7 questions, respectively, and scores of 0.75 and 1.50 were used as cut-off points., Results: Of the 278 patients, 77 (27.7%) had intermittent asthma, 39 (14.0%) had mild persistent asthma, 40 (14.4%) had moderate persistent asthma and 122 (43.9%) had severe persistent asthma. The sensitivity of ACQ to identify uncontrolled asthma ranged from 77% to 99%, and the specificity ranged from 36% to 84%. The positive predictive value ranged from 73% to 90%, and the negative predictive value ranged from 67% to 95%. The positive likelihood ratio ranged from 1.55 to 4.81, and the negative likelihood ratio ranged from 0.03 to 0.27. In the 5- and 6-question versions of the ACQ, the intraclass correlation coefficient was 0.92. These two versions were both responsive to clinical changes in the patients., Conclusions: All three versions of the ACQ satisfactorily discriminated between patients with uncontrolled asthma and those with controlled asthma. The 5- and 6-question versions also presented good reliability and responsiveness. Therefore, the ACQ is a valid tool for evaluating asthma control in adult outpatients in Brazil.

Objective: To evaluate the performance of the turbidimetric method of C-reactive protein (CRP) as a measure of low-grade inflammation in patients admitted with non-ST elevation acute coronary syndromes (ACS)., Methods: Serum samples obtained at hospital arrival from 68 patients (66 11 years, 40 men), admitted with unstable angina or non-ST elevation acute myocardial infarction were used to measure CRP by the methods of nephelometry and turbidimetry., Results: The medians of C-reactive protein by the turbidimetric and nephelometric methods were 0.5 mg/dL and 0.47 mg/dL, respectively. A strong linear association existed between the 2 methods, according to the regression coefficient (b=0.75; 95% C.I.=0.70-0.80) and correlation coefficient (r=0.96; P<0.001). The mean difference between the nephelometric and turbidimetric CRP was 0.02 0.91 mg/dL, and 100% agreement between the methods in the detection of high CRP was observed., Conclusion: In patients with non-ST elevation ACS, CRP values obtained by turbidimetry show a strong linear association with the method of nephelometry and perfect agreement in the detection of high CRP.