Search

Objetivo: Dado que as organizações estão cada vez mais suscetíveis à introdução ou alteração de tecnologias em suas operações, impactando atores e rotinas de diversas naturezas de trabalho, este estudo procurou identificar como uma organização tratou as conexões entre suas rotinas interdependentes ao idealizar uma nova configuração tecnológica. Método: A estratégia de investigação empregada foi o estudo de caso único, com triangulação de dados e análise temática. Principais resultados: Três temas emergiram como resultados desta investigação: i) o papel dos artefatos digitais entre rotinas interdependentes; ii) a ausência de visão holística sobre rotinas interdependentes; e iii) a ausência de identificação profissional com a nova configuração. Enquanto os artefatos digitais foram posicionados como mecanismos de conexão entre as rotinas, os dois últimos temas surgiram como fatores organizacionais de desconexão entre elas. Contribuições acadêmicas: este estudo avança na teoria da interdependência entre rotinas organizacionais, ao apresentar implicações para a caracterização de suas fronteiras. Além disso, embora a literatura aponte a relação entre artefatos e atores a partir de orientações deterministas ou voluntaristas, demonstra-se que os artefatos digitais podem assumir diversas orientações, ao serem concebidos para influenciar ações entre rotinas, levando em consideração aspectos sociomateriais. Contribuições práticas: em intervenções tecnológicas, é importante que gestores e suas equipes interventoras compreendam tanto o estado atual das rotinas impactadas, quanto a percepção dos atores sobre a nova configuração, a fim de identificar possíveis cenários inadequados de execução das rotinas e intercorrências indesejadas.

Abstract Background Cytomegalovirus (CMV) is one of the most important pathogens associated with congenital infection worldwide. Most congenital CMV-infected infants are asymptomatic at birth; however, some can develop delayed sequelae, especially hearing loss. Methods This study aimed to investigate the prevalence of congenital CMV infection in a neonatal intensive care unit in a low-income region of Brazil. The objectives extended to identifying associated factors, assessing the clinical status of infected newborns, and undertaking a two-year follow-up to discern potential long-term consequences in the affected infants. This cross-sectional prospective study enrolled newborns up to three weeks of life requiring intensive medical care. We employed a convenience sampling method to include 498 newborns and 477 mothers in the study. Categorical variables underwent analysis employing Fisher’s exact test, whereas the examination of continuous variables involved the Mann‒Whitney test. Results CMV DNA was detected in saliva/urine samples from 6 newborns (1.21%), confirming congenital infection. We noted a significantly greater incidence (OR: 11.48; 95% CI: 2.519–52.33; p = 0.0094) of congenital infection among twins (7.14%) than among nontwins (0.66%). The twin patients exhibited discordant infection statuses, suggesting that only one of the babies tested positive for CMV. Most of the infected children were born to mothers who initiated sexual activity at a younger age (p = 0.0269). Only three out of the six newborns diagnosed with CMV infection underwent comprehensive clinical assessments and received continuous follow-up until they reached two years of age. Only one of the children had weight and height measurements below the norm for their age, coupled with developmental delays. Conclusions The prevalence of congenital CMV infection among newborns admitted to the NICU was low and similar to that in the general population. However, we found a significantly greater incidence of congenital CMV infection in twins than in singletons. Interestingly, the twin-infected patients exhibited discordant infection statuses, suggesting that CMV was present in only one of the babies. We also found that most of the infected children were born to mothers who initiated sexual activity at a younger age. Diagnostic accessibility and comprehensive surveillance programs are imperative for effectively managing and preventing congenital CMV infections.

Relatamos as estratégias e os procedimentos adotados no desenvolvimento do Programa de musicoterapia para profissionais da saúde (PROMUS). A proposta insere-se no contexto das iniciativas ubimus que visam o incentivo ao bem-estar através da disponibilização e o estudo do impacto do suporte tecnológico em contextos cotidianos. Em particular, atentamos para a utilização de ambientes que previamente não eram considerados como espaços com potencialidade de aplicação musicoterapêutica. Outro aspecto inovador da presente proposta é o reaproveitamento de tecnologia já disponível nas atividades do dia a dia do público-alvo. Essa utilização de tecnologia leve, de baixo custo operativo e compatível com um perfil diverso de potenciais participantes está fortemente alinhada às práticas estabelecidas dentro da comunidade ubimus. Discutimos as implicações desta proposta para a ampliação do vínculo entre ubimus e os usos terapêuticos dos recursos musicais.

BackgroundPeople in low-income countries, especially those with low socio-economic conditions, are likelier to test positive for SARS-CoV-2. The unequal conditions of public health systems also increase the infection rate and make early identification and treatment of at-risk patients difficult. Here, we aimed to characterize the epidemiological profile of COVID-19 patients in intensive care and identify laboratory and clinical markers associated with death.Materials and methodsWe conducted an observational, descriptive, and cross-sectional study in a reference hospital for COVID-19 treatment in the Southern Region of Bahia State, in Brazil, to evaluate the epidemiological, clinical, and laboratory characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Additionally, we used the area under the curve (AUC) to classify survivors and non-survivors and a multivariate logistic regression analysis to assess factors associated with death. Data was collected from the hospital databases between April 2020 and July 2021.ResultsThe use of bladder catheters (OR 79.30; p

Abstract Hepatitis B virus (HBV) infection is a concern for public health due to its high prevalence, high infectivity, morbidity, and mortality worldwide. Brazil presents a low HBV prevalence, but has considerable heterogeneity among its geographic regions. Here, we describe the epidemiological profile of HBV infection in different regions of Brazil during 2007–2018, as well as the historical trends associated with the infection. We conducted an observational, ecological time-series study using secondary data collected from the National Notifiable Diseases Information System (SINAN). Our findings suggest that HBV infection was more likely to occur in young, sexually active adults. Individuals from Northeast and Midwest regions were more likely to present acute HBV infection, while individuals from South region were more likely to present chronic HBV infection, reinforcing that specific strategies are required for each particular region. Additionally, we observed a general decreasing trend of infection starting in 2014, however there was an increasing trend of infection in men and in individuals over 40 years old. Although we observed a decreasing trend in HBV infection, active surveillance is needed to prevent HBV spread and possible epidemics, as well as encouraging the vaccination of adults, especially young adult males. Our findings can inform the conduct of large-scale observational studies to evaluate clinical, economical, and social impacts of HBV infections, leading to improved social policies. Finally, our results highlight the need to improve data quality and completeness of epidemiological data, minimizing eventual errors that can make prevention and control strategies difficult.

The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), challenged public health systems worldwide. Individuals in low-income countries/regions are still at individual and community risk concerning inequality, sanitation, and economic conditions. Besides, during the pandemic, the transmission in municipalities and communities in the countryside and less developed regions kept viral spread and required structured and strengthened clinical and laboratory surveillance. Here, we present an observational, analytic, cross-sectional study conducted using secondary data from the Laboratório de Farmacogenômica e Epidemiologia Molecular (LAFEM)-Universidade Estadual de Santa Cruz (UESC), to evaluate individual and community factors associated to SARS-CoV-2 infection in outpatients from different cities from Southern Region of Bahia State, in Brazil. The data were collected between June 2021 and May 2022. The SARS-CoV-2 positivity by RT-qPCR was correlated with low socio-economic indicators, including the Human development index (HDIc) and Average worker salary (AWSc). Besides, in general, females were less likely to test positive for SARS-CoV-2 (OR = 0.752; CI 95% 0.663–0.853; p < 0.0001), while brown individuals had more positivity for infection (p < 0.0001). In addition, those who had clinical symptoms were more likely to test positive for SARS-CoV-2 (OR = 6.000; CI 95% 4.932–7.299; p < 0.0001). Although dry cough, headache, and fever were the most frequent, loss of taste (OR = 5.574; CI 95% 4.334–7.186) and loss of smell (OR = 6.327; CI 95% 4.899–8.144) presented higher odds ratio to be positive to SARS-CoV-2 by RT-qPCR. Nonetheless, the distribution of these characteristics was not homogenous among the different cities, especially for age and gender. The dynamic of SARS-CoV-2 positivity differed between cities and the total population and reinforces the hypothesis that control strategies for prevention needed to be developed based on both individual and community risk levels to mitigate harm to individuals and the health system.

The sharp increase of COVID-19 cases in late 2020 has made Brazil the new epicenter of the ongoing SARS-CoV-2 pandemic. The novel viral lineages P.1 (Variant of Concern Gamma) and P.2, respectively identified in the Brazilian states of Amazonas and Rio de Janeiro, have been associated with potentially higher transmission rates and antibody neutralization escape. In this study, we performed the whole-genome sequencing of 185 samples isolated from three out of the five Brazilian regions, including Amazonas (North region), Rio Grande do Norte, Paraíba and Bahia (Northeast region), and Rio de Janeiro (Southeast region) in order to monitor the spread of SARS-CoV-2 lineages in Brazil in the first months of 2021. Here, we showed a widespread dispersal of P.1 and P.2 across Brazilian regions and, except for Amazonas, P.2 was the predominant lineage identified in the sampled states. We estimated the origin of P.2 lineage to have happened in February, 2020 and identified that it has differentiated into new clades. Interstate transmission of P.2 was detected since March, but reached its peak in December, 2020 and January, 2021. Transmission of P.1 was also high in December and its origin was inferred to have happened in August 2020. We also confirmed the presence of lineage P.7, recently described in the southernmost region of Brazil, to have spread across the Northeastern states. P.1, P.2 and P.7 are descended from the ancient B.1.1.28 strain, which co-dominated the first phase of the pandemic in Brazil with the B.1.1.33 strain. We also identified the occurrence of a new lineage descending from B.1.1.33 that convergently carries the E484K mutation, N.9. Indeed, the recurrent report of many novel SARS-CoV-2 genetic variants in Brazil could be due to the absence of effective control measures resulting in high SARS-CoV2 transmission rates. Altogether, our findings provided a landscape of the critical state of SARS-CoV-2 across Brazil and confirm the need to sustain continuous sequencing of the SARS-CoV-2 isolates worldwide in order to identify novel variants of interest and monitor for vaccine effectiveness.

Desde a declaração da Organização Mundial de Saúde (OMS) classificando a infecção pelo SARS-COV-2 como pandemia, houve a necessidade da criação de medidas emergenciais para detectar, proteger, tratar e reduzir a transmissibilidade do vírus. Neste contexto, o presente trabalho visa divulgar os resultados obtidos da ação extensionista de consultoria ad hoc em saúde no combate a COVID-19, além das inferências e vivências da equipe multidisciplinar, interdisciplinar e intersetorial responsável por sua execução. Metodologicamente, trata-se de um relato de experiência, descritivo e de abordagem qualitativa sobre uma ação extensionista. Os resultados apontam que dos 42 municípios convidados, 38 pertencentes as microrregiões de saúde de Ilhéus, Itabuna e Valença retornaram solicitando adesão. Das demandas espontâneas, obteve-se a produção de 31 materiais técnico-científicos para (re)orientar as ações gerenciais ou educativas. Com isso, ressalta-se a importância das ações extensionistas e necessidade das consultorias ad hoc para auxiliar no combate a pandemia por COVID-19.

In December 2019, a novel coronavirus was detected in Wuhan, China, and rapidly spread worldwide. In Brazil, to date, there have been more than 20,000,000 confirmed cases of COVID-19 and more than 550,000 deaths. The purpose of the current study was to determine the clinical and epidemiological profile of the population affected by COVID-19 that have attended referral hospitals in Southern region of Bahia State, to better understand the disease and its risk factors in order to enable more appropriate conduct for patients. An observational, descriptive, cross-sectional, exploratory study was conducted using secondary data collected from the Laboratório de Farmacogenômica e Epidemiologia Molecular, Universidade Estadual de Santa Cruz (LAFEM/UESC). Chi-squared and Fisher’s exact tests were applied to determine the association between clinical symptoms and laboratory results, and to identify risk factors associated with SARS-CoV-2 infection. A total of 3135 individuals with suspected severe respiratory illness were analyzed and 41.4% of them tested positive for SARS-CoV-2 infection. Male individuals and having comorbidities were risk factors significantly associated with SARS-CoV-2 infection (OR = 1.17 and OR = 1.37, respectively). Interestingly, being a healthcare professional was a significantly protective factor (OR = 0.81, p < 0.001). Our findings highlight the importance of routinely testing the population for early identification of infected individuals, and also provide important information to health authorities and police makers to improve control measures, management, and screening protocols.

Trophic interactions impose important costs to their host plants, affecting patterns of resource allocation. The relationship between host and consumers is also influenced by the availability of resources, e. g., soil nutrients. In this study, we explored the relationship among mycorrhiza-plant-herbivore in natural populations of Datura stramonium and their correlation with the content of phosphorus, nitrogen and carbon in the soil. We estimated the vegetative and reproductive biomass of plants, the arbuscular mycorrhizal colonization and the level of herbivory in populations of D. stramonium. The local abundance of D. stramonium was negatively related to the content of phosphorus in the soil. In contrast, soil carbon concentration affected positively the vegetative and reproductive mass of D. stramonium, although it was negatively correlated with the specific leaf area (SLA). Of the trophic interactions only herbivory was significantly correlated with the SLA and no relationship was detected between the two interaction types. The lack of significant response of mycorrhizae to the soil nutrients concentration, plant performance, and herbivory may result from the stochasticity in the availability of mycorrhizal inoculum (identity and abundance) in the populations studied.

Objetivo: Comprender la percepción del insomnio por parte de las personas que lo padecen y los profesionales que les atienden en el sistema madrileño de salud para así poder profundizar en las barreras que limitan el acceso y su manejo en el primer nivel asistencia. Metodología: estudio cualitativo, enmarcado en la corriente constructivista, llevándose a cabo entrevistas en profundidad con los pacientes y grupos de discusión con los profesionales. Las entrevistas se realizarán a personas mayores de edad, diagnosticadas de insomnio y que hayan recibido tratamiento para el insomnio en su centro de salud de la Comunidad de Madrid. Por otra parte, los grupos de discusión integrarán profesionales de enfermería y de medicina que trabajen en centros de salud de la Comunidad de Madrid y que atiendan en sus consultas casos de insomnio. El análisis de los datos se llevará a cabo mediante el análisis de las transcripciones de las entrevistas y de los grupos de discusión, extrayéndose categorías y estableciéndose comparaciones entre los datos a varios niveles de significado. Conclusiones: el estudio permitirá conocer en mayor profundidad el problema del insomnio, lo que favorecerá la mejor comprensión por parte del usuario y profesional, así como facilitará la capacidad de mejorar la atención prestada, comprendiendo las barreras que dificultan el acceso de estas personas a los centros de salud y las dificultades en el manejo de los diferentes abordajes propuestos desde el sistema sanitario.

Os erros de dispensação estão compreendidos entre os erros de medicação que podem causar prejuízo na segurança do paciente, acarretando eventos adversos evitáveis. O objetivo do estudo foi levantar a publicação bibliográfica sobre o tema, no período de 2004 a 2014, analisando estudos que identificaram os erros de dispensação, as causas, consequências e medidas de prevenção em nível internacional e de Brasil. Foi realizada uma revisão da literatura sobre erros de dispensação aplicando-se a técnica de bibliometria. O estudo resultou em 767 artigos pesquisados, dos quais 12 foram selecionados e analisados. Portanto, a produção bibliográfica sobre erros de dispensação deve ser ampliada, para que seja oferecida fonte de dados para os possíveis erros, as causas e as formas de evitá-los.

Abstract INTRODUCTION : The human T-lymphotropic virus-1 (HTLV-1) is associated with chronic inflammatory diseases such as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a chronic inflammatory disease. Disturbances in lipid metabolism are involved in inflammatory and demyelinating diseases. METHODS : Plasma levels of triglycerides, total cholesterol, and fractions of HTLV-1-infected individuals of both sexes with different clinical progressions were determined. RESULTS : Elevated levels of triglyceride and very low-density lipoproteins (VLDL) were exclusively detected in HTLV-1-infected women from asymptomatic and HAM/TSP groups compared with uninfected individuals (p = 0.02). CONCLUSIONS : Elevated triglyceride and VLDL levels in HTLV-1-infected women may be related to the predominance of HAM/TSP in women.

The objectives of this study were to compare waist and abdominal circumference and to analyze their association with cardiometabolic risk factors in employees of a university in Bahia. Fifty-five men and 71 women (36.4 ± 11.2 years) were submitted to anthropometric assessment and measurement of systolic and diastolic blood pressure, blood glucose, triglycerides, total cholesterol, and HDL and LDL fractions. Despite strong correlations (P < 0.01) between the different measures (r > 0.93), waist circumference was significantly lower than abdominal circumference in the two genders, with the mean difference being greater in women (8.6 ± 4.1 vs 3.8 ± 4.2 cm; P < 0.01). Waist circumference was significantly associated with two and four risk factors in men and women, respectively. On the other hand, abdominal circumference was significantly associated with one risk factor in men and with five factors in women. No significant differences (P > 0.05) between correlation coefficients were observed in cases in which the two circumference measures were significantly associated with one risk factor. These results suggest that the site of measurement has substantial influence on circumference measured in the lower region of the trunk, particularly in women. However, there is no clear evidence of the superiority of a single measure in terms of the association with traditional cardiometabolic risk factors in the Brazilian sample studied. Further investigations are needed to compare the predictive capacity of different circumference measures for the development of risk factors and cardiovascular diseases in different populations.

The objectives of this study were to compare waist and abdominal circumference and to analyze their association with cardiometabolic risk factors in employees of a university in Bahia. Fifty-five men and 71 women (36.4 ± 11.2 years) were submitted to anthropometric assessment and measurement of systolic and diastolic blood pressure, blood glucose, triglycerides, total cholesterol, and HDL and LDL fractions. Despite strong correlations (P < 0.01) between the different measures (r > 0.93), waist circumference was significantly lower than abdominal circumference in the two genders, with the mean difference being greater in women (8.6 ± 4.1 vs 3.8 ± 4.2 cm; P < 0.01). Waist circumference was significantly associated with two and four risk factors in men and women, respectively. On the other hand, abdominal circumference was significantly associated with one risk factor in men and with five factors in women. No significant differences (P > 0.05) between correlation coefficients were observed in cases in which the two circumference measures were significantly associated with one risk factor. These results suggest that the site of measurement has substantial influence on circumference measured in the lower region of the trunk, particularly in women. However, there is no clear evidence of the superiority of a single measure in terms of the association with traditional cardiometabolic risk factors in the Brazilian sample studied. Further investigations are needed to compare the predictive capacity of different circumference measures for the development of risk factors and cardiovascular diseases in different populations.

Se determinó la frecuencia de alteraciones citogenéticas (micronúcleos y aberraciones cromosómicas), deficiencias en la reparación del ADN y actividad de la acetilcolinesterasa como biomarcadores de exposición a plaguicidas organofosforados y carbamatos en trabajadoras de cultivos de flores en Bogotá. Se realizó un estudio descriptivo en 31 trabajadoras con riesgo ocupacional de exposición a plaguicidas y 30 sin riesgo; la información se obtuvo por medio de una entrevista. Se emplearon como pruebas citogenéticas estándar la frecuencia de aberraciones cromosómicas y de micronúcleos; la prueba de reto (challenge assay) se utilizó para determinar la respuesta a los rayos gamma y como indicador de deficiencias en la reparación del ADN. Los datos se analizaron por porcentaje de células aberrantes, frecuencia de aberraciones cromosómicas y rompimiento cromatídico en 100 células en metafase analizadas en cada trabajadora. En los ensayos citogenéticos, se encontró que el grupo expuesto presentó frecuencias mayores de células con aberraciones cromosómicas y micronúcleos que el grupo no expuesto, con diferencias significativas (p=0,02); sin embargo, con la prueba de reto, la diferencia no fue significativa (p>0,1). Estos hallazgos requieren ser confirmados por estudios de tipo analítico que involucren exámenes clínicos; además, es necesario un mayor número de biomarcadores para la monitorización de trabajadores expuestos a plaguicidas en cualquier situación.

We analyzed, by env and gag heteroduplex mobility assay, 149 human immunodeficiency virus (HIV-1) positive samples collected in Ceará during the year 2000. The prevalence of subtype B was 81.2% and the prevalence of subtype F and B/F recombinants were both 2.7%. Eight (5.4%) and 12 (8%) out of 149 samples showed indeterminate results in the env and gag analysis respectively. By FokI restriction fragment length polymorphism, 34% of the subtype B samples were identified as the typical Brazilian subtype B.In the present study, we identified HIV-1 subtype F and B/F in Ceará for the first time. Our results contribute to the understanding of HIV in Brazil, and may prove useful for the development of vaccine candidates.

INTRODUCTION: Although urine is considered the gold-standard material for the detection of congenital cytomegalovirus (CMV) infection, it can be difficult to obtain in newborns. The aim of this study was to compare the efficiency of detection of congenital CMV infection in saliva and urine samples. METHODS: One thousand newborns were included in the study. Congenital cytomegalovirus deoxyribonucleic acid (DNA) was detected by polymerase chain reaction (PCR). RESULTS: Saliva samples were obtained from all the newborns, whereas urine collection was successful in only 333 cases. There was no statistically significant difference between the use of saliva alone or saliva and urine collected simultaneously for the detection of CMV infection. CONCLUSIONS: Saliva samples can be used in large-scale neonatal screening for CMV infection.

Ver PDF