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Community-Based Participatory Research (CBPR) is a methodology hinged on flexible power relationships and unobstructed flow of expert and local knowledge among project partners. Success in CBPR depends on authentic dialogue, free flow of information, and trust. But accurate, unmediated, and timely channels of communication, while key to successful CBPR, are difficult to create and maintain. As participatory methodologies evolve, popular arts and education techniques have increasingly taken center stage as culturally fluent, bidirectional modalities for conveying information, building responsive channels for communication, promoting policy, and enhancing the effectiveness of grassroots organizing. [ABSTRACT FROM AUTHOR]

This article seeks to examine the impact of technology importation on occupational health and safety in both Saudi Arabian and U.S. oil refining industries. Technologies imported to the Saudi oil industry take two forms: hardware (sophisticated equipment to run oil facilities) and software (policies and regulations pertaining to workers' health and safety, and employment rights installed by Aramco's founding multinational companies).This study utilizes qualitative, historically oriented, cross-national case studies to compare and assess workers' health, safety, and rights in Saudi Aramco with its U.S. counterpart, Motiva Enterprises. Two facilities were chosen to conduct field research: the Saudi Aramco oil refinery at Jeddah and Motiva's refinery at Port Arthur, Texas. The Jeddah refinery is fully owned by Saudi Aramco, thus, representing Aramco's health and safety policies and regulations. The Port Arthur refinery serves as a reference case study for U.S. oil refining facilities. The aspects of occupational health and safety in Saudi Aramco--ExxonMobil's joint ventures SAMREF and LUBREF--also are discussed to examine workers' health policies in both companies.The American oil industry made a significant contribution in establishing the Saudi oil industry, with the cooperation of the Saudi government. Despite having outstanding employment benefits schemes in Saudi Aramco, the presence of an organized work force better serves employee participation in Motiva than in Aramco. Safety systems such as Process Safety Management (PSM)--applied in Motiva--partially exist in Aramco to operate hardware technologies safely. Motiva training systems are better through PACE's Triangle of Prevention (TOP). Both companies follow the same pattern of handling occupational injuries and diseases; however, Saudi government agencies (GOSI) are responsible for compensating and treating injured workers. Saudi workers expressed conditional support for the worker committee program proposed by the Ministry of Labor. American and Saudi workers are concerned about the quality and sufficiency of health and safety training, employment promotion, work pressure, and job uncertainty due to continuous downsizing.This article recommends that Saudi social actors increase safety and health awareness in the work environment by providing intensive occupational safety training to the employees (as demanded by Saudi and American workers), improve labor-management relations through establishing strong cooperative contacts with regional and international trade unions, and establish uniform and standard occupational health and safety regulations for Saudi Aramco and its subsidiaries in order to provide an equal level of protection for Saudi workers. [ABSTRACT FROM AUTHOR]

This article summarizes the origins and implementation of labor-management negotiated tobacco control policies in public workplaces in New York state during the 1980s and 1990s. It is an in-depth case study that illustrates the confrontation and cooperation among three main social actors involved in the design and implementation of workplace smoking policies: public-sector labor unions, public health professionals, and state managers. The policy debates, legal, and political issues that emerge from this history suggest hopeful avenues for improving the dialogue and cooperation on the design and implementation of workplace smoking policies between and among public health professionals, managers, and labor union leaders in the United States. Understanding how these parties can reach agreement and work together may help tobacco control advocates and labor leaders join forces to enact future tobacco control policies. [ABSTRACT FROM AUTHOR]

Objective: To determine the minimum alveolar concentration (MAC) of sevoflurane in Holstein steers using electric stimulation., Study Design: Prospective experimental study., Animals: A total of 15 Holstein steers aged 7.3 ± 1.2 months and weighing 121 ± 25 kg., Methods: Animals were anesthetized with sevoflurane at 8% in oxygen at 5 L minute -1 via facemask and were intubated with an orotracheal tube of a compatible size. After 15 minutes of stabilization of the initial expired concentration of sevoflurane (Fe'Sevo) at 2.6%, electrical stimulation on the thoracic limb was initiated with a sequence of 2 × 10 ms followed by 2 × 3 second electrical currents of 50 V and 50 Hz, 5 seconds apart. Following each stimulus with a negative response, the Fe'Sevo was decreased by 0.2% and a 15 minute interval was awaited before the next stimulus. The procedure was repeated until the first Fe'Sevo value with a positive motor response was obtained. The Fe'Sevo was then increased by 0.1%, followed by a new stimulus, until a negative response was obtained. The value of MAC was calculated as the arithmetic mean between the lowest Fe'Sevo associated with a negative motor response and the highest Fe'Sevo associated with a positive response., Results: The mean MAC for the 15 steers was 2.0 ± 0.3%, which corresponds to 2.1 ± 0.3% at sea level., Conclusions: Based on the proposed methodology, the MAC of sevoflurane for healthy Holstein steers is 2.1 ± 0.3% at sea level., Clinical Relevance: This Fe'Sevo value can be used to guide depth of anesthesia in steers weighing approximately 120 kg in clinical practice., (Copyright © 2023. Published by Elsevier Ltd.)

Background: High blood pressure is an important public health problem due to its high prevalence, the difficulty to control it, and its high contribution to morbidity. A series of changes may be linked to the aging process, compromising cardiac conduction, and reducing cardiovascular baroreceptor function. Advancing age promotes a decline in heart rate variability and this decrease can increase the probability of cardiovascular disease. The aim of this study was to analyze the autonomic modulation of heart rate in hypertensive elderly individuals during and after a session of aerobic exercise, and to compare it with elderly individuals without cardiovascular or metabolic disease. Our study was a non-randomized controlled study with hypertensive elderly (HBP group) and elderly without cardiovascular and/or metabolic diseases (control group). Data on blood pressure and heart rate variability (HRV) were collected before, during, and after 30 min of aerobic physical exercise on a treadmill. There was a reduction in HF (ms 2 ) and SD1 (ms) in the 5 min of recovery for the elderly in the control group. The elderly in the control group also had greater RMSSD and SD1 30 min post-exercise when compared to the initial mins of recovery. We concluded that there was no difference in autonomic modulation and global heart rate variability between elderly individuals without cardiovascular and metabolic diseases and hypertensive individuals after a bout of aerobic exercise. Elderly individuals without metabolic diseases showed a decrease in parasympathetic modulation and global variability between the time of rest and 5 min of recovery. However, up to 30 min of post-exercise recovery, they restored parasympathetic activity.

Para comprender mejor los factores que influyen en la salud y el bienestar de los inmigrantes dominicanos, exploramos las formas en que la inmigración influye en las prácticas culturales, el comportamiento de salud y la salud. Los inmigrantes dominicanos (n = 42) participaron en cinco discusiones grupales reflexivas y no estructuradas y (n = 5) participaron en un grupo de fotovoz intergeneracional. La pérdida del contexto familiar y social en el que tradicionalmente se llevan a cabo las prácticas dietéticas dominicanas fue un tema destacado. Para los participantes, comer se convirtió en una actividad apresurada y superficial que involucraba a menos personas y menos socialización. Las prácticas dietéticas en la República Dominicana se establecen en el contexto de las normas familiares y los procesos sociales, que brindan apoyo, así como oportunidades para la socialización y la transmisión de prácticas culturales a través de las generaciones. En los Estados Unidos, las fuerzas sociopolíticas más amplias se enfocan en el individualismo y no apoyan el desarrollo o mantenimiento de patrones culturales para los dominicanos. Las políticas que promueven el equilibrio entre el trabajo y la vida personal pueden tener implicaciones importantes para las prácticas dietéticas en las nuevas comunidades de inmigrantes.

Competing Interests: None.

The Outreach Core of the U54 Partnership between the Dana-Farber/Harvard Cancer Center and the University of Massachusetts Boston created a new model for addressing cancer inequities that integrates implementation science, community-engaged research, and health promotion. Key elements of the approach include engaging a Community Advisory Board, supporting students from underrepresented minority backgrounds to conduct health promotion and community-engaged research, increasing the delivery of evidence-based cancer prevention programs to underserved communities (directly and by training local organizations), supporting research-practice partnerships, and disseminating findings. Our model highlights the need for long-term investments to connect underserved communities with evidence-based cancer prevention.

Brazilians represent a growing proportion of immigrants in the USA. Little is known about their health or healthcare utilization after their arrival. This study aimed to gather formative data to understand the needs of Brazilian immigrant women to guide public health interventions. We conducted five focus groups with Brazilian women born in Brazil (n = 47) and 13 key informant interviews with representatives from Brazilian-serving organizations. Participants were recruited from churches and social service organizations in the Greater Boston area. Findings revealed that mental health was the most pressing health priority; many attributed high levels of anxiety and depression to worries about undocumented status, separation from social networks, and strenuous work schedules. Occupational health issues were frequently mentioned, including musculoskeletal complaints, skin rashes, and respiratory problems. Domestic violence was also a concern, and many women feared reporting to police due to undocumented status. Most reported good access to medical care and described the quality of healthcare services as superior to that available in Brazil. However, many reported challenges with interpersonal communication with providers, dissatisfaction with a perceived unwillingness from providers to order medical tests or prescribe treatment, and limited access to mental health services. There was agreement that effective intervention strategies should use social media, radio, and group education in churches., (© 2021. W. Montague Cobb-NMA Health Institute.)

Amazonas suffered greatly during the COVID-19 pandemic. The mortality and fatality rates soared and scarcity of oxygen and healthcare supplies led the health system and funerary services to collapse. Thus, we analyzed the trends of incidence, mortality, and lethality indicators of COVID-19 and the dynamics of their main determinants in the state of Amazonas from March 2020 to June 2021. This is a time-series ecological study. We calculated the lethality, mortality, and incidence rates with official and public data from the Health Department. We used the Prais-Winsten regression and trends were classified as stationary, increasing, or decreasing. The effective reproduction number (Rt) was also estimated. Differences were considered significant when p < 0.05. We extracted 396,772 cases of and 13,420 deaths from COVID-19; 66% of deaths were in people aged over 60; 57% were men. Cardiovascular diseases were the most common comorbidity (28.84%), followed by diabetes (25.35%). Rural areas reported 53% of the total cases and 31% of the total deaths. The impact of COVID-19 in the Amazon is not limited to the direct effects of the pandemic itself; it may present characteristics of a syndemic due to the interaction of COVID-19 with pre-existing illnesses, endemic diseases, and social vulnerabilities.

In order to better understand factors that influence the health and well-being of Dominican immigrants, we explored the ways in which immigration influences cultural practices, health behavior, and health. Dominican immigrants ( n = 42) took part in five reflective and unstructured group discussions and ( n = 5) participated in an intergenerational photovoice group. The loss of the familial and social context in which Dominican dietary practices traditionally take place was a salient theme. For participants, eating became a rushed, perfunctory activity involving fewer people and less socializing. Dietary practices in the Dominican Republic are set in the context of familial norms and social processes, which provide support as well as opportunities for socializing and the transmission of cultural practices across generations. In the United States, broader sociopolitical forces are guided by individualism and do not support the development or maintenance of these factors for Dominicans. Policies that promote work-life balance may have important implications for dietary practices in new immigrant communities.

This is an ecological and time-series study using secondary data on perinatal mortality and its components from 2008 to 2017 in Espírito Santo, Brazil. The data were collected from the Mortality Information System (SIM) and Live Births Information System (SINASC) of the Unified Health System Informatics Department (DATASUS) in June 2019. The perinatal mortality rate (×1000 total births) was calculated. Time series were constructed from the perinatal mortality rate for the regions and Espírito Santo. To analyze the trend, the Prais-Winsten model was used. From 2008 to 2017 there were 8132 perinatal deaths (4939 fetal and 3193 early neonatal) out of a total of 542,802 births, a perinatal mortality rate of 15.0/1000 total births. The fetal/early neonatal ratio was 1.5:1, with a strong positive correlation early neonatal mortality rate, perinatal mortality rate, r (9) = 0.8893, with a significance level of p = 0.000574. The presence of differences in trends by health region was observed. Risk factors that stood out were as follows: mother's age ranging between 10 and 19 or 40 and 49 years old, with no education, a gestational age between 22 and 36 weeks, triple and double pregnancy, and a birth weight below 2499 g. Among the causes of death, 49.70% of deaths were concentrated in category of the tenth edition of the International Classification of Diseases, fetuses and newborns affected by maternal factors and complications of pregnancy, labor, and delivery (P00-P04), and 11.03% were in the category of intrauterine hypoxia and birth asphyxia (P20-P21), both related to proper care during pregnancy and childbirth. We observed a slow reduction in the perinatal mortality rate in the state of Espírito Santo from 2008 to 2017.

Mining dam failures have increased worldwide since the 1980s. Two large mining dam failures occurred recently in Mariana and Brumadinho, both in the state of Minas Gerais, Brazil. We hypothesize that there were significant differences in legal post-disaster decisions. The aim of this article is to understand the similarities and differences of post-disaster actions and controversies in Mariana and Brumadinho. We reviewed 686 news reports about court decisions and settlement agreements from the websites of state and federal courts and judicial institutions. After classifying the reports using an adapted protocol from a media health observatory, we conducted a thematic analysis. Our analysis suggests that there were significant differences in legal post-disaster decisions in the cases of Mariana and Brumadinho. In Mariana, there was privatization of post-disaster management, with the creation of the Renova Foundation, a mediated indemnity program, lack of access to information for those affected, and uncertainties in health and resettlement issues. In Brumadinho, there was faster implementation of the recovery and compensation measures, faster recognition of affected parties, and stronger participation of the population since the first hearings. Even though there were particularities in post-disaster management, the ultimate goal of the corporations responsible for the disasters was to protect their profits.

Canine leishmaniasis (CanL) is a chronic disease caused by Leishmania infantum , and the limitations of the current treatments have encouraged new alternatives, such as the use of immunomodulatory nutrients. The objective of this study was to determine the serum levels of vitamin A (retinol), vitamin D (25(OH)VD 3 ), and zinc (Zn) in dogs with CanL and the effect of in vitro supplementation with the respective active forms ATRA, 1,25(OH) 2 VD 3 , and SZn on spleen leukocyte cultures. Serum retinol, 25(OH)VD 3 , and Zn were determined by HPLC, ELISA, and ICP-MS, respectively. Spleen leukocyte cultures were used for the detection of NO and ROS by flow cytometry; the IFN-γ, TNF-α, and IL-10 levels were determined by ELISA; and the parasite load was determined by microscopy. We detected low serum levels of retinol and Zn and high levels of 25(OH)VD 3 in the CanL group. The in vitro supplementation of CanL spleen leukocytes with ATRA, 1,25(OH) 2 VD 3 , and SZn, in addition to a soluble leishmania antigen (SLA) treatment, increased the NO and ROS levels, while the treatments with only ATRA and SZn increased the TNF-a levels. Increased IL-10 and IFN-g levels were observed with the addition of SLA to the medium, although the addition of the three nutrients led to a reduction of the IL-10 levels, and the addition of 1,25(OH) 2 VD 3 and SZn led to a reduction of IFN-g. A supplementation with 1,25(OH) 2 VD 3 and SZn reduced the parasite load but only in the absence of SLA. We suggest that the nutrients we tested are involved in the leishmanicidal mechanism, showing a potential for investigation in future studies.

The Brazilian state apparatus was reformed throughout the 1990s, influenced by New Public Management (NPM). NPM was embodied in the health care sector by the creation of Social Health Organizations ( Organizações Sociais de Saúde or OSS), private non-profit entities to provide welfare services. We performed a systematic review of the literature outlining the origins and role of OSS in Brazil. Our selected articles (peer-reviewed) cover the origins/performance of OSS and their services provision between 1998 and 2018, in English or Portuguese. Databases used were Lilacs, Bireme, Medline, Pubmed, and SciELO. We identified 4,732 articles applying a pre-defined set of descriptors, from which we selected 49 for analysis. The main findings reveal that NPM is the central theme of most articles about OSS in Brazil (n = 26). There is evidence corroborating our hypothesis that transferring management of public health care services to private non-profit organizations is a softer version of privatization as, although financing is kept public, the rationale and ethos of OSS services institutionally and operationally mimic the private sector. The practical consequence is that attainment of health care in Brazil ends up being neither fully commodified (based on ability to pay) nor fulfilled as a citizen's right following its national constitution.

Nalbuphine is an agonist-antagonist opioid with adequate analgesic properties and few depressant effects on the respiratory system. However, there are no detailed reports available on cardiovascular effects of nalbuphine in dogs. The aim of this study was to assess the effects of a continuous rate infusion (CRI) of nalbuphine on left ventricular systolic and diastolic function of healthy sevoflurane-anesthetized dogs. Eighteen mixed-breed bitches aged 1-4 years and weighing 9.9 ± 3.8 kg were used. Dogs were randomly assigned to one of two groups: nalbuphine (G N , n  = 9) and control (G C , n  = 9). Anesthesia was induced and maintained with sevoflurane (2V%) followed by an intravenous (IV) bolus of nalbuphine (0.3 mg/kg) or 0.9% NaCl at equal volume and then CRI of nalbuphine (0.4 mg/kg/h) or 0.9% NaCl at an equal infusion rate. Echocardiographic and hemodynamic variables were determined at baseline and 20, 40, 60, and 80 minutes following start of CRI. No differences were found between groups for left ventricular systolic and diastolic variables obtained through conventional echocardiography and two-dimensional speckle tracking. Likewise, hemodynamic variables did not differ between groups. The E'/A' ratio significantly increased at 20 minutes compared to baseline only in GN. Nalbuphine given at a CRI does not influence left ventricular systolic and diastolic function in healthy sevoflurane-anesthetized dogs., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2020 Marcel G. Marques et al.)

Canine leishmaniasis (CanL) is caused by the intracellular parasite Leishmania infantum. Prostaglandin E2 (PGE 2 ) exerts potent regulatory effects on the immune system in experimental model Leishmania infection, but this influence has not yet been studied in CanL. In this study, PGE 2 and PGE 2 receptor levels and the regulatory effect of PGE 2 on arginase activity, NO 2 , IL-10, IL-17, IFN-γ, TNF-α and parasite load were evaluated in cultures of splenic leucocytes obtained from dogs with CanL in the presence of agonists and inhibitors. Our results showed that splenic leucocytes from dogs with CanL had lower EP2 receptor levels than those of splenic leucocytes from healthy animals. We observed that NO 2 levels decreased when the cells were treated with a PGE 2 receptor agonist (EP1/EP2/EP3) or COX-2 inhibitor (NS-398) and that TNF-α, IL-17 and IFN-γ cytokine levels decreased when the cells were treated with a PGE 2 receptor agonist (EP2) or PGE 2 itself. The parasite load in splenic leucocyte cell cultures from dogs with CanL decreased after stimulation of the cells with PGE 2 . We conclude that Leishmania infection of dogs modulates PGE 2 receptors and speculate that the binding of PGE 2 to its receptors may activate the microbicidal capacity of cells., (© 2020 John Wiley & Sons Ltd.)

In the last decades, few epidemiological studies have discussed the mortality rates due to leukemia and lymphoma in Brazil. This study analyzes the evolution over time of the number of deaths due to leukemia and lymphoma in Brazil, between 2010 and 2016, considering the population's characteristics and spatial distribution. This is a retrospective epidemiological study based on data obtained in the Brazilian Health Informatics Department (DATASUS), associated with the quantitative population. We created choropleth maps and predictive models of mortality rates, using the incidence rate ratio (IRR) to measure the size of the effect. Leukemia had a 1.76 higher mortality rate than lymphoma. Leukemia mortality trends increased by 1.2% per year between 2010 and 2016. Regions with the lowest social inequality had higher mortality rates for both diseases. There was a difference between peaks with higher chances of death due to leukemia (> 60 years) and lymphoma (> 70 years). Older age, male, white, and South and Southeast regions were associated with higher mortality by leukemia or lymphoma.

The study aimed to assess the implementation of the More Doctors Program (PMM in Portuguese) based on a case study of the Espírito Santo State, Brazil. The first stage involved analyzing the documents that launched the PMM, allowing the creation of a logic model. In the second stage, data on the PMM in Espírito Santo State were analyzed (2013-2016) based on population brackets, creating indicators for the proportion of physicians before and after the Program with the following parameters: unacceptable (0 to 0.99 physicians/1,000 inhabitants); acceptable (1 to 1.99); and desirable (2.0 or more). Data were analyzed with the Wilcoxon and Kruskal-Wallis non-parametric tests. The model included the size, inputs, activities, outputs, results, and impact of the PMM, orienting analysis of the Program's implementation. Of all the physicians in the emergency supply to Espírito Santo State (432), the majority (63.8%) were cooperative exchange physicians (Cubans), while 31.2% were regional board-accredited Brazilians. The Brazilian and individual exchange physicians were allocated mainly in medium and large municipalities, while the Cubans were distributed more heterogeneously in municipalities of all population sizes and were thus more common in areas with greater social vulnerability and lower social capital. There was a significant increase in the number of physicians in Espírito Santo State, but the supply to the extremely poor population did not reach the desired level, presenting an unacceptable mean rate in municipalities with up to 10,000 inhabitants and an acceptable rate in municipalities in the other population brackets.

The study's objective was to discuss public policies for drug abuse prevention targeted to young people in Brazil and the United States. Brazil has formulated its policy with programs that are questioned at the international level on epistemological, theoretical, and methodological grounds. The authors conclude that social policymaking in Latin America is still permeated by dependence on central countries, since the tension between the prohibitionist and harm reduction policies persists in the policy provisions for drug abuse prevention under the National Secretariat for Drug Policies and the Ministry of Health and what is actually implemented. The article suggests pursuing autonomy vis-à-vis the models for preventive measures imposed by the dominant countries, through a wider debate between researchers, health professionals, users, and social movements in the leadership of more appropriate policies for Brazil.

Structural inequalities in the U.S. work environment place most immigrants in low paying, high-risk jobs. Understanding how work experiences and influence the health of different immigrant populations is essential to address disparities. This article explores how Brazilian and Dominican immigrants feel about their experiences working in the U.S. and how the relationship between work and culture might impact their health. In partnership with the Dominican Development Center and the Brazilian Worker Center, we held five cultural conversations (CCs) with Brazilians ( n = 48) and five with Dominicans ( n = 40). CCs are participatory, unstructured groups facilitated by representatives from or embedded in the community. Brazilian immigrants focused on physical health and the American Dream while Dominicans immigrants emphasized concerns about the influence of work on mental health. Dominicans' longer tenure in the U.S. and differences in how Brazilians and Dominicans are racialized in the region might account for the variation in perspectives between groups. Future studies should further investigate the relationship between health and how immigrants' work lives are shaped by culture, race and immigrant status.

Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences to pregnancies has made governments, national and international agencies issue advices and recommendations to women. There is a clear need to investigate how the Zika outbreak affects the decisions that women take concerning their lives and the life of their families, as well as how women are psychologically and emotionally dealing with the outbreak. We conducted a qualitative study to address the impact of the Zika epidemic on the family life of women living in Brazil, Puerto Rico, and the US, who were affected by it to shed light on the social repercussions of Zika. Women were recruited through the snowball sampling technique and data was collected through semi-structured interviews. We describe the effects in mental health and the coping strategies that women use to deal with the Zika epidemic. Zika is taking a heavy toll on women's emotional well-being. They are coping with feelings of fear, helplessness, and uncertainty by taking drastic precautions to avoid infection that affect all areas of their lives. Coping strategies pose obstacles in professional life, lead to social isolation, including from family and partner, and threaten the emotional and physical well-being of women. Our findings suggest that the impacts of the Zika epidemic on women may be universal and global. Zika infection is a silent and heavy burden on women's shoulders.

Background: This study analyzed several political determinants of increased private-sector management in Brazilian health care. In Brazil, the poor depend almost exclusively on the public Unified Health System (the SUS), which remains severely underfunded. Given the overhead costs associated with privately contracted health services, increased private management is one driver of higher expenditures in the system. Although left parties campaign most vocally in support of greater public control of the SUS, the extent to which their stated positions translate into health care policy remains untested., Methods: Drawing on multiple publicly available data sources, we used linear regression to analyze how political party-in-power and existing private sector health care contracting affect the share of privately managed health care services and outsourcing in municipalities. Data from two election periods-2004 to 2008 and 2008 to 2012-were analyzed., Results: Our findings showed that although private sector contracting varies greatly across municipalities, this variation is not systematically associated with political party in power. This suggests that electoral politics plays a relatively minor role in municipal-level health care administration. Existing levels of private sector management appear to have a greater effect on the public-private makeup of the Brazilian healthcare system, suggesting a strong role of path dependence in the evolution of Brazilian health care delivery., Conclusion: Despite campaign rhetoric asserting distinct positions on privatization in the SUS, factors other than political party in power have a greater effect on private-sector health system management at the municipal-level in Brazil. Given the limited effect of elections on this issue, strengthening participatory bodies such as municipal health councils may better enfranchise citizens in the fundamental debate over public and private roles in the health care sector.

Objective: To assess the cardiopulmonary effects caused by reverse Trendelenburg position (RTP) at 5° and 10° in sevoflurane-anesthetized yearling steers., Study Design: Prospective, experimental study., Animals: Eight Holstein steers aged (mean ± standard deviation) 12 ± 2 months and weighing 145 ± 26 kg., Methods: In the first phase of the study, the individual minimum alveolar concentration (MAC) of sevoflurane was determined using electrical stimulation. In the second phase, the effects of RTP were assessed. The animals were anesthetized on three separate events separated by ≥7 days in an incomplete crossover design: control treatment using a table without tilt (RTP0); treatment with the table at 5° RTP (RTP5) and table tilted 10° RTP (RTP10). Subjects were physically restrained in dorsal recumbency on the table, which was already tilted according to each treatment. Anesthesia was induced with sevoflurane at 8% in 5 L minute -1 oxygen via face mask followed by maintenance with sevoflurane at 1.3 MAC and spontaneous breathing. Cardiopulmonary variables were obtained immediately after instrumentation (T 0 ) and then after 30, 60, 120 and 180 minutes (T 30 , T 60 , T 120 and T 180 , respectively)., Results: The mean sevoflurane MAC for the eight steers was 2.12 ± 0.31%. Cardiac output was lower at all time points and the systemic vascular resistance index was higher at T 120 and T 180 in RTP10 compared with RTP0. Oxygen consumption was lower at T 0 and at T 180 in RTP10 compared with RTP0 and at all time points except T 30 compared with RTP5. Oxygen extraction was lower at T 0 in RTP10 compared with RTP0 and RTP5, and at T 60 and T 180 compared with RTP5., Conclusions and Clinical Relevance: RTP 5° and 10° did not improve ventilatory and oxygenation variables in sevoflurane-anesthetized steers when compared with no tilt, however the cardiovascular variables were adversely affected in RTP10., (Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objectives: To investigate the prevalence of work-related musculoskeletal disorders amongst dentists who work in public clinics in São Paulo, Brazil, to investigate their awareness of the presence of risk factors in the workplace, disability due to pain, and the influence of pain on this awareness and disability., Material and Methods: A cross-sectional study was conducted among 204 dentists who work in public health clinics in the northwest of São Paulo, Brazil. The data was collected through interviews, using the Nordic Questionnaire and the Work-Related Activities that May Contribute to Job-Related Pain Questionnaire. In the case of workers who reported pain, the Pain Disability Questionnaire (PDQ) and the Numeric Pain Scale were also administered. Statistical analyses were performed using SPSS 21.0., Results: Most dentists (81.4%) had musculoskeletal disorders, especially in the neck, shoulders and lower back. We found that the presence of symptoms in the neck (15.7%), shoulders (12.7%) and lower back (15.7%) were the major causes of absenteeism over the past 12 months. Occupational risk factors perceived as the most problematic ones were: bending or twisting the back in an awkward way, continuing to work when injured or hurt and working in the same position for long periods. Comparison between the symptomatic and asymptomatic dentists showed a statistically significant difference (p < 0.05) in the perception of occupational risk factors. The analysis of the intensity of pain and disability with PDQ in the symptomatic dentists showed an average pain intensity of 3.8. Mean scores of the PDQ total (11.46) and its dimensions - functional condition (7.1) and psychosocial condition (4.4) - suggest a moderate disability in the dental surgeons. There was a strong t correlation (r = 0.697) between pain intensity and the total score of disability caused by pain., Conclusions: Pain and work-related musculoskeletal disorders interfere significantly with the dentists' lives. In the case of dental surgeons there is a significant correlation between pain intensity and disability. Int J Occup Med Environ Health 2017;30(3):367-377., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Mosquito-borne alphaviruses are widely distributed throughout the world, causing important human illnesses. Therefore, the development of methods to enable early diagnosis of infections by alphavirus is essential. We show here the development and evaluation of a quantitative real-time RT-PCR using genus-specific primers to the nsP1 viral gene of all mosquito-borne alphaviruses. The specificity and sensitivity of the assay were tested using seven alphaviruses and RNA transcribed from Venezuelan equine encephalitis virus. The detection limits of real-time RT-PCR ranged from 10 to 76 copies per ml. The melting temperature (TM) values for amplification of the alphavirus genomes were 83.05 °C and 85.28 °C. Interestingly, the assay suggested the possibility the arthritogenic alphaviruses with TM peaks of 84.83 to 85.28 °C and encephalitic alphaviruses of 83.34 °C to 84.68 °C could be discriminated both diseases. Real-time RT-PCR may prove very useful for the screening and preliminary diagnosis in outbreaks and surveillance studies as well as for measuring the viral load in pathogenesis studies.

Brazilian immigrants in the United States experience various social, labor, and health challenges. This study aimed to analyze the profile of female Brazilian domestic workers in Massachusetts, USA, through a description of their working conditions and self-rated health. This was a cross-sectional study of 198 domestic workers in Massachusetts, recruited with "snowball" sampling. The instrument addressed participants' demographic characteristics, work conditions, and self-rated health. Data were analyzed with SPSS 21.0. Among the interviewees, 95.5% were women, 62.1% were 30 to 49 years of age, and 55.6% were undocumented. Documented and undocumented participants showed statistically significant differences in demographics, work conditions, and health. Irregular immigrant status appears to have a negative impact on domestic workers' living and health conditions.

Vesiculoviruses (VSV) are zoonotic viruses that cause vesicular stomatitis disease in cattle, horses and pigs, as well as sporadic human cases of acute febrile illness. Therefore, diagnosis of VSV infections by reliable laboratory techniques is important to allow a proper case management and implementation of strategies for the containment of virus spread. We show here a sensitive and reproducible real-time reverse transcriptase polymerase chain reaction (RT-PCR) for detection and quantification of VSV. The assay was evaluated with arthropods and serum samples obtained from horses, cattle and patients with acute febrile disease. The real-time RT-PCR amplified the Piry, Carajas, Alagoas and Indiana Vesiculovirus at a melting temperature 81.02 ± 0.8ºC, and the sensitivity of assay was estimated in 10 RNA copies/mL to the Piry Vesiculovirus. The viral genome has been detected in samples of horses and cattle, but not detected in human sera or arthropods. Thus, this assay allows a preliminary differential diagnosis of VSV infections.

Objective: To assess the bispectral index (BIS) and the hemodynamic effects of propofol administered by continuous infusion at different rates in calves., Study Design: Experimental crossover study., Animals: Eight intact male Dutch calves, aged 6-12 months and weighing 84-124 kg., Methods: The calves were anesthetized with propofol (5 mg kg(-1) ) intravenously (IV), and after endotracheal intubation, positioned in right lateral recumbency and allowed to breathe ambient air. Anesthesia was maintained by continuous infusion of propofol, administered IV with an infusion pump at 0.6 mg kg(-1)  minute(-1) (treatment G6) or 0.8 mg kg(-1)  minute(-1) IV (treatment G8), for 60 minutes. The eight animals were anesthetized twice, 1 week apart. The following hemodynamic variables and BIS were assessed before the induction of anesthesia (baseline) and 15, 30, 45, and 60 minutes after beginning the infusion of propofol: heart rate, systolic, diastolic and mean arterial pressures, cardiac output, mean pulmonary artery pressure, cardiac index, stroke index, pulmonary vascular resistance index, and systemic vascular resistance index, BIS, electromyography, and signal quality index., Results: The continuous infusions of propofol at different rates did not alter BIS variables during the infusion time between dose rates, and no clinically significant hemodynamic changes were observed., Conclusions and Clinical Relevance: A continuous infusion of propofol at 0.6 or 0.8 mg kg(-1)  minute(-1) caused minimal hemodynamic changes without clinical relevance in calves. BIS could not be reliably used to discriminate the anesthetic depth during the two propofol infusion rates., (© 2015 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.)

Introduction: In Brazil, Mato Grosso (MT) has the highest number of hantavirus cardiopulmonary syndrome cases. Our study aimed to identify anti-hantavirus antibodies in the sera of patients from Sinop, MT, presenting with acute febrile illness., Methods: A retrospective analysis of data for 198 sera samples assessed using enzyme-linked immunosorbent assay (ELISA) was conducted., Results: Immunoglobulins G (IgGs) against the hantavirus nucleoprotein were found in 13.6% of the tested sera. No sample had immunoglobulin M (IgM) antibodies to hantavirus. Seropositivity occurred mainly in female residents in urban areas who worked around the household., Conclusions: Our findings suggest circulation of hantavirus in Sinop.

Arboviruses are common agents of human febrile illness worldwide. In dengue-endemic areas illness due to other arboviruses have been misdiagnosed as dengue based only on clinical-epidemiological data. In this study we investigated the presence of Brazilian arboviruses in sera of 200 patients presenting acute febrile illness, during a dengue outbreak in Sinop, MT, Brazil. The results showed that 38 samples were positive to Dengue virus (DENV) type 1, two samples to DENV type 4, and six to Mayaro virus. These results indicate that arboviruses others than DENV are circulating in Sinop and the surrounding region, which are going undiagnosed. In addition, molecular and evolutionary analyses indicate that two MAYV genotypes are co-circulating in Mato Grosso, Brazil. Thus, a strong surveillance program must be implemented to evaluate and monitor the distribution and the true importance of non-dengue arboviruses in the etiology of acute febrile illnesses., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: This article introduces some key labor, economic, and social policies that historically and currently impact occupational health disparities in the United States., Methods: We conducted a broad review of the peer-reviewed and gray literature on the effects of social, economic, and labor policies on occupational health disparities., Results: Many populations such as tipped workers, public employees, immigrant workers, and misclassified workers are not protected by current laws and policies, including worker's compensation or Occupational Safety and Health Administration enforcement of standards. Local and state initiatives, such as living wage laws and community benefit agreements, as well as multiagency law enforcement contribute to reducing occupational health disparities., Conclusions: There is a need to build coalitions and collaborations to command the resources necessary to identify, and then reduce and eliminate occupational disparities by establishing healthy, safe, and just work for all., (© 2013 Wiley Periodicals, Inc.)

The occupational health and safety conditions of a sample of Brazilian housecleaners in Massachusetts are examined in this article. We administered a main survey to a convenience sample of 626 Brazilian immigrant workers of all trades and a supplemental survey to 163 Brazilian housecleaners in Massachusetts in 2005 and 2006. Survey questions addressed housecleaner demographics, socioeconomic status, working conditions, and hazards of housecleaning work. Housecleaners are exposed to a variety of ergonomic, chemical, and biological hazards. Professional housecleaners' work is fast-paced, requires awkward postures, and involves repetitive movements, use of force, and heavy lifting. The most common symptoms reported include back pain, and pain in the muscles, arms, legs, neck, shoulder, hands, fingers, and feet. To reduce exposures to occupational hazards, we propose the substitution of green cleaners for toxic chemical cleaning products, the use of ergonomic equipment, the use of personal protective equipment, and changes in work organization.

The scope of this study was to discuss the administrative sustainability of Brazil's Vocational Health Schools (ETSUS) based on the principle of teaching and service integration, which brings a new dimension to healthcare work as yet unregulated by Brazilian public administration. It was a qualitative study using case study methodology. The research involved a semi-structured questionnaire given to ETSUS managers addressing institutional, administrative, and work management aspects. The sample was composed of 6 ETSUS that belong to the Network of Vocational Health Schools (RET-SUS). The ETSUS showed centralized planning and management, and decentralized implementation of their core activities. The majority did not have administrative autonomy and relied heavily on funding from the federal government. According to ETSUS managers, the lack of regulation of teaching activities by civil servants weakens the management of ETSUS. The ETSUS have managerial problems related to teaching-service integration, which has to be regulated in order to guarantee the sustainability of these schools and avoid conflicts with Brazilian legislation.

Background: Photovoice, a photographic participatory action research methodology was used in a workplace setting to assess hazards that were creating extremely high injury and incidents rates for university custodians and to promote the conditions to eliminate or reduce those hazards., Methods: University custodians participated in a Photovoice project to identify, categorize, and prioritize occupational hazards and to discuss and propose solutions to these problems. Results were presented to management and to all custodians for further discussion. The effort was led by a worker-based union-sponsored participatory evaluation team in partnership with a university researcher., Results: Visual depiction of hazardous tasks and exposures among custodians and management focused primarily on improper or unsafe equipment, awkward postures, lifting hazards, and electrical hazards. The process of taking pictures and presenting them created an ongoing discussion among workers and management regarding the need for change and for process improvements, and resulted in greater interest and activity regarding occupational health among the workers. In a follow-up evaluation 1-year later, a number of hazards identified through Photovoice had been corrected. Injury rates for custodians had decreased from 39% to 26%., Conclusions: Photovoice can be an important tool, not just for identifying occupational hazards, but also empowering workers to be more active around health and safety and may facilitate important changes in the workplace., (© 2010 Wiley-Liss, Inc.)

Informal labor markets have grown in peripheral countries, accounting for more than 50% of jobs. There is anecdotal evidence of a direct relation between informal sector growth and an increase in the frequency and severity of work-related diseases and injuries. Two sister pilot projects were conducted in Uberaba and Campinas, Brazil to develop population-based epidemiological surveillance of workplace injuries in the informal sector. Results for Campinas and Uberaba found cumulative yearly incidences of 5.1% and 10.4%, with incidence rates of 2.2 and 6.5 injuries per 100,000 worked hours, respectively. The proportions of lost work time were 0.3% and 0.31%. Rates found were comparable to those found in the literature for both formal and informal jobs. These results suggest that bad working conditions in the formal labor market are replicated in the informal market as subcontracting and outsourcing contribute to the growth of informal jobs.

This research intends to analyze the model adopted in the construction of community advisory committees. The empirical object is the Community Advisory Committee of Camaçari Complex (BA), the first one to be set up in the country and that has been used as a reference for the implementation of others. Participant observation and seventeen interviews were the main sources of data. The advisory committee constitutes itself in a sophisticated mechanism of docilization and responsabilization for the spread of an organizational hegemonic ideology and neoliberal modes of governance.