Mechanism of Tumor T Cell Exhaustion from Perspective of ''Sanjiao-Yingwei'' Qi Transformation Malfunction / 中国实验方剂学杂志

In order to promote the innovative application of Sanjiao theory and Yingwei theory， this paper tries to apply the ''Sanjiao-Yingwei'' Qi transformation theory to the treatment of tumor diseases， integrating it with T cell exhaustion mechanism to elaborate on its scientific connotation and using network pharmacology and bioinformatics to elucidate the correlation between the anti-tumor mechanism of ''Sanjiao-Yingwei'' Qi transformation and T cell exhaustion. The ''Sanjiao-Yingwei'' Qi transformation function is closely related to the immunometabolic ability of the human body， and the ''Sanjiao-Yingwei'' Qi transformation system constitutes the immunometabolic exchange system within and outside the cellular environment. Cancer toxicity is generated by the fuzzy Sanjiao Qi， and the long-term fuzzy Sanjiao Qi is the primary factor leading to T cell exhaustion， which is related to the long-term activation of T cell receptors by the high tumor antigen load in the tumor microenvironment. Qi transformation malfunction of the Sanjiao produces phlegm and collects stasis， which contributes to T cell exhaustion and is correlated with nutrient deprivation， lipid accumulation， and high lactate levels in the immunosuppressed tumor microenvironment， as well as with the release of transforming growth factor-β and upregulated expression of programmed death receptor-1 by tumor-associated fibroblasts and platelets in the tumor microenvironment. Ying and Wei damage due to Sanjiao Qi transformation malfunction is similar to the abnormal manifestations such as progressive loss of exhausted T cell effector function and disturbance of cellular energy metabolism. Guizhi decoction， Shengming decoction， and Wendan decoction can correct T cell exhaustion and exert anti-tumor effects through multi-target and multi-pathways by regulating ''Sanjiao-Yingwei'' Qi transformation， and hypoxia inducible factor-1α （HIF-1α） may be one of the main pathways to correct T cell exhaustion. It was found that HIF-1α may be one of the important prognostic indicators in common tumors by bioinformatics. The use of the ''Sanjiao-Yingwei'' Qi transformation method may play an important part in improving the prognosis of tumor patients in clinical practice.

Preocupación por el contagio de la COVID-19 y carga laboral como predictores del malestar psicológico durante la emergencia sanitaria en personal de salud de Perú

Introducción: Durante la emergencia sanitaria, preocupan las repercusiones en la salud mental que pudieran estar experimentando los trabajadores sanitarios peruanos, quienes representan la primera línea de atención contra la COVID-19. Objetivo: Determinar si la preocupación por la COVID-19 y la carga laboral predicen el malestar psicológico en personal de salud. Métodos: Estudio predictivo en 367 trabajadores (enfermeros, médicos, técnicos en enfermería, obstetras, odontólogos, psicólogos, nutricionistas, entre otros) de ambos sexos en 12 redes de salud de la región de Puno, seleccionados a través de un muestreo no probabilístico intencional. Los datos se recogieron a través de la Escala de malestar psicológico de Kessler, la Escala de preocupación por el contagio de la COVID-19 y la Escala de carga de trabajo (ECT). Resultados: Se encontró que no hay diferencias significativas entre varones y mujeres en el malestar psicológico, la preocupación por el contagio de la COVID-19 y la carga laboral; además, se hallaron correlaciones muy significativas entre las variables de estudio (p < 0,01). El análisis de regresión múltiple demostró un ajuste adecuado para el modelo (F = 94,834; p < 0,001), en el que la preocupación por la COVID-19 (ß =-0,436; p < 0,01) y la carga laboral (ß = 0,239; p < 0,01) son variables que predicen significativamente el malestar psicológico (R2 ajustado = 0,33). Conclusiones: La preocupación por la COVID-19 y la sobrecarga de trabajo predicen el malestar psicológico en el personal sanitario de la región de Puno.

Introduction: During the health emergency, there is concern about the mental health repercussions that Peruvian health workers, who represent the front line of care for COVID-19, may be experiencing. Objective: To determine whether concern about COVID-19 and workloads predict psychological distress in healthcare workers. Methods: Predictive study in which 367 workers (nurses, doctors, nursing assistants, obstetricians, dentists, psychologists, nutritionists, among others) from 12 health networks in the Puno region participated, selected through intentional non-probabilistic sampling. The data were collected via the Kessler Psychological Distress Scale, the COVID-19 Scale of Concern and the Workload Scale. Results: It was found that there are no significant differences between men and women in psychological discomfort and concern about COVID-19 infection and workload. Furthermore, highly significant correlations were found between the study variables (p <0.01). Multiple regression analysis showed an adequate adjustment for the model (F = 94.834; p <0.001), where concern about COVID-19 (ß = -0.436; p <0.01) and workload (ß = 0.239; p <0.01) are variables that significantly predict psychological discomfort (adjusted R2 = 0.33). Conclusions: Concern about COVID-19 and work overload predict psychological distress in health personnel in the Puno region.

Covid-19: a sobrecarga de trabalhona luta pela vida. Representações sociaisde profissionais de enfermagem / Covid-19: work overload in the fight for life. Social representations of nursing professionals

Conhecer as representações sociais de profissionais de enfermagem que atuaram no atendimento aos pacientes acometidos pela COVID-19 diante da sobrecarga de trabalho. Método: Estudo de natureza descritiva com abordagem qualitativa utilizando como referencial a Teoria das Representações Sociais. O cenário foi um hospital que atendeu pacientes acometidos pela COVID-19. Os participantes foram profissionais de enfermagem. Os dados se deram através de entrevistas semiestruturadas. A análise ocorreu conforme a perspectiva de Bardin. Resultados: As representações retrataram condições de trabalho identificando desgaste mental diante em um cenário de inúmeras incertezas, de modo a suprir as necessidades exigida pela crise sanitária, impactando diretamente na sua saúde mental. Conclusão: Possibilidade da construção de um modelo de assistência que reestruture no processo de trabalho da enfermagem, minimizando possíveis sobrecarga de trabalho associados à sua saúde mental, otimizando assim a melhoria das suas condições de trabalho, fortalecendo respostas rápidas e precisas quando necessárias.(AU)

Objective: To learn about the social representations of nursing professionals who worked in the care of patients affected by COVID-19 in the face of work overload. Method: A descriptive study with a qualitative approach, using the Theory of Social Representations as a reference. The setting was a hospital that treated patients affected by COVID-19. The participants were nursing professionals. The data was collected through semi-structured interviews. The analysis took place according to Bardin's perspective. Results: The representations portrayed working conditions identifying mental exhaustion faced in a scenario of countless uncertainties, in order to meet the needs demanded by the health crisis, directly impacting on their mental health. Conclusion: The possibility of building a care model that restructures the nursing work process, minimizing possible work overload associated with their mental health, thus optimizing the improvement of their working conditions, strengthening quick and precise responses when necessary.(AU)

Objetivo: Conocer las representaciones sociales de los profesionales de enfermería que han trabajado en el cuidado de pacientes afectados por COVID-19 ante la sobrecarga de trabajo. Método: Estudio descriptivo con enfoque cualitativo, tomando como referencia la Teoría de las Representaciones Sociales. El escenario fue un hospital que atendía a pacientes afectados por COVID-19. Los participantes fueron profesionales de enfermería. Los datos se recogieron mediante entrevistas semiestructuradas. El análisis se realizó según la perspectiva de Bardin. Resultados: Las representaciones retrataron condiciones de trabajo que identifican agotamiento mental enfrentado en un escenario de innumerables incertidumbres, para atender a las necesidades demandadas por la crisis de salud, impactando directamente en su salud mental. Conclusión: Es posible construir un modelo de atención que reestructure el proceso de trabajo de enfermería, minimizando la posible sobrecarga de trabajo asociada a su salud mental, optimizando así la mejora de sus condiciones de trabajo, fortaleciendo respuestas rápidas y precisas cuando sea necesario.(AU)

Síndrome de Burnout en médicos residentes de medicina interna

Introducción: el síndrome de Burnout se define como una respuesta al estrés laboral crónico, integrado por actitudes y sentimientos negativos hacia las personas con las que se trabaja y hacia el propio rol profesional. Se considera como la fase avanzada del estrés profesional. Objetivos: evaluar la prevalencia del síndrome de Burnout en médicos residentes del área de medicina interna en un hospital de tercer nivel. Materiales y métodos: se realizó un estudio observacional, descriptivo y transversal mediante una encuesta en línea a través de Google Forms™, a médicos residentes del área de medicina interna aplicando el test Maslach Burnout Inventory (MBI). Resultados: de los 60 residentes, que incluyen a los de primer, segundo y tercer año, se obtuvo una participación de 71,6%. El 58,1% corresponde al sexo femenino y 41,9% al sexo masculino. El grupo etario con mayor participación (79,1%) tiene 26 a 30 años. Si se tiene en cuenta la presencia de 2 de 3 variables (cansancio emocional, despersonalización, falta de realización personal), la prevalencia de síndrome de Burnout fue 46,5% (20 de 43 encuestados). Conclusión: la prevalencia de síndrome de Burnout en base a 2 de sus 3 criterios fue 46,5%.

Introduction: Burnout syndrome is defined as a response to chronic work stress, made up of negative attitudes and feelings towards the people with whom one works and towards one's own professional role. It is considered as the advanced phase of professional stress. Objectives: To evaluate the prevalence of Burnout syndrome in internal medicine residents in a tertiary level hospital. Materials and methods: An observational, descriptive and cross-sectional study was carried out by means of an online survey through Google Forms™ applied to resident physicians in the area of ​​internal medicine applying the Maslach Burnout Inventory (MBI) test. Results: Of the 60 residents, which include first, second and third-year students, 71.6% participated, 58.1% correspond to women and 41.9% to men. The age group with the highest participation (79.1%) is between 26 and 30 years old. If the presence of 2 of 3 variables is taken into account (emotional exhaustion, depersonalization, lack of personal fulfillment), the prevalence of Burnout syndrome was 46.5% (20 of 43 respondents). Conclusion: The prevalence of Burnout syndrome based on 2 of its 3 criteria was 46.5%.

Evaluation of peripheral blood T-lymphocyte subpopulations features in patients with hepatitis B virus-related acute-on-chronic liver failure based on single-cell sequencing technology / 中华肝脏病杂志

Objective: T lymphocyte exhaustion is an important component of immune dysfunction. Therefore, exploring peripheral blood-exhausted T lymphocyte features in patients with hepatitis B virus-related acute-on-chronic liver failure may provide potential therapeutic target molecules for ACLF immune dysfunction. Methods: Six cases with HBV-ACLF and three healthy controls were selected for T-cell heterogeneity detection using the single-cell RNA sequencing method. In addition, exhausted T lymphocyte subpopulations were screened to analyze their gene expression features, and their developmental trajectories quasi-timing. An independent sample t-test was used to compare the samples between the two groups. Results: Peripheral blood T lymphocytes in HBV-ACLF patients had different differentiation trajectories with different features distinct into eight subpopulations. Among them, the CD4(+)TIGIT(+) subsets (P = 0.007) and CD8(+)LAG3(+) (P = 0.010) subsets with highly exhausted genes were significantly higher than those in healthy controls. Quasi-time analysis showed that CD4(+)TIGIT(+) and CD8(+)LAG3(+) subsets appeared in the late stage of T lymphocyte differentiation, suggesting the transition of T lymphocyte from naïve-effector-exhausted during ACLF pathogenesis. Conclusion: There is heterogeneity in peripheral blood T lymphocyte differentiation in patients with HBV-ACLF, and the number of exhausted T cells featured by CD4(+)TIGIT(+)T cell and CD8(+)LAG3(+) T cell subsets increases significantly, suggesting that T lymphocyte immune exhaustion is involved in the immune dysfunction of HBV-ACLF, thereby identifying potential effective target molecules for improving ACLF patients' immune function.

Fadiga por compaixão em enfermeiros intensivistas: revisão integrativa / Compassion fatigue in intensive care nurses: integrative review / Fatiga por compasión en enfermeras de cuidados intensivos: revisión integradora

Introdução: A fadiga por compaixão é caracterizada pelo desenvolvimento de exaustão emocional, física e/ou espiritual como resultado do trabalho com indivíduos em estado crítico. Objetivos: analisar as evidências empíricas atuais relacionadas à prevalência, causas e resultados da fadiga por compaixão entre enfermeiros de cuidados intensivos. Método: Trata-se de uma revisão integrativa por meio de uma pesquisa avançada em bancos de dados: Pubmed, Scielo e Medline. A amostra foi composta por dez artigos que atenderam aos critérios de inclusão. A busca limitou-se a pesquisas realizadas de 2017 a 2022. Resultados: Os principais achados desta revisão integrativa foram que a prevalência de fadiga por compaixão entre os enfermeiros variou entre os diversos ambientes de cuidados intensivos. Em relação às causas e consequências da fadiga por compaixão, esta revisão descobriu que o ambiente de trabalho e a demografia dos enfermeiros, como idade e anos de experiência, foram preditores de fadiga por compaixão, e os fatores que atenuam os efeitos da fadiga por compaixão entre enfermeiros intensivista incluíram líder e suporte administrativo dentro do cenário clínico e as estratégias de enfrentamento empregadas pelos enfermeiros. Há evidências inconclusivas para identificar preditores explícitos de fadiga por compaixão entre enfermeiros intensivistas. Conclusão: É provável que o início da fadiga por compaixão entre os enfermeiros de cuidados intensivos possa ser reduzido com uma monitorização cuidadosa do bem-estar físico e emocional no ambiente de cuidados intensivos, bem como através da oferta de educação em saúde aos enfermeiros para ajudar no desenvolvimento de estratégias de enfrentamento para evitar fadiga da compaixão.

Introduction: Compassion fatigue is characterized by the development of emotional, physical, and/or spiritual exhaustion as a result of working with critically ill individuals. Aims: To analyze the current empirical evidence related to the prevalence, causes, and outcomes of compassion fatigue among critical care nurses. Method: This is an integrative review by means of an advanced search in databases: Pubmed, Scielo and Medline. The sample was composed of ten articles that met the inclusion criteria. The search was limited to research conducted from 2017 to 2022. Results: The main findings of this integrative review were that the prevalence of compassion fatigue among nurses varied across different acute care settings. Regarding the causes and consequences of compassion fatigue, this review found that work environment and nurse demographics, such as age and years of experience, were predictors of compassion fatigue, and factors that mitigate the effects of compassion fatigue among intensivist nurses included leader and administrative support within the clinical setting and the coping strategies employed by nurses. There is inconclusive evidence to identify explicit predictors of compassion fatigue among intensivist nurses. Conclusion: It is likely that the onset of compassion fatigue among intensive care nurses can be reduced with careful monitoring of physical and emotional well-being in the intensive care setting, as well as through the provision of health education to nurses to assist in the development of coping strategies to avoid compassion fatigue.

Introducción: La fatiga por compasión se caracteriza por el desarrollo de agotamiento emocional, físico y/o espiritual como resultado del trabajo con enfermos críticos. Objetivos: Analizar la evidencia empírica actual relacionada con la prevalencia, las causas y los resultados de la fatiga por compasión entre las enfermeras de cuidados intensivos. Método: Se trata de una revisión integradora a través de una búsqueda avanzada en las bases de datos: Pubmed, Scielo y Medline. La muestra se compuso de diez artículos que cumplían los criterios de inclusión. La búsqueda se limitó a investigaciones realizadas entre 2017 y 2022. Resultados: Los principales hallazgos de esta revisión integradora fueron que la prevalencia de la fatiga por compasión entre las enfermeras varió en los diferentes entornos de cuidados agudos. En relación con las causas y consecuencias de la fatiga por compasión, esta revisión encontró que el entorno de trabajo y los datos demográficos de las enfermeras, como la edad y los años de experiencia, fueron predictores de la fatiga por compasión, y los factores que mitigan los efectos de la fatiga por compasión entre las enfermeras de cuidados intensivos incluyeron el apoyo del líder y administrativo dentro del entorno clínico y las estrategias de afrontamiento empleadas por las enfermeras. No hay pruebas concluyentes para identificar predictores explícitos de la fatiga por compasión entre las enfermeras de cuidados intensivos. Conclusión: Es probable que la aparición de la fatiga por compasión entre las enfermeras de cuidados intensivos pueda reducirse con una cuidadosa monitorización del bienestar físico y emocional en el entorno de los cuidados intensivos, así como mediante la provisión de educación sanitaria a las enfermeras para ayudar en el desarrollo de estrategias de afrontamiento para evitar la fatiga por compasión.

Engajamento com o trabalho e exaustão emocional de profissionais da socioeducação / Engagement with work and emotional exhaustion of socio-education professionals / Comprometimiento con el trabajo y agotamiento emocional de profesionales de la socioeducación

Buscou-se compreender a percepção dos profissionais das medidas socioeducativas acerca do seu engajamento e exaustão com o trabalho. Para isso, realizou-se um estudo qualitativo, descritivo e exploratório, por meio de uma entrevista semiestruturada a três integrantes da equipe técnica e dois coordenadores de segurança (idades entre 28 e 57 anos). A análise dos dados foi conduzida com o auxílio do software Iramuteq, que gerou cinco classes temáticas: a) rotina das unidades socioeducativas e as demandas do trabalho dos profissionais; b) gestão de conflitos nas unidades, da mediação à polícia; c) recursos pessoais e institucionais relacionados ao exercício da profissão; d) aspectos relacionados ao contexto de trabalho; e, por último, e) indicadores de esgotamento laboral, adversidades e adoecimento profissional. Os participantes descreveram diversas demandas relacionadas à exaustão física e psicológica (e.g. equipe reduzida, insalubridade, baixo salário e fragilidade do vínculo empregatício), mas também ressaltaram a relevância social de sua prática profissional junto aos adolescentes e o relacionamento positivo entre os profissionais como fatores que justificam o seu engajamento e permanência nas instituições socioeducativas. Conclui-se evidenciando que os contextos têm influência direta na saúde desses profissionais, o que sublinha a importância de se olhar para suas condições de trabalho e para aspectos ligados à saúde mental, promovendo, desse modo, avanços na realidade socioeducativa.(AU)

The aim was to understand the perception of professionals of socio-educational measures about their engagement and exhaustion with work. To that end, a qualitative, descriptive, and exploratory study was carried out by means of a semi-structured interview with three members of the technical team and two safety coordinators (ages between 28 and 57 years). Data analysis was conducted with the help of the IRAMUTEQ software, which generated five thematic classes: a) routine of socio-educational units and work demands of professionals; b) conflict management in the units, from mediation to the police; c) personal and institutional resources related to the exercise of the profession; d) aspects related to the work context; and, lastly, e) indicators of labor exhaustion, adversity, and occupational illness. Participants described several demands related to physical and psychological exhaustion (e.g. reduced team, insalubrity, low salary, and fragility of the employment relationship), but also emphasized the social relevance of their professional practice with adolescents and the positive relationship among professionals as factors that justify their engagement and permanence in socio- educational institutions. It is concluded that the contexts have a direct influence on the health of these professionals, which highlights the importance of looking at their working conditions and aspects related to mental health, thus promoting advances in the socio-educational reality.(AU)

Se procuró comprender la percepción de los profesionales que trabajan con medidas socioeducativas sobre su comprometimiento y el agotamiento en el trabajo. Para esto, se realizó un estudio cualitativo, descriptivo y exploratorio, por medio de una entrevista semiestructurada a tres integrantes del equipo técnico y dos coordinadores de seguridad (edades entre 28 y 57 años). El análisis de los datos fue conducido en el software IRAMUTEQ, que generó cinco clases temáticas: a) rutina de las unidades socioeducativas: demandas del trabajo de los profesionales; b) manejo de conflictos en las unidades: desde la mediación hasta la policía; c) recursos personales e institucionales relacionados al ejercicio de la profesión; d) aspectos relacionados al contexto del trabajo; e) indicadores de agotamiento laboral, adversidades y enfermedad del profesional. Los participantes describieron diversas demandas relacionadas al agotamiento físico y psicológico (por ej.: equipo reducido, insalubridad, bajos sueldos y fragilidad del vínculo laboral), pero también destacaron la importancia social de su práctica profesional junto a los adolescentes y el vínculo positivo entre los profesionales como factores que justifican su comprometimiento y permanencia en las instituciones socioeducativas. Se concluye que los contextos influyen directamente en la salud de estos profesionales, lo que rescata la importancia de verificar sus condiciones de trabajo y los aspectos relacionados a la salud mental, promoviendo, de este modo, avances en la realidad socioeducativa.(AU)

Síndrome de Burnout en profesionales de la salud antes y durante la pandemia de COVID-19 / Burnout Syndrome Among Health Professionals Before and During the COVID-19 Pandemic

Objective: To describe the differences in burnout syndrome (BS) before and during the COVID-19 pandemic among health professionals, according to prevalence, levels, sociodemographic, occupational, risk, and protective factors. Methods: A comparative descriptive study was conducted, with two samples of similar characteristics from public hospitals in Peru. The sample was 177 for 2019 and 167 for 2021. The instrument used was the Maslach Burnout Inventory. Results: It was found that there is a higher prevalence of BS and lower personal fulfillment (PF) during the pandemic. For BS, female sex is a risk factor during the pandemic. For emotional exhaustion (EE), the female gender is a risk factor before and during the pandemic. For depersonalization (DP), being 39 years of age or older is a protective factor before the pandemic. Conclusions: There are significant differences in the scores of BS, EE, and PF; no significant differences for DP were found in both periods(AU)

Objetivo: Describir las diferencias en el síndrome de burnout (BS) antes y durante la pandemia de COVID-19 en los profesionales de la salud, según la prevalencia, niveles, factores sociodemográficos, ocupacionales, de riesgo y protectores. Materiales y Métodos: Se realizó un estudio descriptivo comparativo, con dos muestras de características similares de hospitales públicos en Perú. La muestra fue de 177 para 2019 y 167 para 2021. El instrumento utilizado fue el Inventario de Burnout de Maslach. Resultados: Se encontró que existe una mayor prevalencia de BS y menor realización personal (RP) durante la pandemia. Para BS, el sexo femenino es un factor de riesgo durante la pandemia. Para el agotamiento emocional (AE), el género femenino es un factor de riesgo antes y durante la pandemia. Para la despersonalización (DE), la edad de 39 años y más es un factor protector antes de la pandemia. Conclusiones: Existen diferencias significativas en las puntuaciones de BS, AE y RP; para DE no se encontraron diferencias significativas en ambos períodos(AU)

Prevalência da síndrome de burnout em profissionais de saúde durante a pandemia de COVID-19 / Prevalence of burnout syndrome in health professionals during the COVID-19 pandemic

Introdução: A síndrome de Burnout no âmbito profissional é uma condição causada por estresse de longo prazo no local de trabalho e que diante da pandemia causada pela COVID-19, foram evidenciados agravos à saúde psíquica de trabalhadores da saúde. Objetivo: Analisar as diferentes categorias e setores de atuação profissional, elencando os principais fatores de risco e as principais formas de enfrentamento adotadas pelos profissionais de saúde associados à síndrome de Burnout. Métodos: Foi realizada busca bibliográfica e aplicação de formulário eletrônico, aos profissionais de saúde que prestaram assistência médica direta a pacientes diagnosticados e hospitalizados com COVID-19 no município de Curitiba-PR entre o período de março de 2020 a novembro de 2021; contendo questionário com informações pessoais, profissionais e relacionadas com as condições específicas vivenciadas durante a pandemia/ medidas de enfrentamento e aplicação do questionário Maslach Burnout Inventory ­ Human Services Survey para análise da prevalência da Síndrome de Burnout. Resultados: A amostra foi composta por 89 profissionais de saúde. Evidenciou-se uma prevalência de 48,31% de Síndrome de Burnout. Não foram encontrados resultados estatisticamente significantes ao analisar diferentes categorias profissionais e setores de atuação. A mudança de setor durante a pandemia foi fato estatisticamente significante (p=0,0245), assim como a busca por apoio emocional/psiquiátrico/psicológico (p=0,0004) e a relevância acerca do uso de mediação durante a pandemia (p=0,0027). Conclusões: A mudança de setor durante a pandemia foi considerada o único fator de risco encontrada no estudo. As principais formas de enfrentamento à Síndrome de Burnout adotadas pelos profissionais de saúde durante a pandemia de COVID-19 foram a procura por apoio emocional, psicológico, psiquiátrico e o aumento do uso de medicação psicotrópica

Introduction: Burnout syndrome in the professional context is a condition caused by long-term stress in the workplace. In the face of the COVID-19 pandemic it has been observed that healthcare workers have experienced psychological health issues. Objective: This study aims to analyze different professional categories and sectors, identifying the main risk factors and coping mechanisms adopted by healthcare professionals associated with Burnout syndrome. Methods: A literature search was conducted, and an electronic form was administered to healthcare professionals who provided direct medical care to COVID-19 diagnosed and hospitalized patients in the city of Curitiba, Brazil, from March 2020 to November 2021. The questionnaire included personal and professional information, as well as specific conditions experienced during the pandemic, coping strategies, and the application of the Maslach Burnout Inventory - Human Services Survey to assess the prevalence of Burnout syndrome. Results: The sample consisted of 89 healthcare professionals, and a prevalence of 48.31% for Burnout syndrome was identified. No statistically significant results were found when analyzing different professional categories and sectors. However, changing sectors during the pandemic was statistically significant (p=0.0245), as well as seeking emotional/ psychiatric/psychological support (p=0.0004), and the importance of using mediation during the pandemic (p=0.0027). Conclusions: Changing sectors during the pandemic was identified as the only risk factor in this study. The main coping mechanisms adopted by healthcare professionals during the COVID-19 pandemic to address Burnout syndrome included seeking emotional, psychological, and psychiatric support, as well as an increased use of psychotropic medication.

Family caregivers of older adults and physical and psychological health conditions and family support in care / Cuidadores familiares de ancianos y condiciones de salud física y psicológica y apoyo familiar en el cuidado / Cuidadores familiares de idosos e condições de saúde física, psicológica e apoio familiar no cuidado

ABSTRACT Objective: to analyze the existence of overload in family caregivers of older adults in the physical and psychological health and family support dimensions. Method: a qualitative study conducted with 23 participants from Dianópolis, Tocantins, Brazil. Data were collected through semi-structured interviews in September 2022. Data analysis was performed using content analysis in Minayo's thematic modality, which includes ordering, classification and final analysis of data. Results: the results show that the exercised role of caregiver is related to social representation, which is enhanced: by the context, cultural and family values; by the naturalization of the role of women as caregivers; by increasing the burden due to excessive responsibility and lack of support from other family members; and by the presence of psychological symptoms overlapping physical symptoms in caregivers. Conclusion: it is concluded that the support of professionals is essential to rethink new practices and ways of producing care through individual or collective activities, with a view to preventing caregivers from becoming ill.

RESUMEN Objetivo: analizar la existencia de sobrecarga de cuidadores familiares de ancianos en las dimensiones de salud física y psicológica y apoyo familiar. Método: estudio cualitativo, realizado con 23 participantes de Dianópolis, Tocantins, Brasil. Los datos fueron recolectados a través de entrevistas semiestructuradas en septiembre de 2022. El análisis de datos se realizó mediante análisis de contenido en la modalidad temática de Minayo, que incluye ordenamiento, clasificación y análisis final de datos. Resultados: los resultados muestran que el ejercicio del rol de cuidador está relacionado con la representación social, que se ve potenciada: por el contexto, los valores culturales y familiares; por la naturalización del rol de la mujer como cuidadora; al aumentar la carga por exceso de responsabilidad y falta de apoyo de otros miembros de la familia; y por la presencia, en los cuidadores, de síntomas psicológicos superpuestos a los físicos. Conclusión: se concluye que el apoyo de los profesionales es fundamental para repensar nuevas prácticas y formas de producir cuidado, a través de actividades individuales o colectivas, con miras a prevenir que los cuidadores se enfermen.

RESUMO Objetivo: analisar a existência de sobrecarga de cuidadores familiares de idosos nas dimensões de saúde física, psicológica e apoio familiar. Método: estudo qualitativo, realizado com 23 participantes de Dianópolis, Tocantins, Brasil. Os dados foram coletados mediante entrevistas semiestruturadas em setembro de 2022. A análise dos dados foi efetuada utilizando-se a análise de conteúdo na modalidade temática de Minayo, que abrange a ordenação, a classificação e a análise final dos dados. Resultados: os resultados evidenciam que o exercício da função de cuidador está relacionado à representação social, a qual é potencializada: pelo contexto, valores culturais e familiares; pela naturalização da função da mulher como cuidadora; pela potencialização da sobrecarga em razão do excesso de responsabilidade e falta de apoio de outros membros da família; e pela presença, nos cuidadores, de sintomas psicológicos sobrepondo-se aos físicos. Conclusão: conclui-se que o apoio dos profissionais é essencial para repensar novas práticas e formas de produzir o cuidado, por meio de atividades individuais ou coletivas, com vistas a prevenir o adoecimento dos cuidadores.

Repercusiones vocales tras el uso ocupacional de la voz y estrés en profesoras de primaria bajo la modalidad de teletrabajo en la comuna de Temuco. Un estudio piloto / Vocal Repercussions after Occupational Voice Use and Stress in Primary School Teachers under the Teleworking Modality in Temuco City. A Pilot Study

Introducción. El teletrabajo producto del COVID-19 ha generado exigencias que podrían promover la generación de un sobreesfuerzo vocal. Objetivo. Evaluar cómo las condiciones de trabajo pueden afectar la salud vocal, evaluar el estrés laboral y valorar los cambios en la calidad vocal de profesoras de primaria de la comuna de Temuco.Método. Se evaluó a 18 profesoras de primaria de la comuna de Temuco, Chile, quienes se encontraban trabajando en modalidad de teletrabajo durante el año 2021, realizando una evaluación al comienzo y al final del año escolar, a través del Voice Handicap Index (VHI-30), Vocal Tract Disconfort (VTD), Maslach Burnout Inventory (MBI) y análisis acústico mediante medidas de perturbación y espectro promedio a largo plazo. Resultados. Solo el 21% de las profesoras contaba con un espacio físico adecuado para el teletrabajo. El 52,6% debía compartir responsabilidades del hogar, como el cuidado de hijos menores durante su jornada de teletrabajo. Los resultados muestran un aumento de la sintomatología y sensaciones de incomodidad a nivel del tracto vocal medidas mediante el VHI-30 y el VTD. En cuanto al estrés laboral medido por la escala de Burnout, solo se evidenció un valor significativo para la subescala agotamiento emocional. No se evidenciaron diferencias significativas en los parámetros acústicos Jitter, Shimmer, HNR y Alpha ratio. Conclusiones. La gran mayoría de las participantes manifestó un aumento del malestar y sintomatología vocal autopercibida (sequedad de garganta, fatiga vocal) en conjunto con un mayor nivel de estrés, lo que a la larga puede desencadenar trastornos de voz

Introduction. Teleworking as a result of COVID-19 has generated high demands that could promote the generation of vocal overexertion.Aim. To evaluate how working conditions assess changes in vocal health, evaluate work stress, and assess changes in the vocal quality of primary school teachers in the Temuco commune.Method. Eighteen elementary school teachers from the commune of Temuco, Chile, who were teleworking during the year 2021, were evaluated not only at the beginning but also at the end of the school year through the Voice Handicap Index (VHI-30), Vocal Tract Discomfort (VTD), Maslach Burnout Inventory (MBI), and acoustic analysis using long-term average spectrum and disturbance measurements.Results. Only 21% of the teachers had adequate physical space for teleworking. In addition, 52.6% had to share household responsibilities such as taking care of minor children during their teleworking day. The results show an increase in symptoms and sensations of discomfort at the level of the vocal tract measured by the VHI-30 and the VTD. Regarding job stress measured by the Burnout scale, only a significant value for the emotional exhaustion subscale was found. Besides, there were not found any significant differences in the acoustic parameters Jitter, Shimmer, HNR, and Alpha ratio.Conclusions. The vast majority of the participants reported increased discomfort and self-perceived vocal symptoms (dry throat, vocal fatigue) together with a higher level of stress, which in the long run can trigger voice disorders

Expression of TIGIT, PD-1 and HLA-DR/CD38 markers on CD8-T cells of children and adolescents infected with HIV and uninfected controls

ABSTRACT Immune exhaustion and senescence are scarcely studied in HIV-pediatric patients. We studied the circulatory CD8 T cells activation/exhaustion and senescent phenotype of children and adolescents vertically infected with HIV or uninfected controls based on the expression of human leukocyte antigen (HLA-DR), CD38, T cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motif (ITIM) domain (TIGIT), programmed death 1 (PD-1) and CD57 by flow cytometry, during approximately one year. Eleven HIV-infected (HI) and nine HIV-uninfected (HU) children/adolescents who received two doses or one dose of meningococcal C conjugate vaccine (MenC), respectively, were involved in this study. Blood samples were collected before the immunization (T0), 1-2 months after the first dose (T1), and 1-2 months after the second dose (T2), which was administered approximately one year after the first one. HI patients not receiving combined antiretroviral therapy (cART) showed a higher frequency of CD8 T cells TIGIT+, PD-1+ or CD57+, as well as a higher frequency of CD8 T cells co-expressing CD38/HLA-DR/TIGIT or CD38/HLA-DR/PD-1 when compared to HI treated or HU individuals, at all times that they were assessed. CD8 T cells co-expressing CD38/DR/TIGIT were inversely correlated with the CD4/CD8 ratio but positively associated with viral load. The co-expression of CD38/DR/TIGIT or CD38/DR/PD-1 on CD8 T cells was also inversely associated with the CD4 T cells expressing co-stimulatory molecules CD127/CD28. The results showed a higher expression of exhaustion/senescence markers on CD8 T cells of untreated HI children/adolescents and its correlations with viral load.

Relationship between emotional exhaustion and work stress, thought suppression, difficulties in emotion regulation in clinical nurses / 中国职业医学

Objective To explore the current status of emotional exhaustion among clinical nurses and its relationship with work stress, thought suppression, difficulties in emotion regulation. Methods A totally of 1 159 clinical nurses from 10 cities in Henan Province and Fujian Province were enrolled as the research subjects using grabbing random balls method. And their status of work stress, thought suppression, difficulties in emotion regulation and emotional exhaustion were investigated by Depression-Anxiety-Stress Scale, White Bear Suppression Inventory, Brief Version of the Difficulties in Emotion Regulation Scale and Emotional Exhaustion Scale. Results The scores for work stress, thought suppression, difficulties in emotion regulation, emotional exhaustion were (23.5±3.8), (47.4±6.5), (54.1±7.2), (11.7±4.2), respectively. Among them, 40.0% of nurses experienced emotional exhaustion. Bootstrap analysis results showed that work stress positively affected emotional exhaustion among clinical nurses [standardized partial regression coefficient (β)=0.42, 95% confidence intervals (CI)： 0.36-0.44］. Work stress affected emotional exhaustion through thought suppression (β=0.16, 95%CI： 0.14-0.20), difficulties in emotion regulation (β=0.16, 95%CI： 0.14-0.19), and the chain mediating role of thought suppression and difficulties in emotion regulation (β=0.07, 95%CI： 0.04-0.09). Conclusion Emotional exhaustion symptoms are prevalent among clinical nurses. Work stress directly and indirectly influences thought suppression, difficulties in emotion regulation and emotional exhaustion of nurses.

Exaustão algorítmica: influenciadores digitais, trabalho de plataforma e saúde mental / Algorithmic exhaustion: digital influencers, platform work, and mental health / Agotamiento algorítmico: influencers digitales, trabajo en plataformas y salud mental

Este trabalho tem como objetivo articular as noções de tecnologia, trabalho, saúde e influenciadores digitais e reivindicar essa articulação como objeto de investigação para o campo da comunicação. Especificamente, busca-se entender as particularidades do esgotamento vivido por influenciadores digitais, a partir de revisão bibliográfica e exposição de exemplos (coletados a partir de observação espontânea). Como resultado, propõe-se a noção de 'exaustão algorítmica', uma sensação relatada por influenciadores digitais relacionada aos 'problemas psicológicos' vivenciados por eles e gerados pelo ritmo de trabalho que vem sendo ditado pelo que reconhecem como 'o algoritmo'. A 'exaustão'caracteriza-se por um sentimento permanente de insatisfação, desânimo e esgotamento, ausência de criatividade, medo de penalidades das plataformas e de 'não dar conta'.

This work aims to articulate the notions of technology, work, health and digital influencers and claim this articulation as an object of investigation for the field of communication. Specifically, we seek to understand the particularities of the exhaustion experienced by digital influencers from a literature review and exposition of examples (obtained by spontaneous observation). As a result, the notion of 'algorithmic exhaustion' is proposed, a sensation reported by digital influencers that one is going through 'psychological problems' generated by the pace of work dictated by what they recognize as 'the algorithm'. 'Exhaustion' is characterized by a permanent feeling of dissatisfaction, discouragement and exhaustion, lack of creativity, fear of platform penalties and 'not getting it done'.

Este trabajo tiene como objetivo articular las nociones de tecnología, trabajo, salud e influencers digitales y reivindicar esa articulación como objeto de investigación para el campo de la comunicación. En concreto, buscamos comprender las particularidades del agotamiento que experimentan los influencers digitales a partir de una revisión bibliográfica y exposición de ejemplos (obtenidos por observación espontánea). Como resultado, se propone la noción de 'agotamiento algorítmico', sensación reportada por influencersdigitales de que se está pasando por 'problemas psicológicos' generados por el ritmo de trabajo dictado por lo que reconocen como 'el algoritmo'. El agotamiento se caracteriza por un sentimiento permanente de insatisfacción, desánimo y agotamiento, falta de creatividad, miedo a las sanciones de la plataforma y al 'no hacerlo'.

O protocolo ASSYST-RG reduz estresse em profissionais da saúde na pandemia / The ASSYST protocol reduces stress in health care workers in the pandemic

Introdução: o aparecimento de casos de COVID-19 acarretou o surgimento de estresse agudo na população em geral, em especial nos profissionais da saúde e, dentre eles, nos de saúde mental, que passaram a ter alta demanda para atendimento a pessoas acometidas de transtornos relacionados a trauma e a estressores, em decorrência de isolamento social, internação hospitalar, óbitos, piora da situação financeira com a perda de emprego, dentre outros. Objetivo: este trabalho, realizado com o Protocolo para Estabilização da Síndrome do Estresse Agudo remoto, em formato grupal, tem por Objetivo fornecer os primeiros cuidados psicológicos, visando a reduzir as perturbações e melhorar o funcionamento adaptativo, evitando a evolução para quadros psicológicos mais disfuncionais, como o transtorno de estresse pós-traumático (TEPT). Metodologia: foram selecionados 23 participantes (psicólogos) e todos responderam às escalas de avaliação psicométrica (HADS e PCL-5) antes e depois de duas (2) sessões de terapia on-line (videoconferência), com aplicação do referido Protocolo. Resultados: o modelo de regressão mostra redução média no escore de ansiedade de -2,3 (ep 0,9), com p-valor = 0,0010 (significante); no escore de depressão, média de 1,13 (p=0,125); e no escore de TEPT, redução média de ­9,5 (3,3), com p-valor=0,006. Discussão: os Resultados estatísticos revelaram aproximação com os Resultados da pesquisa realizada por Becker et al. Assim como esses autores, nenhum efeito adverso foi relatado pelos participantes durante a intervenção, confirmando a eficácia, a viabilidade e a segurança do Assyst-RG. Conclusão: os Resultados evidenciam que o Assyst-RG foi eficaz na diminuição da ansiedade, da depressão e do TEPT.

Introduction: the emergence of cases of COVID-19 led to the emergence of acute stress in the general population, especially in health professionals and, among them, in mental health, who began to have a high demand for care for people suffering from disorders. related to trauma and stressors as a result of: social isolation, hospitalization, deaths, worsening of the financial situation with loss of job, among others. Objective: this work with the Protocol for the Stabilization of Acute Remote Stress Syndrome in Group Format aims to provide the first psychological care to reduce disturbances and improve adaptive functioning, avoiding the evolution to more dysfunctional psychological conditions such as Post Stress Disorder -Traumatic (PTSD). Methodology: twenty-three (23) participants (psychologists) were selected and all responded to psychometric assessment scales (HADS and PCL-5) before and after 2 (two) online therapy sessions (videoconference) with application of the protocol. Results: the regression model shows a mean reduction in the anxiety score of -2.3 (ep 0.9), with p-value = 0.0010; significant; in the depression score, mean of 1.13 (p=0.125); and in the PTSD score, a mean reduction of ­9.5 (3.3), with p-value=0.006. Discussion: the statistical Results revealed an approximation with the Results of the research carried out by Becker et al (2021). According to these authors, no adverse effects were reported by the participants during the intervention, confirming the efficacy, feasibility and safety of ASSYST-RG. Conclusion: the Results show that ASSYST-RG was effective in reducing anxiety, depression and PTSD.

SYNTHESIS AND CHARACTERIZATION OF REACTIVE DYES BASED ON 4-AMINO-N-(5-METHYLISOXAZOL-3-YL)-BENZENESULFONAMIDE AND THEIR DYEING APPLICATION ON VARIOUS FIBRES.

A new series of cold brand reactive dyes (D1 to D12) were synthesized by the coupling of diazotized 4-Amino-N-(5- methylisoxazol-3-yl)-benzenesulfonamide with various cyanurated coupling components in good yield. These reactive dyes were confirmed by 1H NMR analysis and FTIR. The synthesized dyes have been applied to cotton, silk, and wool fibres. They exhibited a variety of color shades with good dept and informality on the fibres. % Exhaustion and % fixation of dyes were determined by using Glauber salt as a fixing agent at various temperature conditions.

Síndrome de burnout entreprofissionais de enfermagem / Burnout syndrome among nursing professionals / Síndrome de burnout en profesionales de enfermeira

Objetivo: analisar as produções científicas disponíveis na literatura sobre incidência da Síndrome de Burnout nos profissionais da equipe de enfermagem. Métodos: Revisão integrativa da literatura realizada em março de 2020, nas bases de dados LILACS, SCIELO, BDENF e PubMed. Amostra composta por nove artigos, após seleção baseada nos critérios de inclusão e exclusão previamente estabelecidos. Utilizou-se os descritores controlados dos Descritores em Ciência da Saúde (DeCS) "Esgotamento Profissional", "Equipe de Enfermagem", "Prevalência" e as do Medical Subject Headings (MeSH) foram "Burnout Professional", "Nursing Team", "Prevalence", utilizando o operador booleano and para realização da pesquisa. Resultados: A Síndrome de Burnout entre os profissionais de enfermagem tem alta incidência, mostrando valores mais acentuados em serviços de atendimento móvel de urgência, mas sendo evidenciado algo distinto, uma realidade também no âmbito da atenção primária à saúde. O perfil dos profissionais mais acometidos pela síndrome foram os do sexo feminino, com um menor tempo de formação e menor tempo de atuação na unidade, duplo vínculo empregatício, altas demandas de trabalho com baixo controle e apoio social. Conclusão: Percebe-se a necessidade de reestruturações organizacionais abrindo espaços institucionais para discussões entre gestores e profissionais da enfermagem, no direcionamento da elaboração de estratégias que visem à promoção da saúde dos trabalhadores. (AU)

Objective: To analyze the scientific productions available in the literature on the incidence of Burnout Syndrome in the professionals of the nursing team. Methods: Integrative literature review conducted in March 2020, in the LILACS, SCIELO, BDENF and PubMed databases. Sample composed of nine articles, after selection based on the inclusion and exclusion criteria previously established. The controlled descriptors of the Health Science Descriptors (DeCS) "Professional Exhaustion", "Nursing Team", "Prevalence" and the Medical Subject Headings (MeSH) were used "Burnout Professional", "Nursing Team", " Prevalence ", using the Boolean operator and to perform the research. Results: The Burnout Syndrome among nursing professionals has a high incidence, showing more pronounced values in mobile emergency care services, but with something different, a reality also in the context of primary health care. The profile of the professionals most affected by the syndrome were women, with less training time and shorter time in the unit, double employment, high demands for work with low control and social support. Conclusion: There is a need for organizational restructuring, opening institutional spaces for discussions between managers and nursing professionals, in the direction of developing strategies aimed at promoting workers' health. (AU)

Objetivo: Analizar las producciones científicas disponibles en la literatura sobre la incidencia del Síndrome de Burnout en los profesionales del equipo de enfermería. Métodos: Revisión bibliográfica integrativa realizada en marzo de 2020, en las bases de datos LILACS, SCIELO, BDENF y PubMed. Muestra compuesta por nueve artículos, previa selección en base a los criterios de inclusión y exclusión previamente establecidos. Se utilizaron los descriptores controlados de los Descriptores de Ciencias de la Salud (DeCS) "Agotamiento Profesional", "Equipo de Enfermería", "Prevalencia" y los de los Encabezamientos de Materia Médica (MeSH) fueron "Burnout Profesional", "Equipo de Enfermería", "Prevalencia" , utilizando el operador booleano y para realizar la investigación. Resultados: El Síndrome de Burnout entre los profesionales de enfermería tiene una alta incidencia, mostrando valores más pronunciados en los servicios móviles de atención de emergencia, pero con algo diferente, una realidad también en el contexto de la atención primaria de salud. El perfil de los profesionales más afectados por el síndrome fueron las mujeres, con menor tiempo de formación y menor permanencia en la unidad, doble empleo, alta demanda de trabajo con bajo control y apoyo social. Conclusión: Existe la necesidad de una reestructuración organizacional, abriendo espacios institucionales de discusión entre gerentes y profesionales de enfermería, en el sentido de desarrollar estrategias orientadas a promover la salud de los trabajadores. (AU)

Relationships between self-reported dyspnea, health conditions and frailty among Brazilian community-dwelling older adults: a cross-sectional study

ABSTRACT CONTEXT: Dyspnea is a symptom present in several chronic diseases commonly seen among older adults. Since individuals with dyspnea tend to stay at rest, with consequently reduced levels of physical activity, they are likely to be at greater risk of developing frailty, especially at older ages. DESIGN AND SETTING: Cross-sectional study at community level, Brazil. OBJECTIVE: To analyze the relationships between self-reported dyspnea, health conditions and frailty status in a sample of community-dwelling older adults. METHOD: Secondary data from the follow-up of the Frailty in Brazilian Elderly (FIBRA) study, involving 415 community-dwelling older adults (mean age: 80.3 ± 4.68 years), were used. The variables analyzed were sociodemographic characteristics, reported dyspnea, clinical data and frailty phenotype. Associations between dyspnea and other variables (age, sex, education and body mass index) were verified through the crude (c) and adjusted (a) odds ratios. RESULTS: The prevalence of dyspnea in the entire sample was 21.0%. Dyspnea was more present in individuals with pulmonary diseases, heart disease, cancer and depression. Older adults with multimorbidities (adjusted odds ratio, ORa = 2.91; 95% confidence interval, CI = 1.41-5.99) and polypharmacy (ORa = 2.02; 95% CI = 1.15-3.54) were more likely to have dyspnea. Those who reported dyspnea were 2.54 times more likely to be frail (ORa = 2.54; 95% CI = 1.08-5.97), and fatigue was their most prevalent phenotype component. CONCLUSION: Dyspnea was associated with different diseases, multimorbidities, polypharmacy and frailty. Recognizing the factors associated with dyspnea may contribute to its early identification and prevention of its negative outcomes among older adults.