Detection and persistence of Zika virus in body fluids and associated factors: a prospective cohort study.

This study aimed to analyze the detection and duration of the Zika virus (ZIKV) in plasma, urine, saliva, sweat, rectal swabs, vaginal secretions, breast milk, and semen and to explore risk factors associated with prolonged viral persistence. A prospective cohort study of symptomatic patients and their household contacts was conducted in Brazil from July 2017 to June 2019. A total of 260 individuals (184 women and 76 men) with confirmed ZIKV infection were enrolled and followed up for 12 months. ZIKV RNA was present in all body fluid specimens and detectable for extended periods in urine, sweat, rectal swabs, and semen. The longest detection duration was found in semen, with high viral loads in the specimens. ZIKV RNA clearance was associated with several factors, including age, sex, education level, body mass index, non-purulent conjunctivitis, joint pain, and whether the participant had a history of yellow fever vaccination. The influence of each of these factors on the low or fast viral clearance varied according to the specific body fluid under investigation. Recurrent ZIKV detection events after total viral clearance were observed in the cohort. Our findings provide valuable insights into the persistence and potential recurrence of ZIKV infection, highlighting the need for continued monitoring and follow-up of individuals infected with ZIKV and for effective prevention measures to reduce the risk of transmission.

Working conditions and mental health of community health workers in the COVID-19 pandemic. / Condições de trabalho e saúde mental de agentes comunitários de saúde na pandemia de COVID-19.

This study examined the prevalence of anxiety and depression associated with Community Health Workers' (CHWs') working conditions in the context of the COVID-19 pandemic. This cross-sectional study was carried out in the north of Minas Gerais, Brazil by applying a questionnaire addressing sociodemographic conditions, command of technologies and working conditions during the pandemic, as well as the State-Trait Anxiety Inventory and the Patient Health Questionnare-9 (PHQ-9). Descriptive and multiple Poisson regression analyses were performed with robust variance, to a 5% level of significance (p < 0.05) for the final model. A total of 1,220 CHWs from 36 municipalities participated in the study. Prevalences were 41.8% and 31.6% for anxiety and depression, respectively, while 22.5% of the group displayed symptoms of both conditions. Being female, up to 40 years old, having more than 500 users registered for monitoring, and inadequate supply of personal protective equipment were associated with anxiety and depression among the CHWs. Prevalence of anxiety and depression was high among CHWs during the pandemic and working conditions figured prominently among the associated factors.

O objetivo deste estudo foi analisar a prevalência de ansiedade e depressão associada às condições de trabalho dos agentes comunitários de saúde (ACS) no contexto da pandemia de COVID-19. Estudo transversal, realizado no norte de Minas Gerais. Foi aplicado um questionário que abordava condições sociodemográficas, domínio de tecnologias e condições de trabalho durante a pandemia, além do Inventário de Ansiedade Traço-Estado e do Patient Health Questionnare-9 (PHQ-9). Foram realizadas análises descritivas e de regressão múltipla de Poisson com variância robusta, considerando um nível de significância de 5% (p < 0,05) para o modelo final. Participaram do estudo 1.220 ACS de 36 municípios. A prevalência foi de 41,8% e 31,6% para ansiedade e depressão, respectivamente, e 22,5% para ambas as condições. O sexo feminino, idade até 40 anos, ter mais de 500 usuários cadastrados para acompanhamento e oferta inadequada de equipamentos de proteção individual estiveram associados à ansiedade e à depressão. Registrouse uma elevada prevalência de ansiedade e depressão entre ACS no período da pandemia, com destaque para as condições de trabalho entre os fatores associados.

Condições de trabalho e saúde mental de agentes comunitários de saúde na pandemia de COVID-19 / Working conditions and mental health of community health workers in the COVID-19 pandemic

Resumo O objetivo deste estudo foi analisar a prevalência de ansiedade e depressão associada às condições de trabalho dos agentes comunitários de saúde (ACS) no contexto da pandemia de COVID-19. Estudo transversal, realizado no norte de Minas Gerais. Foi aplicado um questionário que abordava condições sociodemográficas, domínio de tecnologias e condições de trabalho durante a pandemia, além do Inventário de Ansiedade Traço-Estado e do Patient Health Questionnare-9 (PHQ-9). Foram realizadas análises descritivas e de regressão múltipla de Poisson com variância robusta, considerando um nível de significância de 5% (p < 0,05) para o modelo final. Participaram do estudo 1.220 ACS de 36 municípios. A prevalência foi de 41,8% e 31,6% para ansiedade e depressão, respectivamente, e 22,5% para ambas as condições. O sexo feminino, idade até 40 anos, ter mais de 500 usuários cadastrados para acompanhamento e oferta inadequada de equipamentos de proteção individual estiveram associados à ansiedade e à depressão. Registrouse uma elevada prevalência de ansiedade e depressão entre ACS no período da pandemia, com destaque para as condições de trabalho entre os fatores associados.

Abstract This study examined the prevalence of anxiety and depression associated with Community Health Workers' (CHWs') working conditions in the context of the COVID-19 pandemic. This cross-sectional study was carried out in the north of Minas Gerais, Brazil by applying a questionnaire addressing sociodemographic conditions, command of technologies and working conditions during the pandemic, as well as the State-Trait Anxiety Inventory and the Patient Health Questionnare-9 (PHQ-9). Descriptive and multiple Poisson regression analyses were performed with robust variance, to a 5% level of significance (p < 0.05) for the final model. A total of 1,220 CHWs from 36 municipalities participated in the study. Prevalences were 41.8% and 31.6% for anxiety and depression, respectively, while 22.5% of the group displayed symptoms of both conditions. Being female, up to 40 years old, having more than 500 users registered for monitoring, and inadequate supply of personal protective equipment were associated with anxiety and depression among the CHWs. Prevalence of anxiety and depression was high among CHWs during the pandemic and working conditions figured prominently among the associated factors.

Oral manifestations of COVID-19 in unvaccinated patients: a cross-sectional study.

BACKGROUND: Early studies have highlighted the possible development of dysgeusia and anosmia in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and these manifestations should be considered a potential indication of coronavirus disease 19 (COVID-19). As potential contributors to these symptoms, dentists should perform careful oral and oropharyngeal examinations and document suspicious oral lesions in patients with COVID-19, especially in those who complain of loss of taste and smell. The study's objective was to assess the prevalence of oral manifestations among ambulatory unvaccinated symptomatic patients with suspected COVID-19 during the acute phase of the disease. METHODS: This cross-sectional study evaluated oral manifestations in adults (aged ≥ 18 years) with suspected and confirmed SARS-CoV-2 infection. Chi-square and Fisher's exact tests were used to compare data between the groups (rRT-PCR-positive and rRT-PCR-negative patients). RESULTS: One hundred thirty-six participants were included. Most were female (n = 79; 58.1%), with a mean age of 39.53 (± 14.17) years. Of these, 54 (39.7%) had a positive rRT-PCR test, and 82 (60.3%) had negative rRT-PCR results. Oral manifestations were observed in 40 participants (74.1%) in the rRT-PCR-positive group and 67 participants (81.7%) in the rRT-PCR-negative group. The most common oral manifestations were xerostomia (n = 85; 62.5%) and dysgeusia/ageusia (n = 57; 41.9%). Different rates of gingivitis (n = 12; 22.2% vs. n = 5; 6.1%; p = 0.005) and halitosis (n = 7; 13.0% vs. n = 1; 1.2%; p = 0.007) were observed between the rRT-PCR-positive and -negative groups, respectively. Mouth ulcers, glossitis, tongue coating, and petechiae were reported in both groups without significant differences. CONCLUSIONS: A high prevalence of oral manifestations was observed in symptomatic patients with suspected or confirmed COVID-19. CLINICAL RELEVANCE: This study highlights the importance of routine oral examinations by dentists as part of the multidisciplinary care of COVID-19 patients.

Enablers, barriers and strategies to build resilience among cancer survivors: a qualitative study protocol.

Cancer is a life-threatening illness affecting all dimensions of a person's health. Cancer survivors must build resilience to face this adversity and continue their life projects. The present study explores the enablers, barriers, and strategies to build resilience among cancer survivors. This qualitative, descriptive exploratory study will use purposive sampling to recruit cancer survivors and healthcare professionals from two hospital centers in Lisbon and Tagus Valley. Interviews will be conducted until data saturation occurs. Data analysis will be performed using an inductive content analysis process with the help of the QDA Miner Lite database. The findings from this study will generate knowledge that may help stakeholders to identify effective strategies to build resilience among cancer survivors. By implementing strategies to foster resilience, healthcare professionals can potentially promote positive adaptations to cancer by strengthening resilience enablers and reducing the impact of barriers.

Análise dos indicadores de prazer e sofrimento no trabalho associados a ansiedade e depressão entre agentes comunitários de saúde / Analysis of indicators of pleasure and suffering at work associated with anxiety and depression among community health agents

RESUMO Objetivo Analisar os indicadores de prazer e sofrimento no trabalho associados a depressão e ansiedade entre agentes comunitários de saúde (ACSs). Métodos Estudo transversal, no qual variáveis dependentes foram a presença de sintomas de ansiedade e depressão, avaliadas com o Patient Health Questionnaire (PHQ-9) e com o Inventário de Ansiedade de Traço-Estado (IDATE). As variáveis independentes foram avaliadas com um questionário sociodemográfico e a Escala de Indicadores de Prazer e Sofrimento no Trabalho (EIPST) do Inventário do Trabalho e Riscos de Adoecimento (ITRA). As associações entre as variáveis foram testadas com o uso de regressão logística multinominal. Resultados Participaram do estudo 675 ACSs, sendo a maioria mulheres (83,7%), com até 40 anos (51,3%). As chances de apresentar sintomas de ansiedade foram maiores entre ACSs efetivos (1,61 [1,10-2,36]), e avaliações críticas ou graves nos fatores realização (Crítica 1,87 [1,30-2,68]; Grave 4,16 [2,06-8,40]) e esgotamento profissional (Crítica 2,60 [1,78-3,80]; Grave 3,97 [2,53-6,21]). Sexo feminino (2,12 [1,03-4,40]), idade de até 40 anos (1,741 [1,05-2,89]), tempo de serviço superior a cinco anos (1,88 [1,18-2,99]), avaliações crítica ou grave nos fatores realização (Crítica 2,53 [1,55-4,10]; Grave 6,07 [2,76-13,38]), esgotamento profissional (Crítica 5,21 [2,30-11,80]; Grave 15,64 [6,53-37,44]) e falta de reconhecimento (Crítica 1,93 [1,13-3,28]) estiveram associados a maiores chances de sintomas depressivos. Conclusões Apesar de se tratar de estudo transversal, que não permite inferir causalidade, os achados sugerem importante associação entre aspectos laborais dos ACS e os sintomas de ansiedade e depressão. Sexo feminino e possuir 40 anos ou menos também mostraram relação com o aumento dos sintomas de depressão.

ABSTRACT Objective To analyze indicators of pleasure and suffering at work associated with depression and anxiety among community health workers (CHW). Methods Crosssectional study in which the dependent variables were the presence of anxiety and depression symptoms, assessed using the Patient Health Questionnaire (PHQ-9) and State-Trait Anxiety Inventory (STAI). The independent variables were evaluated using the Scale of Indicators of Pleasure and Suffering at Work (EIPST) of the Inventory of Work and Risks of Illness (ITRA). Associations between dependent and independent variables were tested using multinomial logistic regression. Results 675 CHW participated in the study, the majority being women (83.7%), aged up to 40 years (51.3%). The chances of presenting anxiety symptoms were higher among effective CHW (OR=1.61; 95%CI: 1.10-2.36), and critical or severe assessments in the achievement factors (Critical OR=1.87; 95%CI: 1.30-2.68; Severe OR=4.16; 95%CI: 2.06-8.40) and professional exhaustion (Critical OR=2.60; 95%CI: 1.78-3.80; Severe OR=3.97; 95% CI: 2.53-6.21). Female gender (OR=2.12; 95%CI: 1.03-4.40), age up to 40 years (OR=1.74; 95%CI: 1.05-2.89), length of service greater than five years (OR=1.88; 95%CI: 1.18-2.99), critical or severe ratings on achievement factors (Critical OR=2.53; 95%CI: 1.55-4.10; Severe OR= 6.07; 95%CI: 2.76-13.38), professional exhaustion (Critical OR=5.21; 95%CI: 2.30-11.80; Severe OR=15.64; 95%CI: 6.53 -37.44) and lack of recognition (Critical OR=1.93; 95%CI: 1.13-3.28) were associated with greater chances of depressive symptoms. Conclusions Despite being a cross-sectional study, which does not allow inferring causality, the findings suggest an important association between the work aspects of the CHW and the symptoms of anxiety and depression. Female gender and being 40 years old or younger also showed a relationship with increased symptoms of depression.

Brain MRI Abnormalities, Epilepsy and Intellectual Disability in LAMA2 Related Dystrophy - a Genotype/Phenotype Correlation.

BACKGROUND: LAMA2-related muscular dystrophy is a disorder that causes muscle weakness and varies in severity, from a severe, congenital type to a milder, late-onset form. However, the disease does not only affect the muscles, but has systemic involvement and can lead to alterations such as brain malformation, epilepsy and intellectual disability. OBJECTIVE: Describe the frequency of cortical malformations, epilepsy and intellectual disability in LAMA2-RD in a Brazilian cohort and correlate the neurological findings to genetic and motor function. METHODS: This is an observational study of 52 LAMA2-RD patients, who were divided into motor function subgroups and compared based on brain MRI findings, epilepsy, intellectual disability, and type of variants and variant domains. RESULTS: 44 patients (84.6%) were only able to sit, and 8 patients (15.4%) were able to walk. 10 patients (19.2%) presented with cortical malformations (polymicrogyria, lissencephaly-pachygyria, and cobblestone),10 patients (19.2%) presented with epilepsy, and 8 (15.4%) had intellectual disability. CNS manifestations correlated with a more severe motor phenotype and none of the patients able to walk presented with cortical malformation or epilepsy. There was a relation between gene variants affecting the laminin-α2 LG-domain and the presence of brain malformation (P = 0.016). There was also a relation between the presence of null variants and central nervous system involvement. A new brazilian possible founder variant was found in 11 patients (21,15%) (c.1255del; p. Ile419Leufs*4). CONCLUSION: Cortical malformations, epilepsy and intellectual disability are more frequent among LAMA2-RD patients than previously reported and correlate with motor function severity and the presence of variants affecting the laminin-α2 LG domain. This brings more insight fore phenotype-genotype correlations, shows the importance of reviewing the brain MRI of patients with LAMA2-RD and allows greater attention to the risk of brain malformation, epilepsy, and intellectual disability in those patients with variants that affect the LG domain.

Barrier Discharge Ionization Detector in Gas Chromatography: A Review on Applications.

The barrier discharge ionization detector (BID) is one of the latest detection technologies used in gas chromatography (GC). 306 papers from 2012 to 2021 with GC-BID analyses were considered. An overview of the main applications with the BID, considering the trends for the most common analyses, explored compounds, extraction methods, and comparative studies with other detectors is shown. Interest in BID applications has grown, and the number of publications reflects this. Despite having the potential to analyze different compounds, gases are more explored, mainly H2, CH4, and CO. The BID should be further explored for water analysis, as studies show its good performance in larger quantities and at the level of traces. Most of the determinations of these compounds were applied in studies focused on CO2 reduction (by photocatalysis or electro-reduction) and biogas (for CH4). BID is effective for determinations on the order of mmol to µmol. Headspace extraction (HS) is most often applied BID analysis. Reduced dynamic range and nonlinear response to carbon mass are some disadvantages to BID. On the other hand, the BID has a signal-to-noise ratio (S/N) 100 times higher than thermal conductivity detector (TCD) (for inorganic gases and water), a high linear sensitivity for dodecane (LOD less than 1.0 pgC/sec) and other compounds (being able to reach µg/L). Combined with simple extraction methods such as HS, the BID allows quick and simple analysis with great sensitivity, in addition, it is a good alternative for the analysis of inorganic gases and water compared to usual detectors.

Validação da Escala de Medo da COVID-19 para Agentes Comunitários de Saúde / Validation of the COVID-19 Fear Scale for Community Health Agents

A pandemia da COVID-19 definiu uma nova dinâmica social, devido à intensificação de sentimentos de medo, especialmente o medo de se infectar e de infectar pessoas queridas, o que impôs novos desafios à Atenção Primária à Saúde (APS) e ao trabalho do Agente Comunitário de Saúde (ACS), evidenciando a necessidade de um instrumento para avaliar o medo e seus impactos nos aspectos físico-emocionais e na realidade laboral desses profissionais. Assim, o objetivo desse trabalho foi desenvolver e validar uma escala para avaliação do medo da COVID-19 para os ACS. Estudo metodológico desenvolvido junto aos ACS da macrorregião de saúde Norte de Minas Gerais, no período de julho a outubro de 2020. A elaboração dos itens foi realizada pelos autores a partir de construtos de sentimentos de medo e escalas de avaliação de medo e ansiedade identificadas na literatura. Foi feita a análise fatorial exploratória e confirmatória, a fim de verificar a validade de construto do instrumento. A escala apresentou índices satisfatórios de ajustes nas análises realizadas, demonstrando adequação dos dados para a realização da validade de construto. Dois indicadores refutaram a unidimensionalidade da escala. A escala elaborada e validada poderá subsidiar a definição de estratégias direcionadas aos ACS, de modo orientar o trabalho junto à comunidade, além de atuar preventivamente na identificação de problemas de saúde mental no contexto de pandemia.

The COVID-19 pandemic defined a new social dynamic, due to the intensification of feelings of fear, especially the fear of getting infected and of infecting loved ones, which imposed new challenges upon Primary Health Care (PHC) system and the work of the Community Health Agent (CHA) program, highlighting the need for an instrument to assess fear and its impacts on the physical-emotional aspects and on the work reality of these professionals. Thus, the objective of this study was to develop and validate a scale for assessing the fear of COVID-19 among CHAs. This methodological study was developed with the CHAs of the northern Minas Gerais health macro-region, from July to October 2020. The elaboration of the items was carried out by the authors based on constructs of feelings of fear and the anxiety and fear assessment scales identified in the literature. An exploratory and confirmatory factor analysis was performed in order to verify the validity of the constructed instrument. The scale showed satisfactory levels of adjustment in the analyses carried out, demonstrating adequacy of the data for the achievement of construct validity. Two indicators refuted the one-dimensionality of the scale. The elaborated and validated scale will be able to subsidize the definition of strategies directed to the CHA program, in order to guide their work within the community, in addition to acting preventively in the identification of mental health problems in the context of a pandemic.

Contexto de trabalho e custo humano no trabalho para agentes comunitários de saúde / Work context and the occupational health cost for community health workers

Resumo Este estudo objetivou avaliar o contexto de trabalho e o custo humano no trabalho entre Agentes Comunitários de Saúde (ACS). Trata-se de estudo transversal, censitário, com aplicação de questionário socioeconômico, Escala de Avaliação do Contexto de Trabalho (EACT) e Escala de Custo Humano no Trabalho (ECHT), que compõem o Inventário sobre Trabalho e Risco de Adoecimento (ITRA). Foram realizadas análises descritivas das médias dos escores fatoriais, comparação de médias entre os itens e entre as características sociodemográficas do grupo, por meio dos testes de Mann-Whitney e Kruskal-Wallis e nível de significância de 5%. Participaram do estudo 675 ACS. Todos os fatores relativos às condições de trabalho e custo humano no trabalho apresentaram avaliação moderada/crítica. Idade, tempo de serviço e vínculo empregatício foram as variáveis associadas a todos os fatores da EACT, enquanto para a ECHT, apenas o tempo de serviço se mostrou associado a todos os fatores. Avaliações mais negativas do contexto de trabalho e do custo humano no trabalho foram mais evidentes entre ACS com maior tempo de atuação. Os resultados destacam a necessidade de melhoria das condições de trabalho e das relações profissionais relativas aos ACS.

Abstract The scope of this study was to evaluate the work context and the occupational health cost among Community Health Workers (CHWs). It is a cross-sectional, census study, using a socioeconomic questionnaire, the Work Context Assessment Scale (WCAS) and the Human Cost at Work Scale (HCWS), which make up the Inventory of Work and Illness Risk (IWIR). Descriptive analyses of mean factor scores were performed and comparison of means between items and sociodemographic characteristics of the group, through Mann-Whitney and Kruskal-Wallis's tests with a 5% significance level. A total of 675 CHWs participated in the study. All factors related to working conditions and human cost at work presented a moderate/critical evaluation. Age, length of service and employment ties were variables associated with all factors of WCAS, while only length of service was associated with all factors for CHWs. More negative assessments of the work context and the occupational health cost were more evident among CHWs with longer experience. The results highlight the need to improve working conditions and professional relationships related to CHW.

[Work context and the occupational health cost for community health workers]. / Contexto de trabalho e custo humano no trabalho para agentes comunitários de saúde.

The scope of this study was to evaluate the work context and the occupational health cost among Community Health Workers (CHWs). It is a cross-sectional, census study, using a socioeconomic questionnaire, the Work Context Assessment Scale (WCAS) and the Human Cost at Work Scale (HCWS), which make up the Inventory of Work and Illness Risk (IWIR). Descriptive analyses of mean factor scores were performed and comparison of means between items and sociodemographic characteristics of the group, through Mann-Whitney and Kruskal-Wallis's tests with a 5% significance level. A total of 675 CHWs participated in the study. All factors related to working conditions and human cost at work presented a moderate/critical evaluation. Age, length of service and employment ties were variables associated with all factors of WCAS, while only length of service was associated with all factors for CHWs. More negative assessments of the work context and the occupational health cost were more evident among CHWs with longer experience. The results highlight the need to improve working conditions and professional relationships related to CHW.

Este estudo objetivou avaliar o contexto de trabalho e o custo humano no trabalho entre Agentes Comunitários de Saúde (ACS). Trata-se de estudo transversal, censitário, com aplicação de questionário socioeconômico, Escala de Avaliação do Contexto de Trabalho (EACT) e Escala de Custo Humano no Trabalho (ECHT), que compõem o Inventário sobre Trabalho e Risco de Adoecimento (ITRA). Foram realizadas análises descritivas das médias dos escores fatoriais, comparação de médias entre os itens e entre as características sociodemográficas do grupo, por meio dos testes de Mann-Whitney e Kruskal-Wallis e nível de significância de 5%. Participaram do estudo 675 ACS. Todos os fatores relativos às condições de trabalho e custo humano no trabalho apresentaram avaliação moderada/crítica. Idade, tempo de serviço e vínculo empregatício foram as variáveis associadas a todos os fatores da EACT, enquanto para a ECHT, apenas o tempo de serviço se mostrou associado a todos os fatores. Avaliações mais negativas do contexto de trabalho e do custo humano no trabalho foram mais evidentes entre ACS com maior tempo de atuação. Os resultados destacam a necessidade de melhoria das condições de trabalho e das relações profissionais relativas aos ACS.

Elaboração e Validação de Conteúdo de um instrumento sobre as atividades dos Agentes Comunitários de Saúde / Elaboración y Validación de Contenido de un instrumento sobre las actividades de los Agentes Comunitarios de Salud / Elaboration and Content Validity of an instrument on the activities of Community Health Workers

Resumo Objetivo elaborar e conduzir a validação de conteúdo e de aparência de um instrumento para identificação das atividades desempenhadas pelos agentes comunitários de saúde na Estratégia Saúde da Família. Método trata-se de um estudo metodológico composto por três etapas: a primeira foi a elaboração do instrumento a partir da revisão de literatura; a segunda foi constituída pela validação de conteúdo por 10 juízes experts; e a terceira pela validação aparente pela população-alvo. Para a análise, calculou-se o Índice de Validade de Conteúdo. Resultados inicialmente, o instrumento foi composto por 45 itens dispostos em 10 dimensões. Os especialistas analisaram e sugeriram a modificação de termos e o acréscimo e o desmembramento de itens. Todas as sugestões foram acolhidas e a versão final do instrumento foi composta por 60 itens. O Índice de Validade de Conteúdo foi ≥ 0,90 para todos os itens. O instrumento abrangeu as atividades preconizadas pelas normativas ministeriais e pelas atribuições que fogem do escopo de atuação, mas que estão presentes na prática dos profissionais. Conclusão e implicações para a prática o instrumento apresentou validade satisfatória e refletiu a realidade do trabalho dos agentes comunitários de saúde, sendo seus itens compostos pela ampla gama de atividades desenvolvidas por esses profissionais.

Resumen Objetivo desarrollar y realizar la validación de contenido y la apariencia de un instrumento para la identificación de las actividades realizadas por los agentes comunitarios de salud en la Estrategia de Salud de la Familia. Método se trata de un estudio metodológico compuesto por tres etapas: la primera fue la elaboración del instrumento, a partir de una revisión bibliográfica; la segunda consistió en la validación de contenido por 10 jueces expertos y la tercera en validación aparente por parte de la población objetivo. Para el análisis se calculó el Índice de Validez de Contenido. Resultados Inicialmente, el instrumento constaba de 45 ítems, ordenados en diez dimensiones. Los expertos analizaron y sugirieron la modificación de los términos y la adición y desmembración de elementos. Todas las sugerencias fueron aceptadas y la versión final del instrumento constó de 60 ítems. El Índice de Validez de Contenido fue ≥ 0,90 para todos los ítems. El instrumento abarcó actividades recomendadas por normas ministeriales y actividades que están fuera del ámbito de actuación, pero que están presentes en la práctica profesional. Conclusión e implicaciones para la práctica El instrumento presentó validez satisfactoria y refleja la realidad del trabajo de los agentes comunitarios de salud. Sus ítems están compuestos por la amplia gama de actividades desarrolladas por estos profesionales.

Abstract Objective to develop and validate the content and appearance of an instrument to identify activities performed by community health workers in Family Health Strategy. Method this is a methodological study composed of three stages: the first was the elaboration of the instrument based on a literature review, the second consisted of content validity by ten expert judges, and the third by apparent validity by the target population. For analysis, the content validity index was calculated. Results Initially, the instrument consisted of 45 items arranged in ten dimensions. The experts analyzed and suggested modification of terms and addition and dismemberment of items. All suggestions were accepted, and the final version of the instrument consisted of 60 items. The content validity index was ≥ 0.90 for all items. The instrument covered the activities recommended by ministerial regulations and activities that are outside the scope of action, but which are present in the practice of the community health workers. Conclusion and implications for practice The instrument presented satisfactory validity and reflected the reality of the community health workers, and its items are composed of the wide range of activities developed by these professionals.

Potential risk of BPA and phthalates in commercial water bottles: a minireview.

The global water bottling market grows annually. Today, to ensure consumer safety, it is important to verify the possible migration of compounds from bottles into the water contained in them. Potential health risks due to the prevalence of bisphenol A (BPA) and phthalates (PAEs) exposure through water bottle consumption have become an important issue. BPA, benzyl butyl phthalate (BBP), di-n-butyl phthalate (DBP) and di (2-ethylhexyl) phthalate (DEHP) can cause adverse effects on human health. Papers of literature published in English, with BPA, BBP, DBP and DEHP detections during 2017, by 2019 by liquid chromatography and gas chromatography analysis methods were searched. The highest concentrations of BPA, BBP, DBP and DEHP in all the bottled waters studied were found to be 5.7, 12.11, 82.8 and 64.0 µg/L, respectively. DBP was the most compound detected and the main contributor by bottled water consumption with 23.7% of the Tolerable Daily Intake (TDI). Based on the risk assessment, BPA, BBP, DBP and DEHP in commercial water bottles do not pose a serious concern for humans. The average estrogen equivalent level revealed that BPA, BBP, DBP and DEHP in bottled waters may induce adverse estrogenic effects on human health.

Cohort profile: Study on Zika virus infection in Brazil (ZIKABRA study).

Zika virus (ZIKV) has been detected in blood, urine, semen, cerebral spinal fluid, saliva, amniotic fluid, and breast milk. In most ZIKV infected individuals, the virus is detected in the blood to one week after the onset of symptoms and has been found to persist longer in urine and semen. To better understand virus dynamics, a prospective cohort study was conducted in Brazil to assess the presence and duration of ZIKV and related markers (viral RNA, antibodies, T cell response, and innate immunity) in blood, semen, saliva, urine, vaginal secretions/menstrual blood, rectal swab and sweat. The objective of the current manuscript is to describe the cohort, including an overview of the collected data and a description of the baseline characteristics of the participants. Men and women ≥ 18 years with acute illness and their symptomatic and asymptomatic household contacts with positive reverse transcriptase-polymerase chain reaction test for ZIKV in blood and/or urine were included. All participants were followed up for 12 months. From July 2017 to June 2019, a total of 786 participants (284 men, 502 women) were screened. Of these, 260 (33.1%) were enrolled in the study; index cases: 64 men (24.6%), 162 (62.3%) women; household contacts: 12 men (4.6%), 22 (8.5%) women. There was a statistically significant difference in age and sex between enrolled and not enrolled participants (p<0.005). Baseline sociodemographic and medical data were collected at enrollment from all participants. The median and interquartile range (IQR) age was 35 (IQR; 25.3, 43) for men and 36.5 years (IQR; 28, 47) for women. Following rash, which was one of the inclusion criteria for index cases, the most reported symptoms in the enrollment visit since the onset of the disease were fever, itching, arthralgia with or without edema, non-purulent conjunctivitis, headache, and myalgia. Ten hospitalizations were reported by eight patients (two patients were hospitalized twice) during follow up, after a median of 108 days following symptom onset (range 7 to 266 days) and with a median of 1.5 days (range 1 to 20 days) of hospital stay. A total of 4,137 visits were performed, 223 (85.8%) participants have attended all visits and 37 (14.2%) patients were discontinued.

Galactosamine reduces sandfly gut protease activity through TOR downregulation and increases Lutzomyia susceptibility to Leishmania.

In sandflies, males and females feed on carbohydrates but females must get a blood meal for egg maturation. Using artificial blood meals, this study aimed to understand how galactosamine interferes with sandfly digestive physiology. We also used galactosamine to manipulate the digestive physiology of Lutzomyia longipalpis to investigate its influence on sandfly digestion and Leishmania development within their insect vectors. Galactosamine was capable to reduce Lu. longipalpis trypsinolytic activity in a dose-dependent manner. This effect was specific to galactosamine as other similar sugars were not able to affect sandfly trypsin production. An excess of amino acids supplemented with the blood meal and 15 mM galactosamine was able to abrogate the reduction of the trypsinolytic activity caused by galactosamine, suggesting this phenomenon may be related to an impairment of amino acid detection by sandfly enterocytes. The TOR inhibitor rapamycin reduces trypsin activity in the L. longipalpis midgut. Galactosamine reduces the phosphorylation of the TOR pathway repressor 4EBP, downregulating TOR activity in the gut of L. longipalpis. Galactosamine reduces sandfly oviposition, causes an impact on sandfly longevity and specifically reduces sandfly gut proteases whereas increasing α-glycosidase activity. The administration of 15 and 30 mM galactosamine increased the number of promastigote forms of Le. mexicana and Le. infantum in galactosamine-treated L. longipalpis. Our results showed that galactosamine influences amino acid sensing, reduces sandfly gut protease activity through TOR downregulation, and benefits Leishmania growth within the Lu. longipalpis gut.

Isolation of xylose-assimilating yeasts and optimization of xylitol production by a new Meyerozyma guilliermondii strain.

Production of xylitol from lignocellulosic biomass is of interest to modern biorefineries, because this biomass should be processed into a spectrum of chemicals (bio-based products) and not only energy. The isolation of new yeast strains capable of efficiently converting xylose into xylitol and withstanding inhibitors released from biomass hydrolysis can contribute to making its production feasible in biorefineries. Forty-three out of 128 yeast strains isolated from the gut of Passalidae beetles were capable of assimilating xylose as the sole carbon source. Meyerozyma guilliermondii UFV-1 was selected due to its ability to grow and ferment D-xylose in a synthetic medium. This yeast assimilated the broad range of sugars present in lignocellulosic biomass hydrolysates, such as xylose, raffinose, cellobiose, rhamnose, arabinose, and glucose. Its optimum growth conditions were pH 8.0 and a temperature of 30 °C. In concentrations of 0.07 mol/L acetic acid, 0.05 mol/L 5-hydroximethylfurfural, and 0.04 mol/L furfural, M. guilliermondii UFV-1 did not grow. Maximum xylitol production in aerobiosis and hypoxia were 51.88 and 27.73 g/L, respectively. Under aerobic condition, xylose concentration and agitation rate were the factors which were statistically significant, while only the agitation rate was significant in hypoxia. We fitted a response surface (RS) that estimated the best agitation rate (113.33 rpm) and xylose concentration (90 g/L) for maximum xylitol production in aerobiosis. Therefore, M. guilliermondii UFV-1 displays potential for being used for xylitol production in biorefineries.

Diagnostic detection systems and QuEChERS methods for multiclass pesticide analyses in different types of fruits: An overview from the last decade.

This manuscript is a bibliographic review about analyses of different classes of pesticide in fruits using QuEChERS as sample preparation methodology. The aim is to clarify different trends and facilitate decision-making by the scientific community in order to carry out further studies in this field. It is well known that different countries have different pesticides regulations for maximum level of pesticide residue permitted. The comparative analysis amongst the main producer countries reveals that for some fruits they are not studied enough. Recent improvements to QuEChERS make it possible to minimize the pesticides instability due the matrix pH, and achieving cleaner extracts. Regarding the detection systems, the tandem MS are preferred once they have high sensitivity and selectivity, although traditional techniques (GC-ECD and HPLC-DAD) are still commonly used due to their accessibility and good sensitivity to some pesticides. Also, studies involving metabolites usually show that they are more toxic than their precursor compounds.

Scientific production indicators and researchers training in the Brazilian Collective Health.

OBJECTIVE: To evaluate the scientific production, generation of patents and researchers training among Brazilian Collective Health professors who were awarded a Pq/CNPq productivity scholarship from 2000 to 2012 and to verify the existence of an association between these production modalities and the characteristics of the professors, such as gender, training and origin. METHOD: An analytical cross-sectional study was carried out from 2000 to 2012, and the Prevalence Ratio was calculated using Poisson regression. For the statistical analyzes, the SPSS® program was used. RESULTS: Of particular note are regional and institutional concentration, consistent scientific output, important researchers training, and a primordial but still timid generation of patents. We found an association between the "scientific production", "researchers training" outcomes, and the gender characteristics, such as the formation and origin of the Pq professor. CONCLUSION: These findings can guide the decision-making aimed at the deconcentration of scientific production and researchers training in the Brazilian Collective Health.

Scientific production indicators and researchers training in the Brazilian Collective Health / Indicadores de la producción científica y la formación de investigadores en la Salud Colectiva Brasileña / Indicadores de produção científica e formação de pesquisadores na Saúde Coletiva brasileira

ABSTRACT Objective: To evaluate the scientific production, generation of patents and researchers training among Brazilian Collective Health professors who were awarded a Pq/CNPq productivity scholarship from 2000 to 2012 and to verify the existence of an association between these production modalities and the characteristics of the professors, such as gender, training and origin. Method: An analytical cross-sectional study was carried out from 2000 to 2012, and the Prevalence Ratio was calculated using Poisson regression. For the statistical analyzes, the SPSS® program was used. Results: Of particular note are regional and institutional concentration, consistent scientific output, important researchers training, and a primordial but still timid generation of patents. We found an association between the "scientific production", "researchers training" outcomes, and the gender characteristics, such as the formation and origin of the Pq professor. Conclusion: These findings can guide the decision-making aimed at the deconcentration of scientific production and researchers training in the Brazilian Collective Health.

RESUMEN El objetivo del trabajo fue evaluar la producción científica, la generación de patentes y la formación de investigadores entre docentes de la Salud Colectiva brasileña que fueron contemplados con becas de productividad Pq/CNPq en el período de verano y verificar la existencia de la asociación entre estas modalidades de producción; y las características de los docentes, como el género, la formación y el origen. Método: Se realizó un estudio transversal analítico en el período de referencia y se calculó la razón de prevalencia por medio de la regresión de Poisson. Para los análisis estadísticos se utilizó el programa SPSS®. Resultados: Se destacan la concentración regional e institucional, la consistente producción científica, la importante formación de investigadores; y la significativa, pero aún tímida, generación de patentes. Se encontró una asociación entre los resultados de la producción científica, la formación de investigadores y las características género, formación y origen del docente Pq. Conclusión: Esos hallazgos pueden orientar la toma de decisiones dirigidas a la desconcentración de la producción científica y la formación de investigadores en Salud Colectiva en Brasil.

RESUMO Objetivo: Avaliar a produção científica, geração de patentes e formação de pesquisadores entre docentes da Saúde Coletiva brasileira que foram contemplados com bolsas de produtividade Pq/CNPq no período 2000-2012 e verificar a existência de associação entre estas modalidades de produção e características dos docentes, como gênero, formação e origem. Método: Foi realizado um estudo transversal analítico no período 2000-2012 e foi calculada a razão de prevalência por meio da regressão de Poisson. Para as análises estatísticas, utilizou-se o programa SPSS®. Resultados: Destacam-se a concentração regional e institucional, consistente produção científica, importante formação de pesquisadores e primordial, mas ainda tímida geração de patentes. Foi encontrada associação entre os desfechos "produção científica", "formação de pesquisadores", e as características de gênero, como formação e origem do docente Pq. Conclusão: Estes achados podem orientar a tomada de decisões voltadas para a desconcentração da produção científica e formação de pesquisadores em Saúde Coletiva no Brasil.

Position article and guidelines 2018 recommendations of the Brazilian Society of Rheumatology for the indication, interpretation and performance of nailfold capillaroscopy.

Nailfold capillaroscopy (NFC) is a reproducible, simple, low-cost, and safe imaging technique used for morphological analysis of nail bed capillaries. It is considered to be extremely useful for the investigation of Raynaud's phenomenon and for the early diagnosis of systemic sclerosis (SSc). The capillaroscopic pattern typically associated with SSc, scleroderma ("SD") pattern, is characterized by dilated capillaries, microhemorrhages, avascular areas and/or capillary loss, and distortion of the capillary architecture. The aim of these recommendations is to provide orientation regarding the relevance of NFC, and to establish a consensus on the indications, nomenclature, the interpretation of NFC findings and the technical equipments that should be used. These recommendations were formulated based on a systematic literature review of studies included in the database MEDLINE (PubMed) without any time restriction.