O Burnout, ansiedade e depressão nos enfermeiros em contexto de pandemia por COVID-19 / Burnout, anxiety and depression in nurses during the COVID-19 pandemic / Agotamiento, ansiedad y depresión entre el personal de enfermería en el contexto de la pandemia de COVID-19

Resumo Enquadramento: A pandemia por COVID-19, acresce aos enfermeiros momentos de insatisfação, tensões emocionais e relacionais, podendo estar relacionadas com o burnout, ansiedade e depressão. Objetivo: Avaliar o impacto que a pandemia por COVID-19 teve nos enfermeiros, relativamente ao burnout, ansiedade e depressão. Metodologia: Estudo quantitativo descritivo-correlacional e transversal. A amostra não probabilística por conveniência, constituída por 234 enfermeiros de um Hospital dos Açores, sendo aplicado um questionário de caracterização sociodemográfica/questões gerais, a Hospital Anxiety and Depression Scale (HADS) e o Copenhagen Burnout Inventory (CBI) de forma online e presencial, os dados foram analisados com recurso ao programa SPSS. Todos os aspetos ético-legais foram respeitados. Resultados: Identificaram-se a falta e uso prolongado de material de proteção individual, condições de trabalho desfavoráveis, diminuição da realização profissional, medo de contrair a doença e infetar familiares/amigos, isolamento social, relação com os superiores hierárquicos, remuneração inadequada e falta de práticas administrativas. Conclusão: O contexto pandémico, em interligação com o contexto social e familiar, levou os enfermeiros a experienciarem sintomas de burnout, ansiedade e depressão.

Abstract Background: Nurses experienced dissatisfaction and emotional and relational tensions during the COVID-19 pandemic, which may be related to burnout, anxiety, and depression. Objective: To assess the impact of the COVID-19 pandemic on nurses' burnout, anxiety, and depression. Methodology: Quantitative descriptive-correlational and cross-sectional study. The nonprobability convenience sample consisted of 234 nurses from a hospital in the archipelago of the Azores. A questionnaire with sociodemographic/general questions, the Hospital Anxiety and Depression Scale (HADS), and the Copenhagen Burnout Inventory (CBI) were administered online and face-to-face. Data were analyzed using the SPSS software. All ethical and legal aspects were respected. Results: The following aspects were identified: lack of and the prolonged use of personal protective equipment, unfavorable working conditions, decreased professional fulfillment, fear of becoming infected with the virus and infecting family/friends, social isolation, relationship with hierarchical superiors, inadequate remuneration, and lack of administrative practices. Conclusion: The pandemic context, combined with the social and family context, led nurses to experience symptoms of burnout, anxiety, and depression.

Resumen Marco contextual: La pandemia de COVID-19 ha aumentado la insatisfacción y las tensiones emocionales y relacionales del personal de enfermería, que pueden estar relacionadas con el agotamiento, la ansiedad y la depresión. Objetivo: Evaluar el impacto de la pandemia de COVID-19 en el personal de enfermería en términos de agotamiento, ansiedad y depresión. Metodología: Estudio cuantitativo, descriptivo-correlacional, transversal. La muestra de conveniencia no probabilística fue de 234 enfermeros de un hospital de las Azores. Se aplicó un cuestionario para caracterizar cuestiones sociodemográficas/generales, la Hospital anxiety and Depression Scale (HADS) y el Copenhagen Burnout Inventory (CBI) en línea y presencial. Los datos se analizaron con el programa informático SPSS. Se respetaron todos los aspectos éticos y jurídicos. Resultados: Se identificaron la falta y el uso prolongado de equipos de protección individual, las condiciones de trabajo desfavorables, la disminución de la realización profesional, el miedo a contraer la enfermedad e infectar a familiares/amigos, el aislamiento social, la relación con los superiores, la remuneración inadecuada y la falta de prácticas administrativas. Conclusión: El contexto de pandemia, en interconexión con el contexto social y familiar, ha llevado al personal de enfermería a experimentar síntomas de agotamiento, ansiedad y depresión.

Prevalence of and factors associated with unmanageable pain levels in people with knee or hip osteoarthritis: a cross-sectional population-based study.

BACKGROUND: Pain due to knee and / or hip osteoarthritis (HKOA) is the most common symptom for seeking healthcare. Pain interferes on daily activities, social and occupational participation in people with HKOA. The goal of this study is to estimate the prevalence of unmanageable pain levels (UPL) among people with HKOA), characterize this population and identify factors associated with UPL, and compare therapeutic strategies used by people with UPL versus manageable pain levels (MPL). METHODS: We analysed data from the EpiReumaPt study (n = 10,661), that included a representative sample of the Portuguese population. Among these, 1081 participants had a validated diagnosis of HKOA by a rheumatologist.. Sociodemographic, lifestyle and health-related data were collected in a structured interview. Pain intensity (NPRS) data were collected in a medical appointment. Painmedication (last month), physiotherapy and surgery were considered as therapies for pain management. UPL was defined as a mean pain intensity in the previous week of ≥5 points on 11-point numeric pain rating scale. The factors associated with UPL were analyzed with logistic regression (p < 0.05, 95%CI). The effect of unmanageable pain levels was assessed by the HOOS/KOOS activities of daily living and quality of life subscales. Symptoms of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Analysis was completed with linear and logistic regression. All analysis were weighted. RESULTS: The estimated prevalence of UPL among people with HKOA was 68.8%. UPL was associated with being female (odds ratio (OR) = 2.36, p < 0.001), being overweight (OR = 1.84, p = 0.035) or obese (OR = 2.26, p = 0.006), and having multimorbidity (OR = 2.08, p = 0.002). People with UPL reported worse performance in activities of daily living and lower quality of life (ß = - 21.28, p < 0.001 and ß = - 21.19, p < 0.001, respectively) than people with MPL. People with UPL consumed more NSAIDs (22.0%, p = 0.003), opioids (4.8%, p = 0.008), paracetamol (2.7%, p = 0.033), and overall analgesics (7.3%, p = 0.013) than people with MPL. A higher proportion of people with UPL underwent physiotherapy (17.5%, p = 0.002) than people with MPL. CONCLUSION: Two-thirds of people with HKOA in Portugal have poor management of their pain levels. Clinical and lifestyle factors, that are highly presented in individuals with HKOA, are associated with unmanageable pain. Our results highlighting the need for further research and implementation of effective interventions to improve pain, function and quality of life in people with HKOA.

Burnout, ansiedade e depressão nos Enfermeiros no contexto de pandemia por COVID-19 / Burnout, anxiety and depression in nurses in the context of a COVID-19 pandemic

O surgimento de um surto pandémico por COVID-19, acresce aos enfermeiros momentos de insatisfação, tensões emocionais e relacionais que podem ser motivadoras para o desenvolvimento de burnout, ansiedade e depressão. Assim desenvolveu-se o estudo com base na temática "Burnout, ansiedade e depressão nos Enfermeiros no contexto de pandemia por COVID-19". O objetivo deste estudo consiste em avaliar o impacto que a pandemia por COVID-19 tem nos enfermeiros, relativamente ao burnout, ansiedade e depressão. Este estudo enquadrase na abordagem de caráter quantitativo descritivo-correlacional, transversal. A amostra, não probabilística por conveniência, foi constituída por um total de 234 enfermeiros. No processo de recolha de dados utilizou-se um questionário estruturado com caracterização sociodemográfica/questões gerais, avaliação dos níveis de ansiedade e depressão obtida através da aplicação da escala Hospital Anxiety and Depression Scale (HADS) - Versão Portuguesa (Pais-Ribeiro et al., 2007), e avaliação dos níveis de burnout através da escala de Copenhagen Burnout Inventory (CBI), adaptada para a população Portuguesa (Fonte, 2011). O local de recolha de dados foi no Hospital do Divino Espírito Santo de Ponta Delgada ­ EPER (HDES-EPER), nos serviços que cumpriam os critérios de inclusão e exclusão, a recolha de dados deu-se no mês de julho de 2021, após parecer favorável da comissão de ética e do conselho de administração da referida instituição. O tratamento dos dados foi efetuado com recurso ao programa SPSS (Statistical Package for the Social Sciences) versão 27 para Windows. Os resultados mostraram que a pandemia por COVID-19 teve um impacto nos enfermeiros relativamente ao burnout, ansiedade e depressão, com a manifestação de níveis de burnout, ansiedade e depressão, independentemente do serviço onde prestam cuidados, sexo e estado civil, não havendo relação direta. Denota-se uma relação entre o desenvolvimento de burnout, ansiedade e depressão com a falta e uso prolongado de material de proteção individual, condições de trabalho desfavoráveis, diminuição da realização profissional, medo de contrair a doença, medo de infetar familiares e amigos, isolamento social, relação com os superiores hierárquicos e amigos. Considerando ainda a remuneração como inadequada e a falta de práticas administrativas, como fatores contributivos para o desenvolvimento de burnout, ansiedade e depressão.

The emergence of a pandemic outbreak by COVID-19, adds to the nurse's moments of dissatisfaction, emotional and relational tensions that can be motivating for the development of burnout, anxiety and depression. Thus, the study was developed based on the theme "Burnout, anxiety and depression in nurses in the context of pandemic by COVID19". The aim of this study is to evaluate the impact that the COVID-19 pandemic has on nurses in relation to burnout, anxiety and depression. This study is based on the descriptivecorrelational, cross-sectional quantitative approach. The sample, non-probabilistic for convenience, consisted of a total of 234 nurses. In the data collection process, we used a structured questionnaire with sociodemographic characterization/general questions, evaluation of anxiety and depression levels obtained through the application of the Hospital Anxiety and Depression Scale (HADS) - Portuguese Version (Pais-Ribeiro et al., 2007), and evaluation of burnout levels through the Copenhagen Burnout Inventory (CBI) scale, adapted for the Portuguese population (Fonte, 2011). The place of data collection was at the HDES-EPER, in the services that met the inclusion and exclusion criteria, the data collection took place in July 2021, after the assent of the ethics committee and the board of directors of that institution. Data were processed using the SPSS version 27 for Windows. The results showed that the pandemic by COVID-19 had an impact on nurses regarding burnout, anxiety and depression, with the manifestation of burnout levels, anxiety and depression, regardless of the service where they provide care, sex and marital status, with no direct relationship. Interrelation is denoted for the development of burnout, anxiety and depression with the lack of personal protective material, unfavorable working conditions, decreased professional achievement, fear of contracting the disease, fear of infecting family and friends, social isolation, relationship with hierarchical superiors and prolonged use of personal protective equipment. The nurses manifested symptoms of generalized anxiety and insomnia, considered inadequate remuneration and lack of administrative practices.

Cyclic fatigue resistance of three rotary file systems in a dynamic model after immersion in sodium hypochlorite.

To evaluate the effect of immersion in 3% sodium hypochlorite solution in the resistance to cyclic fatigue of three nickel-titanium (NiTi) rotary file systems, ProTaper Next (PTN), Hyflex CM (CM), and Hyflex EDM (EDM), in a mechanical model featuring axial movement. Ninety instruments of three different NiTi rotary file systems, PTN (size 25, 0.06 taper), CM (25, 0.06), and EDM (25/~, variable taper), were randomly divided according to a 3 × 3 factorial design and tested under dynamic immersion in a 3% NaOCl solution (1 or 5 min) or without immersion, making a total of 9 groups (n = 10). Files were tested in an artificial root canal with 45° angle and 5 mm radius apical curvature being submitted to back-and-forth movements until fracture. Statistical analysis was performed using two-way factorial ANOVA with Bonferroni post-hoc tests, at a significance level of 5%. Instruments were evaluated for reliability using a Weilbull approach. Regardless of the immersion treatment, PTN had on average 1200 ± 178 cycles to fracture, CM had 1949 ± 362, and EDM had 5573 ± 853, which was a significantly different (P < 0.01). The NaOCl immersion promoted a significant reduction in the mean number of cycles to fracture (P = 0.01), and was reflected in a significant reduction of the characteristic life of the instruments of the CM end EDM groups. Within this study conditions, EDM instruments performed better to cyclic fatigue followed by CM and then PTN. Immersion in NaOCl decreased the resistance to cyclic fatigue of all tested instruments, but affected more those manufactured from CM wire.

Taxocenose de bagres marinhos (Siluriformes, Ariidae) da região estuarina de São Vicente, SP, Brasil / Taxocenose of marine catfish (Siluriformes, Ariidae) in the complex bay-estuary of São Vicente, SP, Brazil

O objetivo do trabalho foi analisar a taxocenose de bagres marinhos do complexo baía-estuário de São Vicente, SP. As coletas foram mensais, no período de setembro de 2000 a agosto de 2002, em quatro regiões do estuário. Foram capturados 3.985 exemplares, pertencentes a cinco gêneros e seis espécies, totalizando 47.807 g. A espécie Cathorops spixii apresentou a maior abundância numérica com 1.569 indivíduos amostrados. No transecto I (próximo da região costeira) foi registrada a maior riqueza e no transecto IV (estuário acima) a maior abundância com 2.602 exemplares e peso de 26.236 g. Em março de 2002 registrou-se a maior abundância com 687 indivíduos e o maior peso ocorreu em fevereiro de 2002 (8.816 g). A salinidade da água de fundo, ao longo do período de estudo, variou entre 14 e 36 e a temperatura da água variou entre 19 e 30 ºC. Na região amostrada foram capturados exemplares jovens e adultos, ocorrendo um predomínio de jovens, o que demonstra que esta área apresenta condições favoráveis para crescimento.

The purpose of this study was to analyze the taxocenose of marine catfish in the complex bay-estuary of Sao Vicente, Brazil. The sampling was done monthly from September/2000 to August/2002, in four places of the estuary. Were caught 3.985 individuals belonging for 5 genus and 6 species, totalizing 47.807 g. The specie Cathorops spixii showed the biggest plentiful with 1.569 individuals sampled. In the transect I (close to the coastal region), it was registered the biggest richness (6 species) and in the transect IV (upper estuary) the biggest number of individuals (n = 2.602) e weight of 26.236 g. In March/2002 were registered the biggest occurrence with 687 individuals and biggest weight in February/2002 (8.816 g). The bottom water salinity, in the time of study, changed between 14 and 36, and the water temperature varied between 19 and 30 ºC. In the sample place juveniles and adults' individuals were caught, a mostly juvenile which demonstrates that of this place shows favorable conditions for growth.

Growth of the hermit crab Clibanarius vittatus (Bosc, 1802) (Crustacea, Anomura, Diogenidae) at São Vicente, São Paulo, Brazil

The present study analyzed the growth of males and females of the hermit crab Clibanarius vittatus (Bosc, 1802), at São Vicente, São Paulo, Brazil. Monthly collections were made from May/2001 through April/2003, at the Pescadores Beach in São Vicente. The 2,501 crabs caught were identified and sexed and the carapace shield length (CSL) was measured. For the seasonal growth study, the population was divided into 5mm size classes (CSL) and analyzed by the Bertalanffy method, with the aid of the program Fisat II. The mean sizes of the 703 males and 1,798 females were 8.94±1.80 and 6.61±1.13 mm, respectively. A seasonal growth pattern was observed, with males reaching an asymptotic size (14.92 mm) larger than that of females (13.85 mm). Males began the growth process approximately five months before the females. This growth pattern probably helped to reduce intraspecific competition for the shells, because the males reached larger size and made the smaller shells available to the females.

O presente estudo teve como objetivo analisar o crescimento de machos e fêmeas do ermitão Clibanarius vittatus (Bosc, 1802), da região de São Vicente, São Paulo, Brasil. Foram realizadas coletas mensais de maio/2001 a abril/2003, na Praia dos Pescadores em São Vicente. Os 2.501 animais capturados foram identificados, determinados quanto ao sexo e mensurados quanto ao seu comprimento de escudo cefalotorácico (CEC). Para o estudo sazonal do crescimento, a população foi dividida em classes de tamanho de 5mm de (CEC), e analisada pelo método de Bertalanffy, com o auxílio do software Fisat II. Foram obtidos 703 indivíduos machos e 1.798 fêmeas, com média de tamanho de 8.94±1.80 e 6.61±1.13mm, respectivamente. Constatou-se um padrão de crescimento sazonal, com machos atingindo um tamanho assintótico (14.92mm) superior ao das fêmeas (13.85mm), além de iniciarem o processo de crescimento aproximadamente cinco meses antes destas. Desta forma, é provável que este seja um padrão que auxilia na diminuição da disputa intra-específica por conchas, uma vez que os machos atingiram maior tamanho e estariam disponibilizando conchas menores para as fêmeas.