Neonatal outcomes associated with tobacco, alcohol, and crack use during pregnancy in three Neonatal Intensive Care Units.

Despite the prevalence of substance use during pregnancy, studies focusing exclusively on Neonatal Intensive Care Units (NICU) admissions remain limited. This study investigates the impact of maternal use of tobacco, alcohol, and/or crack, on neonatal outcomes among infants admitted to three Brazilian NICUs. Additionally, the investigation explores the impact of substance use on DNA damage in newborns. Over a one-year period, data from 254 newborns were collected through medical records, accompanied by blood samples. Findings revealed that 16.1% of newborns had mothers reporting substance use during pregnancy. Significant associations were found between maternal substance use and adverse neonatal outcomes, including low birth weight, preterm birth, and sexually transmitted infections. Maternal variables linked to substance use encompassed non-white skin color, low education, non-masonry housing, lower income, diseases in other children, and fewer prenatal consultations. Notably, neonatal DNA damage showed no significant association with substance use. Our results underscore the substantial impact of maternal substance use on NICU-admitted infants, emphasizing the necessity for targeted interventions that address both neonatal health and maternal well-being, thereby underscoring the crucial role of comprehensive care in NICU settings.

Determinantes sociais do consumo de substâncias psicoativas por adolescentes escolares do município do Rio de Janeiro / Social determinants of the consumption of psychoactive substances by school adolescents in the city of Rio de Janeiro

INTRODUÇÃO: O consumo de substâncias psicoativas durante a adolescência é um importante problema de saúde pública em todo mundo, devido as suas graves consequências, assim como pela imensa vulnerabilidade desta fase para iniciar esse comportamento. Por isso, não pode ser encarado de forma reducionista ou simplista, pois é um fenômeno social multifacetado, que envolve a complexidade do ser humano e suas relações. OBJETIVOS ESPECÍFICOS: Caracterizar os determinantes sociais da saúde dos adolescentes escolares do município do Rio de Janeiro; Comparar as desigualdades entre os determinantes sociais de escolas públicas e privadas; Conhecer os determinantes sociais do consumo atual do álcool, tabaco e drogas ilícitas por adolescentes escolares. OBJETIVO GERAL: Analisar o uso de substâncias psicoativas por adolescentes escolares do município do Rio de Janeiro, na perspectiva dos Determinantes Sociais da Saúde segundo o modelo de Solar e Irwin (OMS, 2011). Método: Tratou-se de um estudo transversal que fez uso dos dados da Pesquisa Nacional de Saúde do Escolar (PeNSE) 2019 referentes ao município do Rio de Janeiro, realizado com adolescentes escolares de 13 a 17 anos de idade, cujo n amostral foi 3.158. Os dados foram submetidos à análise descritiva e cálculo da prevalência. A comparação entre as diferenças dos grupos estudados foi mensurada por meio do teste do qui-quadrado de Pearson, com nível de significância de 5%. As variáveis de exposição do estudo foram organizadas de acordo com o referencial teórico adotado, o modelo de Solar e Irwin (OMS, 2011), organizadas para operacionalização e análise dos dados da pesquisa, comparadas segundo a dependência administrativa da escola. As variáveis de desfecho do presente estudo foram: o consumo de álcool, tabaco e drogas ilícitas. Utilizou-se análise de regressão logística múltipla, calculando-se as OR ajustadas, com seus respectivos IC95%. RESULTADOS: Os determinantes sociais estudados apresentam diferenças significativas em relação ao tipo de escola, além de todas as substâncias estudadas terem apresentado maior prevalência nas escolas públicas. Destacou-se maior chance de consumo de álcool e tabaco por adolescentes do sexo feminino e pelos não brancos, em ambas as escolas. Outro resultado importante e que foi unanimidade nas substâncias estudadas, diz respeito a maior chance em casos de comportamento de risco, como o consumo de outras substâncias, atividade sexual e falta às aulas sem permissão dos pais, além de maior chance de consumo entre os adolescentes mais velhos. CONCLUSÃO: Os dados encontrados reforçam a importância do tipo de escola como um marcador de desigualdades sociais no município do Rio de Janeiro, assim como elevadas prevalências de consumo de substâncias pelos adolescentes escolares e a importância das políticas públicas destacarem seus olhares sobre as questões de gênero e raça no consumo das mesmas. Reforça-se a multidimensionalidade da problemática, cuja prevenção abrange diversos setores da sociedade. Esse olhar poderá contribuir para ampliar o olhar dos profissionais de saúde, especialmente ligados à atenção básica, assim como gestores e pesquisadores sobre a necessidade de abordar o fenômeno de forma abrangente.

INTRODUCTION: The consumption of psychoactive substances during adolescence is an important public health problem worldwide, due to its serious consequences, as well as the immense vulnerability of this phase to initiate this behavior, which is why it cannot be viewed in a reductionist or simplistic way, as it is a multifaceted social phenomenon, which involves the complexity of human beings and their relationships. SPECIFIC OBJECTIVES: Characterize the social determinants of health among school adolescents in the city of Rio de Janeiro; Compare inequalities between social determinants of public and private schools; Know the social determinants of the current consumption of alcohol, tobacco and illicit drugs by school adolescentes. GENERAL OBJECTIVE: To analyze the use of psychoactive substances by school adolescents in the city of Rio de Janeiro, from the perspective of Social Determinants of Health according to the Solar and Irwin model (WHO, 2011). Method: This was a cross-sectional study that used data from the National School Health Survey (PeNSE) 2019 for the city of Rio de Janeiro, carried out with school adolescents aged 13 to 17 years old, whose sample size was 3,158. The data were subjected to descriptive analysis and prevalence calculation, the comparison between the differences between the studied groups was measured by using Pearson's chi-square test, with a significant level of 5%. The study's exposure variables were organized according to the adopted theoretical framework, the Solar and Irwin model (WHO, 2011), organized for operationalization and analysis of research data, according to the administrative dependency of the school. The outcome variables of the present study were: consumption of alcohol, tobacco and illicit drugs. Multiple logistic regression analysis was used, calculating the adjusted ORs, with their respective 95% CI. RESULTS: The social determinants studied present significant differences in relation to the type of school, in addition to all the substances studied having a higher prevalence in public schools. A greater chance of alcohol and tobacco consumption was highlighted by female adolescents and non-whites, in both schools, another important result, which was unanimous in the substances studied, concerns the greater chance in cases of risk behavior, such as consumption of other substances, sexual activity and missing classes without parental permission, in addition to a greater chance of consumption among older adolescents. CONCLUSION: The data found reinforces the importance of the type of school as a marker of social inequalities in the city of Rio de Janeiro, as well as the high prevalence of substance use by school adolescents and the importance of public policies highlighting gender issues and race in their consumption. The multidimensionality of the problem is reinforced, and that its prevention covers different sectors of society. This view may contribute to broadening the perspective of health professionals, especially those linked to primary care, as well as managers and researchers on the need to address the phenomenon in a comprehensive manner.

Exploring the antioxidant activity of Fe(III), Mn(III)Mn(II), and Cu(II) compounds in Saccharomyces cerevisiae and Galleria mellonella models of study.

Reactive oxygen species (ROS) are closely related to oxidative stress, aging, and the onset of human diseases. To mitigate ROS-induced damages, extensive research has focused on examining the antioxidative attributes of various synthetic/natural substances. Coordination compounds serving as synthetic antioxidants have emerged as a promising approach to attenuate ROS toxicity. Herein, we investigated the antioxidant potential of a series of Fe(III) (1), Mn(III)Mn(II) (2) and Cu(II) (3) coordination compounds synthesized with the ligand N-(2-hydroxybenzyl)-N-(2-pyridylmethyl)[(3-chloro)(2-hydroxy)]-propylamine in Saccharomyces cerevisiae exposed to oxidative stress. We also assessed the antioxidant potential of these complexes in the alternative model of study, Galleria mellonella. DPPH analysis indicated that these complexes presented moderate antioxidant activity. However, treating Saccharomyces cerevisiae with 1, 2 and 3 increased the tolerance against oxidative stress and extended yeast lifespan. The treatment of yeast cells with these complexes decreased lipid peroxidation and catalase activity in stressed cells, whilst no change in SOD activity was observed. Moreover, these complexes induced the Hsp104 expression. In G. mellonella, complex administration extended larval survival under H2O2 stress and did not affect the insect's life cycle. Our results suggest that the antioxidant potential exhibited by these complexes could be further explored to mitigate various oxidative stress-related disorders.

The mental health of nurses who are women and mothers during the COVID-19 pandemic.

OBJECTIVE: To reflect on the mental health of nurses who are women and mothers in the context of the COVID-19 pandemic. METHOD: Theoretical-reflective study based on scientific literature, supported by national and international scientific literature, in addition to a critical analysis by the authors. RESULTS: Reflections on the subject go beyond the impact of motherhood on these women's lives, as it portrays a gender issue and the role of women within society. The stress of working on the frontlines of a pandemic, added to the demands of children and housework, can trigger exhaustion and mental health repercussions. CONCLUSION: Workers must seek individual measures and health managers must enable collective strategies in the work environment of the institutions, proposing public policies that make both employers, workers and their families co-responsible.

ROS scavenging of SOD/CAT mimics probed by EPR and reduction of lipid peroxidation in S. cerevisiae and mouse liver, under severe hydroxyl radical stress condition.

The interaction between CuII, FeIII and MnII complexes, derived from the ligands 1-[bis(pyridine-2-ylmethyl)amino]-3-chloropropan-2-ol (hpclnol) and bis(pyridine-2-ylmethyl)amine (bpma), and the free radical 2,2-diphenyl-1-(2,4,6-trinitrophenyl)hydrazyl (DPPH) and reactive oxygen species (ROS), was investigated by colorimetric and EPR (Electron Paramagnetic Resonance) techniques. A comparison between these results and those reported to [Mn(salen)Cl] or EUK-8 was also addressed. EPR studies allowed us the identification of intermediates species such as superoxide­copper(I) and superoxide­copper(II), a mixed-valence FeIIIFeII species and a 16-line feature attributed to MnIII-oxo-MnIV species. The biomarker malondialdehyde (MDA) was determined by TBARS assay in S. cerevisiae cells, and the determination of the IC50 indicate that the antioxidant activity shown dependence on the metal center (CuII ≈ FeIII > MnII ≈ [Mn(salen)Cl]. The lipid peroxidation attenuation was also investigated in liver homogenates obtained from Swiss mice and the IC50 values were in the nanomolar concentrations. We demonstrated here that all the complexes interact with the free radical DPPH and with ROS (H2O2, O2•- and hydroxyl radical), enhancing the cellular protection against oxidative stress generated by hydroxyl radical, employing two experimental model systems, S. cerevisiae (in vivo) and mouse liver (ex vivo).

The mental health of nurses who are women and mothers during the COVID-19 pandemic / Salud mental de enfermeras, mujeres y madres durante el período pandémico del COVID-19 / Saúde mental de enfermeiras, mulheres e mães no período da pandemia de COVID-19

ABSTRACT Objective: To reflect on the mental health of nurses who are women and mothers in the context of the COVID-19 pandemic. Method: Theoretical-reflective study based on scientific literature, supported by national and international scientific literature, in addition to a critical analysis by the authors. Results: Reflections on the subject go beyond the impact of motherhood on these women's lives, as it portrays a gender issue and the role of women within society. The stress of working on the frontlines of a pandemic, added to the demands of children and housework, can trigger exhaustion and mental health repercussions. Conclusion: Workers must seek individual measures and health managers must enable collective strategies in the work environment of the institutions, proposing public policies that make both employers, workers and their families co-responsible.

RESUMEN Objetivo: Reflexionar sobre la salud mental de enfermeras, mujeres y madres en el contexto de la pandemia de COVID-19. Método: Estudio teórico-reflexivo basado en literatura científica, sustentado en literatura científica nacional e internacional y análisis crítico de los autores. Resultados: Las reflexiones sobre el tema van más allá del impacto de la maternidad en la vida de estas mujeres, pues retrata una cuestión de género y el papel de la mujer en la sociedad. El estrés de trabajar en la primera línea de una pandemia, sumado a las exigencias de los niños y las tareas del hogar, pueden desencadenar agotamiento y repercusiones en la salud mental. Conclusión: Corresponde a los trabajadores buscar medidas individuales además de los gestores de salud para brindar estrategias colectivas en el ámbito laboral de las instituciones, propiciando políticas públicas que hagan corresponsables tanto al empleador como al trabajador y sus familias.

RESUMO Objetivo: Refletir sobre a saúde mental de enfermeiras mulheres e mães no contexto da pandemia da COVID-19. Método: Estudo teórico-reflexivo realizado a partir da literatura científica, fundamentado por literatura científica nacional e internacional e análise crítica dos autores. Resultados: As reflexões acerca da temática vão além do impacto no que se refere à maternidade na vida dessas mulheres, pois retrata uma questão de gênero e sobre o papel da mulher dentro da sociedade. O estresse da atividade laboral na linha de frente de uma pandemia somado às demandas dos filhos e do trabalho doméstico pode desencadear exaustão e repercussões na saúde mental. Conclusão: Cabe às trabalhadoras buscarem medidas individuais além de os gestores de saúde oportunizarem estratégias coletivas no ambiente de trabalho das instituições, proporcionando políticas públicas que corresponsabilizem tanto empregador quanto trabalhador e suas famílias.

HIV-1 genetic diversity and transmitted drug resistance to integrase strand transfer inhibitors among recently diagnosed adults in Porto Alegre, South Brazil.

OBJECTIVES: The HIV-1 genetic diversity and the presence of transmitted drug resistance mutations (TDRMs) against integrase strand transfer inhibitors (INSTIs) were assessed sequencing samples of antiretroviral (ARV)-naive HIV-1-infected individuals from South Brazil. METHODS: Viral RNA from 42 ART-naive individuals was submitted to complete HIV-1 integrase gene amplification by RT-PCR and sequencing. RESULTS: Viral strains carrying TDRMs against INSTIs were not detected in the present study. However, the polymorphisms L74M and L74I were each observed in 4.8% of the individuals. These accessory mutations have been reported as putative causes of TDRMs in ART with raltegravir, but only when associated with additional major mutations. When submitted to HIV-1 subtyping, 50% were classified as subtype C, 21% as recombinant BC, 19% as subtype B, 4.8% as subtype F1 and 4.8% as recombinant CF1. CONCLUSIONS: All 42 ARV-naive individuals were apparently susceptible to INSTIs, included in the Brazilian therapeutic guideline since 2009. To the best of our knowledge, this is the first study to evaluate TDRMs against INSTIs in Brazil. The most prevalent HIV-1 subtypes were subtype C, followed by the recombinant BC and subtype B, which is in agreement with previous studies. However, the presence of subtype F1 and recombinant CF1 reported herein was not observed in previous studies.

Clustering the engagement of Brazilian nurses in political advocacy.

OBJECTIVES: to analyze the level of nurses' engagement in political advocacy by performing cluster analysis. METHODS: observational study, with a quantitative approach. A total of 184 nurses working in primary, secondary, and tertiary care in a city in the south of Brazil completed the Policy Advocacy Engagement Scale. Data analysis consisted of descriptive statistics, cluster analysis, analysis of variance, and chi2. The Institutional Review Board approved the study. RESULTS: four differentiated clusters were found according to professional experience, level of healthcare complexity, and unit. The cluster analysis revealed that patient advocacy for community-based obtained the highest mean, indicating that political advocacy is effective in organizational environments and that professional qualification favors greater engagement in political advocacy. CONCLUSIONS: the results reveal that nurses play an active role in political advocacy, seeking to promote positive changes in health, especially those working in tertiary care, the nurse group that obtained the highest means.

Hydrolytic activity of new bioinspired MnIIIMnII and FeIIIMnII complexes as mimetics of PAPs: Biological and environmental interest.

Coordination compounds that mimic Purple Acid Phosphatases (PAPs) have drawn attention in the bioinorganic field due to their capacity to cleave phosphodiester bonds. However, their catalytic activity upon phosphate triesters is still unexplored. Thus, we report the synthesis and characterization of two binuclear complexes, [MnIIMnIII(L1)(OAc)2]BF4 (1) and [MnIIFeIII(L1)(OAc)2]BF4 (2) (H2L1 = 2-[N,N-bis-(2- pyridilmethyl)aminomethyl]-4-methyl-6-[N-(2-hydroxy-3-formyl-5-methylbenzyl)-N-(2-pyridylmethyl)aminomethyl]phenol), their hydrolytic activity and antioxidant potential. The complexes were fully characterized, including the X-Ray diffraction (XRD) of 1. Density functional theory (DFT) calculations were performed to better understand their electronic and structural properties and phosphate conjugates. The catalytic activity was analyzed for two model substrates, a diester (BDNPP) and a triester phosphate (DEDNPP). The results suggest enhancement of the hydrolysis reaction by 170 to 1500 times, depending on the substrate and complex. It was possible to accompany the catalytic reaction of DEDNPP hydrolysis by phosphorus nuclear magnetic resonance (31P NMR), showing that both 1 and 2 are efficient catalysts. Moreover, we also addressed that 1 and 2 present a relevant antioxidant potential, protecting the yeast Saccharomyces cerevisiae, used as eukaryotic model of study, against the exposure of cells to acute oxidative stress.

Clustering the engagement of Brazilian nurses in political advocacy / Agrupando el compromiso de los enfermeros brasileños en la incidencia política / Cluster do engajamento dos enfermeiros brasileiros na advocacia política

ABSTRACT Objectives: to analyze the level of nurses' engagement in political advocacy by performing cluster analysis. Methods: observational study, with a quantitative approach. A total of 184 nurses working in primary, secondary, and tertiary care in a city in the south of Brazil completed the Policy Advocacy Engagement Scale. Data analysis consisted of descriptive statistics, cluster analysis, analysis of variance, and chi2. The Institutional Review Board approved the study. Results: four differentiated clusters were found according to professional experience, level of healthcare complexity, and unit. The cluster analysis revealed that patient advocacy for community-based obtained the highest mean, indicating that political advocacy is effective in organizational environments and that professional qualification favors greater engagement in political advocacy. Conclusions: the results reveal that nurses play an active role in political advocacy, seeking to promote positive changes in health, especially those working in tertiary care, the nurse group that obtained the highest means.

RESUMEN Objetivos: analizar el nivel de compromiso de los enfermeros en la incidencia política a través del análisis de conglomerados. Métodos: estudio observacional con enfoque cuantitativo. Un total de 184 enfermeras que trabajan en atención primaria, secundaria y terciaria en una ciudad en el sur de Brasil completaron la Escala de Compromiso de Incidencia Política. El análisis de datos consistió en estadística descriptiva, análisis de conglomerados, análisis de varianza y chi2. El Comité de Ética en Investigación aprobó el estudio. Resultados: se encontraron cuatro conglomerados diferenciados según experiencia profesional, nivel de complejidad asistencial y unidad. El análisis de conglomerados reveló que la defensa de los pacientes por la comunidad tuvo el promedio más alto, lo que indica que la defensa política es efectiva en entornos organizacionales y que la calificación profesional favorece una mayor participación en la defensa política. Conclusiones: los resultados revelan que los enfermeros tienen un papel activo en la incidencia política, buscando promover cambios positivos en la salud, especialmente aquellos que actúan en el tercer nivel de atención, grupo de enfermeros que obtuvo los promedios más altos.

RESUMO Objetivos: analisar o nível de engajamento dos enfermeiros na advocacia política por meio da análise de cluster. Métodos: estudo observacional, com abordagem quantitativa. Um total de 184 enfermeiros que atuam na atenção primária, secundária e terciária em uma cidade do sul do Brasil preencheram a Policy Advocacy Engagement Scale. A análise dos dados consistiu em estatística descritiva, análise de cluster, análise de variância e chi2. O Comitê de Ética em Pesquisa aprovou o estudo. Resultados: foram encontrados quatro clusters diferenciados de acordo com a experiência profissional, nível de complexidade assistencial e unidade. A análise de agrupamento revelou que a advocacia do paciente para a comunidade obteve a maior média, indicando que a advocacia política é efetiva em ambientes organizacionais e que a qualificação profissional favorece maior engajamento na advocacia política. Conclusões: os resultados revelam que os enfermeiros exercem um papel ativo na advocacia política, buscando promover mudanças positivas na saúde, principalmente os que atuam na atenção terciária, grupo de enfermeiros que obteve as maiores médias.

Prazer e sofrimento de trabalhadores de um centro de atenção psicossocial no cuidado ofertado a crianças e adolescentes frente à pandemia da covid-19 / Pleasure and suffering of workers at a psychosocial care center in the care offered to children and adolescents in the face of the covid-19 pandemic

Introdução: A pandemia causou modificações na organização do trabalho, onde os trabalhadores tiveram que buscar maneiras de se adaptarem a essa nova realidade, a qual pode ser desencadeadora de sofrimento perante a realização do cuidado a crianças e adolescentes que frequentam Centros de Atenção Psicossocial Infantojuvenis (CAPSi). Além disso, ainda há poucos estudos sobre os efeitos do trabalho na saúde mental dos profissionais que atuam nos CAPSi durante o atual cenário. Frente ao exposto questiona-se: "Quais são os fatores geradores de prazer e sofrimento no trabalho nos CAPSi frente à pandemia de COVID-19?" Objetivo: Analisar os fatores geradores de prazer e sofrimento de trabalhadores de um CAPSi de Porto Alegre no cuidado prestado a crianças e adolescentes frente à pandemia da COVID-19. Metodologia: Foi desenvolvida uma pesquisa do tipo estudo de caso de cunho qualitativo, com caráter exploratório-descritivo, utilizando-se o referencial da psicodinâmica do trabalho. O estudo foi realizado com 16 trabalhadores que atuam em um CAPSi do município de Porto Alegre. A coleta de dados ocorreu entre os meses de fevereiro à março de 2022 através de observação participante e entrevista semiestruturada. Resultados: Após análises dos dados emergiram três categorias: Fatores geradores de prazer no trabalho durante a pandemia, fatores geradores de sofrimento no trabalho durante a pandemia e estratégias defensivas utilizadas pelos trabalhadores: individuais e coletivas. Considerações finais: Acredita-se que esta pesquisa possa servir como subsídio para a elaboração e implementação de medidas preventivas para reduzir os agravos relacionados ao trabalho nos CAPSi, bem como para aperfeiçoar as condições laborais e promover melhoria na assistência prestada ao usuário durante a pandemia. O estudo pode contribuir ainda para a discussão sobre questões relacionadas à saúde do trabalhador dos CAPSi, na medida em que dá visibilidade ao sofrimento dessa categoria, contribuindo para o desencadeamento de um processo de reflexão sobre o tema.

Introduction: The pandemic caused changes in the organization of work, the workers had to look for ways to adapt to this new reality, that can trigger suffering in the face of the care provided to children and teenagers who are treated at the Psychosocial Care Center for Children and Adolescents (CAPSi). In addition, there are still few studies on the effects of work on the mental health of professionals working at CAPSi during the current scenario. In view of the above, the following question are posed: "What are the factors that generate pleasure and suffering at work in CAPSi in face of the COVID-19 pandemic?". Objective: Analyze the factors that generate pleasure and suffering of workers at CAPSi in Porto Alegre in the care provided to children and adolescents in the face of the COVID-19 pandemic. Methodology: A qualitative case study research was developed, with an exploratory- descriptive character, based on the work psychodynamics. The study was carried out with 16 workers who work in a CAPSi in Porto Alegre. Data collection was carried out by semi-structured interviews and participant observation between February and March 2022. Results: Three categories met: pleasure at work during the pandemic, suffering at work during the pandemic and defensive strategies category: individual and collective. Final considerations: It is believed that this research can serve as a subsidy for the elaboration and implementation of preventive measures to reduce work-related injuries in CAPSi, as well as to improve working conditions and promote improvement in the assistance provided for the users during the pandemic. The study can be used for discussion on issues related to the health of CAPSi workers, as it gives visibility to the suffering category, also triggering a process of reflection on the subject.

Comunicação de notícias difíceis na atenção básica à saúde: percepção dos estudantes de enfermagem / Communicating difficult news in primary health care: Nursing students' perceptions / Comunicación de noticias difíciles en la atención de salud básica: percepción de estudiantes de enfermería

Objetivo: conhecer a percepção dos estudantes de enfermagem acerca da comunicação de notícias difíceis na Atenção Básica à Saúde mediante suas vivências no período de formação. Método: estudo descritivo com abordagem qualitativa no qual participaram 12 estudantes de enfermagem de uma universidade pública do sul do Brasil. Os dados foram coletados em junho de 2019, a partir da técnica de grupo focal e submetidos à análise textual discursiva. Resultados: emergiram duas categorias: "percepção dos estudantes acerca das notícias difíceis na Atenção Básica à Saúde" e "formação em enfermagem para comunicação de notícias difíceis". Conclusão: percebe-se que os estudantes possuem fragilidades em comunicar notícias difíceis na atenção básica à saúde durante o período de formação. Para que seja possível preencher essa lacuna, as instituições formadoras têm um grande caminho a percorrer, adotando estratégias para o fortalecimento do processo de comunicação de notícias difíceis tanto na teoria quanto na prática.

Objective: to learn Nursing students' perceptions as regards communicating difficult news in Primary Health Care, as experienced during the training period. Method: in this qualitative, descriptive study, the participants were 12 Nursing students from a public university in southern Brazil. Data were collected in June 2019, using the focus group technique, and submitted to discursive textual analysis. Results: two categories emerged: "students' perception of difficult news in Primary Health Care" and "Nursing training to communicate difficult news". Conclusion: the students were found to suffer from weaknesses in communicating difficult news in Primary Health Care during the training period. Training institutions have a long way to go to fill this gap by adopting strategies to strengthen the process of communicating difficult news in both theory and practice.

Objetivo: conocer la percepción de los estudiantes de enfermería sobre la comunicación de noticias difíciles en la Atención Primaria de Salud a través de sus experiencias durante el período de formación. Método: estudio descriptivo con enfoque cualitativo en el que participaron 12 estudiantes de enfermería de una universidad pública del sur de Brasil. Los datos fueron recolectados en junio de 2019, con base en la técnica del grupo focal y sometidos al Análisis Textual Discursivo. Resultados: surgieron dos categorías: "percepción de los estudiantes sobre las noticias difíciles en Atención Primaria de Salud" y "capacitación en enfermería para comunicar noticias difíciles". Conclusión: se observa que los estudiantes tienen debilidades para comunicar noticias difíciles en la atención primaria de salud durante el período de formación. Para poder llenar este vacío, las instituciones a cargo de la capacitación tienen un largo camino por recorrer, adoptando estrategias para fortalecer el proceso de comunicación de noticias difíciles, tanto en la teoría como en la práctica.

Pleasure and suffering in the work of nurses at the oncopediatric hospital unit: qualitative research.

OBJECTIVE: To analyze the experiences that generate pleasure and suffering in the work of nurses in an oncopediatric inpatient unit. METHODS: Qualitative, exploratory, descriptive study. Data collection took place from March to May 2018, through interviews with eight nurses in an oncopediatric inpatient unit. RESULTS: The verbalized experiences of pleasure were the work developed with children, participation in the treatment and cure of patients and the recognition of family members in relation to the work performed. The suffering experiences were palliative care and death of patients, performing invasive procedures and organizing work. FINAL CONSIDERATIONS: It was possible to analyze the experiences of pleasure and suffering of nurses in an oncopediatric unit through the psychodynamics of work, allowing to reinvent prevention and intervention measures by managers in health/mental illness processes at work.

Pieces of the Complex Puzzle of Cancer Cell Energy Metabolism: An Overview of Energy Metabolism and Alternatives for Targeted Cancer Therapy.

Over the past decades, several advances in cancer cell biology have led to relevant details about a phenomenon called the 'Warburg effect'. Currently, it has been accepted that the Warburg effect is not compatible with all cancer cells, and thus the process of aerobic glycolysis is now challenged by the knowledge of a large number of cells presenting mitochondrial function. The energy metabolism of cancer cells is focused on the bioenergetic and biosynthetic pathways in order to meet the requirements of rapid proliferation. Changes in the metabolism of carbohydrates, amino acids and lipids have already been reported for cancer cells and this might play an important role in cancer progression. To the best of our knowledge, these changes are mainly attributed to genetic reprogramming which leads to the transformation of a healthy into a cancerous cell. Indeed, several enzymes that are highly relevant for cellular energy are targets of oncogenes (e.g. PI3K, HIF1, and Myc) and tumor suppressor proteins (e.g. p53). As a consequence of extensive studies on cancer cell metabolism, some new therapeutic strategies have appeared that aim to interrupt the aberrant metabolism, in addition to influencing genetic reprogramming in cancer cells. In this review, we present an overview of cancer cell metabolism (carbohydrate, amino acid, and lipid), and also describe oncogenes and tumor suppressors that directly affect the metabolism. We also discuss some of the potential therapeutic candidates which have been designed to target and disrupt the main driving forces associated with cancer cell metabolism and proliferation.

Pleasure and suffering in the work of nurses at the oncopediatric hospital unit: qualitative research / Placer y sufrimiento en el trabajo de los enfermeros de la unidad de internación oncopediátrica: investigación cualitativa / Prazer e sofrimento no trabalho dos enfermeiros da unidade de internação oncopediátrica: pesquisa qualitativa

ABSTRACT Objective: To analyze the experiences that generate pleasure and suffering in the work of nurses in an oncopediatric inpatient unit. Methods: Qualitative, exploratory, descriptive study. Data collection took place from March to May 2018, through interviews with eight nurses in an oncopediatric inpatient unit. Results: The verbalized experiences of pleasure were the work developed with children, participation in the treatment and cure of patients and the recognition of family members in relation to the work performed. The suffering experiences were palliative care and death of patients, performing invasive procedures and organizing work. Final considerations: It was possible to analyze the experiences of pleasure and suffering of nurses in an oncopediatric unit through the psychodynamics of work, allowing to reinvent prevention and intervention measures by managers in health/mental illness processes at work.

RESUMEN Objetivo: Analizar las vivencias generadoras de placer y sufrimiento en el trabajo de enfermeros en una unidad de internación oncopediátrica. Método: Estudio cualitativo, del tipo exploratorio-descriptivo. La recogida de datos ocurrió de marzo a mayo de 2018, por medio de entrevistas con ocho enfermeros en una unidad de internación oncopediátrica. Resultados: Las vivencias de placer verbalizadas han sido el trabajo desarrollado con niños, la participación en el tratamiento y cura de los pacientes y el reconocimiento de los familiares en relación al trabajo realizado. Las vivencias de sufrimiento han sido los cuidados paliativos y muerte de los pacientes, realización de procedimientos invasivos y organización del trabajo. Consideraciones finales: Ha sido posible analizar las vivencias de placer y sufrimiento de enfermeros en una unidad oncopediátrica por medio de la psicodinámica del trabajo, permitiendo reinventar medidas de prevención e intervención de los gestores en los procesos de salud/enfermedad mental en el trabajo.

RESUMO Objetivo: Analisar as vivências geradoras de prazer e sofrimento no trabalho de enfermeiros em uma unidade de internação oncopediátrica. Método: Estudo qualitativo, do tipo exploratório-descritivo. A coleta de dados ocorreu de março a maio de 2018, por meio de entrevistas com oito enfermeiros em uma unidade de internação oncopediátrica. Resultados: As vivências de prazer verbalizadas foram o trabalho desenvolvido com crianças, a participação no tratamento e cura dos pacientes e o reconhecimento dos familiares em relação ao trabalho realizado. As vivências de sofrimento foram os cuidados paliativos e morte dos pacientes, realização de procedimentos invasivos e organização do trabalho. Considerações finais: Foi possível analisar as vivências de prazer e sofrimento de enfermeiros em uma unidade oncopediátrica por meio da psicodinâmica do trabalho, permitindo reinventar medidas prevenção e intervenção dos gestores nos processos de saúde/doença mental no trabalho.

Percepções de familiares sobre o cuidado de enfermagem às pessoas com sintomas psiquiátricos / Family members' perceptions of nursing care for people with psychiatric symptoms

RESUMO Objetivo compreender as percepções de familiares sobre o cuidado de enfermagem destinado às pessoas com sintomas psiquiátricos. Métodos estudo qualitativo, com 13 familiares, em cinco unidades de internação clínica vinculadas ao serviço de enfermagem clínica de um hospital geral. A coleta de dados ocorreu mediante entrevistas semiestruturadas. Resultados os desafios percebidos pelos familiares foram: rotatividade dos profissionais nas escalas de trabalho e dificuldade de manejo especializado. Os participantes sugeriram capacitação da equipe, maior integração multiprofissional, melhora do manejo e diminuição da rotatividade dos profissionais durante o cuidado. Conclusão os familiares verbalizaram dificuldades e sugestões para subsidiar a reflexão sobre o cuidado ofertado às pessoas com sintomas psiquiátricos internadas em unidades clínicas hospitalares, a fim de melhorar as práticas de trabalho e qualificar o cuidado.

ABSTRACT Objective to understand family members' perceptions of nursing care for people with psychiatric symptoms. Methods qualitative study, with 13 family members, in five clinical inpatient units linked to the clinical nursing service of a general hospital. Data were collected through semi-structured interviews. Results the challenges perceived by family members were turnover of professionals in the work schedules and difficulty in specialized management. The participants suggested training of the team, greater multi-professional integration, improved management and reduced turnover of professionals during care. Conclusion family members verbalized difficulties and suggestions to support reflection on the care offered to people with psychiatric symptoms hospitalized in clinical units, in order to improve work practices and qualify care.

Dificuldades e estratégias relacionadas com a doação de sangue em um serviço de hemoterapia / Difficulties and strategies related to blood donation in a hemotherapy service

RESUMO Objetivo analisar os aspectos dificultadores na doação de sangue e as estratégias para captação de doadores. Métodos estudo qualitativo realizado com 12 doadores. A coleta de dados ocorreu por meio de entrevista semiestruturada e foram analisadas por Análise de Conteúdo. Resultados em relação aos aspectos dificultadores, foram pontuadas a falta de tempo e a pouca flexibilidade nos horários de atendimento, o deslocamento no acesso ao serviço e o medo do processo de doação. Como estratégias de captação, os entrevistados verbalizam sobre a divulgação e campanhas internas nas empresas, educação nas escolas e universidades, fidelização de doadores, flexibilidade nos horários do hemocentro e unidades móveis para doação de sangue em pontos estratégicos da cidade. Conclusão os doadores pontuaram dificuldades e sugestões de estratégias, constituindo-se em informações relevantes para propostas inovadoras que auxiliem no processo de captação de novos doadores de sangue.

ABSTRACT Objective to analyze the aspects that hinder blood donation and strategies to attract donors. Methods qualitative study conducted with 12 donors. The data was collected through semi-structured interviews and analyzed using Content Analysis. Results regarding the complicating aspects, the lack of time and little flexibility in service hours, the displacement in accessing the service and the fear of the donation process were scored. As strategies for attraction, the interviewees talked about the dissemination and internal campaigns in companies, education in schools and universities, loyalty of donors, flexibility in the hours of the blood center and mobile units for blood donation at strategic points in the city. Conclusion donors pointed out difficulties and suggestions for strategies, constituting relevant information for innovative proposals that help in the process of attracting new blood donors.

Comunicação de notícias difíceis na atenção básica / Communication of difficult news in basic attention / Comunicación de noticias difíciles en la atención básica

Objetivo: Conhecer como ocorre a comunicação de notícias difíceis por enfermeiros na atenção básica. Método: pesquisa exploratória, descritiva e de abordagem qualitativa com 15 Enfermeiros de 10 Unidades Básicas de Saúde no sul do país. A coleta de dados foi realizada através de entrevistas semiestruturadas. Os dados foram analisados conforme análise textual discursiva. Resultado: Foram geradas duas categorias: Comunicação como suporte as necessidades do cliente; Comunicação como elemento a suprir a demanda da atenção primária. Conclusão: os enfermeiros adotam alguns aspectos no momento da comunicação de notícia difícil, aspectos esses ancorados, por exemplo, através de empatia, compreensão da realidade do usuário, fala simplificada, privacidade, entre outros, sendo esses essenciais para uma comunicação adequada e humanizada que visa o conforto do usuário nesse momento da comunicação

Objective: To know how the communication of difficult news by nurses in primary care occurs. Method: exploratory, descriptive and qualitative approach with 15 Nurses from 10 Basic Health Units in the south of the country. Data collection was done through semi-structured interviews. Data were analyzed according to discursive textual analysis. Result: two categories were generated: Communication as support the client's needs; Communication as an element to supply the demand for primary care. Conclusion: nurses adopt some aspects at the moment of difficult news communication, aspects that are anchored, for example through empathy, understanding of the user's reality, simplified speech, privacy, among others, being essential for adequate and humanized communication that aims at the comfort of the user in this moment of communication

Objetivo: Conocer cómo ocurre la comunicación de noticias difíciles por enfermeros en la atención básica. Método: investigación exploratoria, descriptiva y de abordaje cualitativo con 15 Enfermeros de 10 Unidades Básicas de Salud en el sur del país. La recolección de datos se realizó a través de entrevistas semiestructuradas. Los datos fueron analizados según el análisis textual discursivo. Resultado: se generaron dos categorías: Comunicación como soporte a las necesidades del cliente; Comunicación como elemento a suplir la demanda de la atención primaria. Conclusión: los enfermeros adoptan algunos aspectos en el momento de la comunicación de noticias difícil, aspectos anclados, por ejemplo, a través de empatía, comprensión de la realidad del usuario, habla simplificada, privacidad, entre otros, siendo estos esenciales para una comunicación adecuada y humanizada que, se refiere a la comodidad del usuario en ese momento de la comunicación

Risk Factors for Hospitalization and Mortality due to COVID-19 in Espírito Santo State, Brazil.

Brazil is, at the time of writing, the global epicenter of COVID-19, but information on risk factors for hospitalization and mortality in the country is still limited. Demographic and clinical data of COVID-19 patients until June 11th, 2020 were retrieved from the State Health Secretariat of Espírito Santo, Brazil. Potential risk factors for COVID-19 hospitalization and death were analyzed by univariate and multivariable logistic regression models. A total of 10,713 COVID-19 patients were included in this study; 81.0% were younger than 60 years, 55.2% were female, 89.2% were not hospitalized, 32.9% had at least one comorbidity, and 7.7% died. The most common symptoms on admission were cough (67.7%) and fever (62.6%); 7.1% of the patients were asymptomatic. Cardiovascular diseases (23.7%) and diabetes (10.3%) were the two most common chronic diseases. Multivariate logistic regression analysis identified an association of all explanatory variables, except for cough and diarrhea, with hospitalization. Older age (odds ratio [OR] = 3.95, P < 0.001) and shortness of breath (OR = 3.55, P < 0.001) were associated with increase of odds to COVID-19 death in hospitalized patients. Our study provided evidence that older age, male gender, Asian, indigenous or unknown race, comorbidities (smoking, kidney disease, obesity, pulmonary disease, diabetes, and cardiovascular disease), as well as fever and shortness of breath increased the risk of hospitalization. For death outcome in hospitalized patients, only older age and shortness of breath increased the risk.

Cessação do tabagismo entre usuários da Estratégia Saúde da Família / Cessation of smoking among Family Health Strategy users / Cese del tabaquismo entre usuarios de la Estrategia de Salud Familiar

Objetivo: descrever a cessação do tabagismo entre usuários da estratégia saúde da família. Método: estudo longitudinal realizado em duas unidades de atenção básica no período de junho a dezembro de 2016 com usuários tabagistas participantes do Programa de Tratamento do Tabagismo. A cessação do tabagismo foi descrita segundo variáveis sociodemográficas e variáveis relacionadas à história tabagística e à participação no Programa. As análises bivariadas se basearam no teste exato de Fisher, nos testes não paramétrico U de Mann-Whitney e Correlação de Spearman); foi adotado nível de significância de 5%. Resultados: verificou-se que sexo masculino, uso de medicamento e número de sessões que o indivíduo participou relacionaram-se estatisticamente à cessação do tabagismo. Conclusão: O presente estudo evidenciou que a cessação do tabagismo é influenciada pelo sexo masculino, participação nas sessões propostas pelo programa de tabagismo e uso de medicamentos oferecidos pelo Sistema Único de Saúde.

Objective: to describe the cessation of smoking among Family Health Strategy users. Method: this longitudinal study was conducted at two primary care units from June to December 2016 with smokers participating in the Smoking Treatment Program. Cessation was described according to sociodemographic, smoking history and program participation variables. The bivariate analyzes were based on Fisher's exact test, non-parametric Mann-Whitney U tests, and Spearman's correlation; a 5% significance level was adopted. Results: cessation of smoking was found to be statistically related to male sex, medication use, and number of program sessions that the individual attended. Conclusion: this study showed that cessation of smoking is influenced by male sex, participation in smoking treatment program sessions, and use of medications offered by the Unified Health System.

Objetivo: describir el cese del tabaquismo entre usuarios de la estrategia de salud familiar. Método: estudio longitudinal realizado en dos unidades de atención básica en el período de junio a diciembre de 2016 junto a fumadores participantes del Programa de Tratamiento del Tabaquismo. El cese del tabaquismo se describió según variables sociodemográficas y variables relacionadas con la historia del fumador y la participación en el Programa. Los análisis bivariados se basaron en la prueba exacta de Fisher, en las pruebas no paramétricas U de Mann-Whitney y la Correlación de Spearman); se adoptó un nivel de significancia del 5%. Resultados: se verificó que el sexo masculino, el uso de remedios y el número de sesiones en que el individuo participó están relacionados estadísticamente al cese de fumar. Conclusión: el presente estudio evidenció que el cese del tabaquismo es influenciado por el sexo masculino, la participación en las sesiones propuestas por el programa de tabaquismo y el uso de remedios ofrecidos por el Sistema Único de Salud.