Abstract Objective: The purpose of this study is to evaluate the pharmaceutical interventions (PI) performed in PRM and the factors associated with their acceptance. Method: This is a descriptive and cross-sectional study that analyzed PIs performed on adult patients from two ICUs in Fortaleza, Brazil, in 2019. PIs were analyzed in the categories quantity of drug and pharmacological strategy, using the classification proposed by Sabater et al. The drugs were also classified by the Anatomical, Therapeutic, and Chemical Classification System and by the High Surveillance Drugs (FAV) classification. Results: 305 patients were included, most of them male (55.1 %), elderly (52.8 %) and treated in the surgical ICU (51.4 %). 1,317 PIs were analyzed and 88.0 % were accepted, being to replace one or more drugs (28.0 %), to add one or more drugs (27.7 %) and to change the dose (24.8 %) the most frequent types. The most prevalent therapeutic class was anti-infectives for systemic use (24.1 %) and AVFs were involved in 21.7 % of the PIs. An association was observed between PIs accepted and admission to the clinical ICU (p<0.0001), AVF (p=0.0013), substitution of one or more drugs (p=0.0062) and the class of blood substitutes and perfusion solutions. (p= 0.0187). Conclusions: A high number of PIs were performed and accepted, which reinforces the importance of the pharmacist in the review of medical prescriptions in the ICU.

Resumen Objetivo: El propósito de este estudio es evaluar las intervenciones farmacéuticas (IF) realizadas sobre PRM y los factores asociados a su aceptación. Método: Se trata de un estudio descriptivo y transversal que analizó las IF realizadas a pacientes adultos de dos UCI de Fortaleza, Brasil, en 2019. Las IF se analizaron en las categorías cantidad de fármaco y estrategia farmacológica, utilizando la clasificación propuesta por Sabater et al. Los fármacos se clasificaron además por el Sistema de Clasificación Anatómica, Terapéutica, Química y por la clasificación de Fármacos de Alta Vigilancia (FAV). Resultados: Se incluyeron 305 pacientes, siendo la mayoría del sexo masculino (55,1 %), ancianos (52,8 %) y atendidos en la UCI quirúrgica (51,4 %). Se analizaron 1.317 IF y se aceptaron el 88,0 %, siendo la sustitución de uno o más fármacos (28,0 %) y la adición de uno o más fármacos (27,7 %) las más frecuentes. La clase terapéutica más prevalente fue antiinfeccioso de uso sistémico (24,1 %) y los FAV estuvieron implicados en el 21,7 % de las IF. Se observó asociación entre las IF aceptadas e ingreso en UCI clínica (p<0,0001), FAV (p=0,0013), sustitución de uno o más fármacos (p=0,0062) y la clase sustitutos sanguíneos y soluciones de perfusión (p= 0,0187). Conclusiones: Se realizaron y aceptaron un elevado número de IF, lo que refuerza la importancia del farmacéutico en la revisión de las prescripciones médicas en UCI.

The specialized therapy for skill acquisition model for children, especially autistic ones, is growing under neoliberal logic. Health professionals experience the precariousness of their work, with repercussions on the care of their health and that of children and families. To deepen the understanding of such aspects, this qualitative, documentary and retrospective research analyzed 131 reports of therapists on social media, under the conditions, dimensions and precariousness of work and historical dimensions, politics and contemporary challenges of care. The results show five themes about the precariousness of work, and three addressing violence and violation of children's rights, institutionalization and the precariousness of relationships. It discusses how the relationship between precarious work and assistance in the "autism industry" affects professionals, children and their families. In order to overcome historical institutionalizing behaviors and promote effective care, integrated with the children's daily experiences and demands, the urgency of the involvement of everyone who is interested in this issue is discussed in order to find dignified solutions in view of the seriousness of the problem at hand.

O modelo de terapias especializadas para aquisição de habilidades para crianças, especialmente autistas, está crescendo sob a lógica neoliberal. Profissionais da saúde vivenciam a precarização do seu trabalho, com repercussões no cuidado de sua saúde e das crianças e famílias. Para aprofundar a compreensão de tais aspectos, esta pesquisa qualitativa, documental e retrospectiva, analisou 131 relatos de terapeutas de uma mídia social, sob as condições, dimensões e precarização do trabalho e dimensões históricas, políticas e desafios contemporâneos da assistência. Os resultados evidenciam cinco temas sobre a precarização do trabalho, e três abordando violência e violação dos direitos das crianças, institucionalização e a precarização das relações. Discute-se como a relação entre trabalho precário e assistência na "indústria do autismo" afeta profissionais, crianças e suas famílias. Para superar condutas históricas institucionalizantes e promover um cuidado efetivo, integrado às vivências e demandas cotidianas das crianças, discute-se a urgência do envolvimento de todos a quem essa questão interessa para encontrar soluções dignas diante da gravidade do problema em pauta.

ABSTRACT. This study aimed to map the world's scientific production of bacterial and fungal microbiota in mollusks. The research was carried out in the Web of Science database, using “Fungi AND Mollusk” and “Bacteria AND Mollusk” descriptors and publication time between 2001 and 2021. Indexes were built by years, countries, research areas, and two maps of the co-occurrence of terms. There was a progressive increase in the production of microbiota in mollusks, with more research on bacteria during the investigated period. China and USA were the countries with the highest percentage of publications. Research with fungi and bacteria accounted for 28.41 and 17.66% in China, respectively. While the USA, the percentage was 21.05% for fungi and 16.02% for bacteria. Areas such as marine and freshwater biology (24.77%), fisheries (23.86%), biochemistry and molecular biology (18.60%), and pharmacy (17.83%) showed a higher percentage of indexed articles. There was also a high concentration of deposits of publications in the immunology area for both themes. The groups formed for bacteria and fungi indicated that studies had described the immune responses of mollusks, the genetic aspects associated with their defense mechanisms, pathogen virulence factors, and symbiotic and pathogenic microbiota, highlighting genera Vibrio, Aspergillus, and Escherichia coli pathogenic pathotypes. The bacterial and fungal microbiota in mollusks have been studied in several areas of knowledge and have given rise to research that can support the proper management of mollusks, application in the pharmaceutical industry, and implementation of measures in public health.

ABSTRACT This case report aims to show the anatomical and functional results of a patient diagnosed as having cancer-associated retinopathy treated with a controlled-release dexamethasone implant (Ozurdex). Anatomical outcomes were assessed using spectral domain optical coherence tomography; and functional outcomes, by measuring visual acuity, microperimetry, and mutifocal electroretinography. The follow-up period was 1 year.

RESUMO Este relato de caso tem como objetivo mostrar os resultados anatômicos e funcionais de um paciente com diagnóstico de retinopatia associada ao câncer tratado com implante de liberação controlada de dexametasona (Ozurdex®). Os resultados anatômicos foram avaliados por SD-OCT e os resultados funcionais por medida de acuidade visual, microperimetria e eletrorretinograma multifocal. O período de acompanhamento foi de um ano.

Abstract The aim of the present study was to investigate the impact of oral health literacy (OHL) on conceptions of care and behaviors related to COVID-19. The sample came from two preliminary cross-sectional studies that determined the level of OHL of parents/guardians of six-to-12-year-old children in two major Brazilian cities (Curitiba and Belo Horizonte). Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) and the Health Literacy Dental Scale (HeLD-14) for the evaluation of interactive OHL. Participants were recruited through e-mail, social media, and telephone contact. The questionnaire on conceptions of care and behaviors related to COVID-19 was created based on the guidelines of the World Health Organization. Two hundred nineteen individuals participated in the study. There was no significant difference in socioeconomic and demographic variables and in the medians of BREALD and HeLD-14 between the two cities (P>0.05). Higher levels of functional OHL were associated with an appropriate conception that individual care affects collective care (P=0.038), but with an inappropriate conception of seeking medical assistance in cases of mild symptoms (P=0.030). Higher levels of interactive OHL were related to social distancing behavior in the city of Curitiba (P=0.049) and in the overall sample (P=0.040). It is concluded that functional OHL was associated with two of the investigated conceptions about COVID-19, while interactive OHL was associated with social distancing behavior. These data may suggest that different dimensions of the OHL can have an impact on different aspects of coping with the pandemic.

ABSTRACT Primary Progressive Aphasia (PPA) is a progressive language disorder associated with frontotemporal impairment and mainly affects the left hemisphere of the brain. In general, this condition compromises abilities related to comprehension and expression of language. The diagnosis of PPA depends on in-depth knowledge regarding functions of language, neurology, and neuropsychology. Speech and language therapists (SLTs) have a pivotal role in the diagnosis and rehabilitation of PPA. The absence of these professionals involved in the diagnosis and rehabilitation may reflect on the quality of care of people with PPA. Objective: To identify the sociodemographic, educational, and professional practice characteristics of SLTs who work with people with PPA in Brazil. Methods: An online questionnaire was disseminated to reach SLTs across Brazil. The questionnaire collected information regarding sociodemographics, training and education, practice (time, setting, service provision), and sources of referral. Results: The study included 71 participants (95.8% women). Specialization was the most frequent educational level followed by master’s degree, and participants where mainly from the Southeast and South regions of Brazil. Neurologists were the professionals who most referred patients with PPA to SLTs. Finally, SLTs worked primarily in homecare settings and provided mainly individual therapy services. Conclusion: SLTs who work with PPA in Brazil can be characterized mainly as professionals with postgraduate degrees, relatively young, and from the South and Southeast regions of Brazil.

RESUMO A afasia progressiva primária (APP) é um distúrbio progressivo da linguagem associado à atrofia de regiões frontotemporais predominantemente do hemisfério esquerdo do cérebro. De modo geral, a APP afeta as capacidades compreensivas e expressivas da linguagem. O diagnóstico depende de profissionais com profundo conhecimento das funções da linguagem, neurologia e neuropsicologia. A fonoaudiologia tem papel essencial no diagnóstico e reabilitação da APP, e a ausência de fonoaudiólogos nesses processos pode refletir na qualidade do cuidado das pessoas com APP. Objetivo: Identificar as características sociodemográficas, educacionais e de atuação profissional de fonoaudiólogos que atuam com APP no Brasil. Métodos: Foi distribuído um questionário em formato online para fonoaudiólogos de todo o Brasil. O questionário coletou informações sobre aspectos sociodemográficos, de formação, atuação profissional (tempo, local de atuação, tipo de serviço oferecido) e fontes de encaminhamento. Resultados: O estudo incluiu 71 participantes (95,8% mulheres). O nível educacional mais frequente foi a especialização, e as regiões demográficas com maior incidência de profissionais que atendiam APP foram as Regiões Sudeste e Sul do país. Os neurologistas foram os profissionais que mais encaminhavam pacientes com APP para os fonoaudiólogos. Por fim, os fonoaudiólogos atuavam, principalmente, em homecare e realizando, em sua maioria, terapia individual. Conclusão: Os fonoaudiólogos que atuam com APP no Brasil podem ser caracterizados principalmente como profissionais pós-graduados, relativamente jovens e das Regiões Sul e Sudeste do Brasil.

Abstract Background The p53 and p21 proteins are important regulators of cell cycle and apoptosis and may contribute to autoimmune diseases, such as systemic lupus erythematosus (SLE). As genetic polymorphisms may cause changes in protein levels and functions, we investigated associations of TP53 and p21 (CDKN1A) polymorphisms (p53 72 G > C—rs1042522; p53 PIN3—rs17878362; p21 31 C > A—rs1801270; p21 70 C > T—rs1059234) with the development of systemic lupus erythematosus (SLE) in a Southeastern Brazilian population. Methods Genotyping of 353 female volunteers (cases, n = 145; controls, n = 208) was performed by polymerase chain reaction, restriction fragment length polymorphism and/or DNA sequencing. Associations between TP53 and p21 polymorphisms and SLE susceptibility and clinical manifestations of SLE patients were assessed by logistic regression analysis. Results Protective effect was observed for the genotype combinations p53 PIN3 A1/A1 -p21 31 C/A, in the total study population (OR 0.45), and p53 PIN3 A1/A2-p21 31 C/C, in non-white women (OR 0.28). In Whites, p53 72 C-containing (OR 3.06) and p53 PIN3 A2-containing (OR 6.93) genotypes were associated with SLE risk, and higher OR value was observed for the combined genotype p53 72 G/C-p53 PIN3 A1/A2 (OR 9.00). Further, p53 PIN3 A1/A2 genotype was associated with serositis (OR 2.82), while p53 PIN3 A2/A2 and p53 72 C/C genotypes were associated with neurological disorders (OR 4.69 and OR 3.34, respectively). Conclusions Our findings showed that the TP53 and p21 polymorphisms included in this study may have potential to emerge as SLE susceptibility markers for specific groups of patients. Significant interactions of the TP53 polymorphisms with serositis and neurological disorders were also observed in SLE patients. Highlights The polymorphisms TP53 rs1042522 (G > C) and TP53 rs17878362 (16 bp Del/Ins) were associated with SLE risk in whites. In whites, the combined genotype TP53 rs1042522 GC- TP53 rs17878362 A1A2 and the haplotype TP53 rs1042522 C-rs17878362 A2 represented higher SLE risk. Combination of TP53 rs17878362 (16 bp Del/Ins) and p21 rs1801270 (C > A) protected against SLE in non-white women. TP53 and p21 (CDKN1A) polymorphisms may be SLE susceptibility markers for specific groups.

Abstract Objective. To carry out a cultural adaptation of the Cultural Competence Measurement Scale for Health Care Workers (EMCC-14) for the Colombian context. Methodology: cultural and content validation by expert judgment, including concordance and reliability analysis. Main results: the overall Kappa index of 0.151 implied a low agreement among coders and a concept of slight reliability. The following categories were explored: concordance, semantic content analysis, item wording, clarity and precision, and cultural relevance; concordance ranged from poor to acceptable, with semantic analysis showing greater affectation. After adjustments, the level of reliability for the scale and by dimensions obtained a Cronbach's alpha 0.738, which is interpreted as an acceptable level of reliability. Main conclusion: The version of the EMCC-14 culturally adapted to the Colombian context obtained an adequate level of comprehensibility and reliability, allowing its application to determine the level of cultural competence in health care workers.

Resumen Objetivo. Realizar adaptación cultural de la Escala de Medición Competencia Cultural en trabajadores de la salud (EMCC-14), para el contexto colombiano. Método: validación cultural y de contenido por juicio de expertos, incluido análisis de concordancia y fiabilidad. Resultados principales: el índice global de Kappa de 0.151, implicó un bajo acuerdo entre codificadores y un concepto de leve fiabilidad. Se exploraron las categorías: congruencia, análisis semántico de contenido, redacción de los ítems, claridad y precisión, y pertinencia cultural; la concordancia osciló entre pobre y aceptable, el análisis semántico presentó mayor afectación. Realizados los ajustes, el nivel de confiabilidad para la escala y por dimensiones, obtuvo un alfa de Cronbach 0.738, interpretándose como un nivel de confiabilidad aceptable. Conclusión principal: La versión del EMCC-14 adaptada culturalmente al contexto colombiano obtuvo un adecuado nivel de comprensibilidad y confiabilidad, permitiendo su aplicación para determinar el nivel de competencia cultural en trabajadores de salud.

RESUMO Objetivo: Avaliar a capacidade de formação de biofilmes de Candida krusei e Candida albicans em cinco tipos de lentes de contato, comparando atividade metabólica e biomassa dos mesmos. Métodos: Após a formação de biofilme de ambas as espécies, a atividade metabólica foi avaliada por ensaio de redução 2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide com Menadiona, e a biomassa foi avaliada por coloração com Cristal Violeta 0,4% para posterior análise estatística. Resultados: Ambas as espécies de Candida foram capazes de formar biofilmes nos diferentes tipos de lentes de contato, havendo em lentes rígidas gás permeável maior atividade metabólica e menor biomassa formada. Conclusão: Esperava-se a obtenção de biofilmes de maior atividade metabólica e maior biomassa em lentes de contato gelatinosas com base no fundamento da Hidrofobicidade Superficial. Porém, o resultado apontou para maior atividade metabólica em lentes de contato rígidas. Apesar de observados resultados significativos, trata-se de um assunto de grande importância frente ao aumento do número de ceratites microbianas, mostrando-se necessários outros estudos para melhor elucidar a formação de biofilmes em diferentes tipos de materiais de lentes de contato.

ABSTRACT Objective: To evaluate the Candida krusei and Candida albicans biofilm formation abilities on 5 different types of contact lenses and compare their metabolic activities and biomass. Methods: After biofilm formation by both the test species, their metabolic activity was assessed by the 2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide reduction assay with menadione, while the biomass was determined by staining with 0.4% crystal violet dye for further statistical analysis. Results: Both the Candida species could form biofilms on different types of contact lenses, with greater metabolic activities and lower biomass formation in rigid gas permeable lenses. Conclusion: Biofilm formation with greater metabolic activity and greater biomass were expected on soft contact lenses considering their surface hydrophobicity. However, the results demonstrated a greater metabolic activity on rigid contact lenses. This result has a great significance with regards to the increasing risk of microbial keratitis, although further studies are warranted to better elucidate the formation of biofilms on different types of contact lens materials in the future.

Resumo As rigorosas medidas de segurança adotadas pelos hospitais, em decorrência da pandemia, estenderam-se também às Unidades de Terapia Intensiva Neonatais (UTIN). Este artigo desvela, por meio de observação sistemática, as mudanças organizacionais e estruturais ancoradas na Teoria Ambientalista de Nightingale que ocorreram na UTIN de um hospital público do interior da Bahia. Observou-se a interconexão entre os Ambientes Físico, Psicológico e Social, porém, com comprometimento na comunicação e relação entre família, neonato e equipe, apresentando um viés sensível das consequências restritivas da covid-19. Salienta-se o paradoxo entre zelar pela segurança e o impedimento das práticas informativas e facilitadoras de vínculos que envolvem o trinômio mencionado. Contudo, novas estratégias emergem desse contexto, levando os profissionais a se reinventarem e ousarem na comunicação, por meio de recursos remotos antes não utilizados, destacando as tecnologias digitais.

Abstract The strict safety measures adopted in hospital environments due to the pandemic have also been extended to Neonatal Intensive Care Units (NICU). By means of a systematic observation and based on Nightingale’s Environmental Theory, this article sought to unveil the organizational and structural changes in the NICU of a public hospital in the countryside of Bahia. Results indicate an interconnection between physical, psychological, and social environments, which were committed to the communication and relationship between family, newborn, and team, thus presenting a sensitive bias of the restrictive consequences of covid-19. These findings highlight the paradox between ensuring security and preventing informational and bond-facilitator practices that involve the aforementioned triad. From this context emerge new communication strategies leading professionals to reinvent themselves, and to dare in communication by remote resources not used before, emphasizing the use of digital technologies.

RESUMO Objetivo: Avaliar o efeito de uma intervenção educativa nas crenças em saúde e na adesão de idosos às medidas preventivas de quedas. Métodos: Estudo quase experimental, realizado em Centro de Convivência para Idosos. Concluíram a intervenção 68 idosos. A intervenção consistiu em quatro encontros com foco nas crenças sobre quedas e prevenção, e a avaliação ocorreu na baseline e 30 dias após o término. Resultados: Predominaram entre os idosos: mulheres (83,82%), um a quatro anos de estudo (36,76%), com problemas de saúde (95,59%); e 48,53% tiveram queda. Houve aumento significante na percepção de suscetibilidade, da severidade, dos benefícios, das barreiras e no escore total de crenças em saúde pós-intervenção educativa. Ao somar a adesão total à parcial, houve aumento significante da adesão dos idosos às medidas preventivas de quedas pós-intervenção educativa. Conclusão: Intervenção educativa foi capaz de melhorar as crenças e a adesão dos idosos às medidas preventivas de quedas.

ABSTRACT Objective: To evaluate the effect of an educational intervention on health beliefs and adherence of elderly people to fall prevention measures. Methods: This is a quasi-experimental study, carried out at the Senior Citizens' Center. Sixty-eight elderly completed the intervention. The intervention consisted of four meetings focused on beliefs about falls and prevention, and the evaluation occurred at baseline and 30 days after completion. Results: The elderly were predominantly women (83.82%), with one to four years of schooling (36.76%), with health problems (95.59%), and 48.53% had fallen. There was a significant increase in perceived susceptibility, severity, benefits, barriers, and total health belief score post educational intervention. By adding total to partial adherence, there was a significant increase in the adherence of the elderly to fall prevention measures after the educational intervention. Conclusion: Educational intervention was able to improve the beliefs and adherence of the elderly to fall prevention measures.

RESUMEN Objetivo: Evaluar efecto de una intervención educativa en las creencias en salud y adhesión de ancianos a medidas preventivas de caídas. Métodos: Estudio cuasi experimental, realizado en Centro de Convivencia para Ancianos. Concluyeron Ia intervención 68 ancianos. La intervención consistió en cuatro encuentros con enfoque en creencias sobre caídas y prevención, y la evaluación ocurrió en la baseline y 30 días tras el término. Resultados: Predominaron entre los ancianos: mujeres (83,82%), un a cuatro años de estudio (36,76%), con problemas de salud (95,59%); y 48,53% tuvieron caída. Hubo aumento significativo en la percepción de susceptibilidad, de severidad, de benefícios, de barreras y escore total de creencias en salud postintervención educativa. Al sumar la adhesión total a parcial, hubo aumento significativo de adhesión de ancianos a medidas preventivas de caídas postintervención educativa. Conclusión: Intervención educativa fue capaz de mejorar Ias creencias y la adhesión de ancianos a medidas preventivas de caídas.

Resumo As rigorosas medidas de segurança adotadas pelos hospitais, em decorrência da pandemia, estenderam-se também às Unidades de Terapia Intensiva Neonatais (UTIN). Este artigo desvela, por meio de observação sistemática, as mudanças organizacionais e estruturais ancoradas na Teoria Ambientalista de Nightingale que ocorreram na UTIN de um hospital público do interior da Bahia. Observou-se a interconexão entre os Ambientes Físico, Psicológico e Social, porém, com comprometimento na comunicação e relação entre família, neonato e equipe, apresentando um viés sensível das consequências restritivas da covid-19. Salienta-se o paradoxo entre zelar pela segurança e o impedimento das práticas informativas e facilitadoras de vínculos que envolvem o trinômio mencionado. Contudo, novas estratégias emergem desse contexto, levando os profissionais a se reinventarem e ousarem na comunicação, por meio de recursos remotos antes não utilizados, destacando as tecnologias digitais.

Abstract The strict safety measures adopted in hospital environments due to the pandemic have also been extended to Neonatal Intensive Care Units (NICU). By means of a systematic observation and based on Nightingale’s Environmental Theory, this article sought to unveil the organizational and structural changes in the NICU of a public hospital in the countryside of Bahia. Results indicate an interconnection between physical, psychological, and social environments, which were committed to the communication and relationship between family, newborn, and team, thus presenting a sensitive bias of the restrictive consequences of covid-19. These findings highlight the paradox between ensuring security and preventing informational and bond-facilitator practices that involve the aforementioned triad. From this context emerge new communication strategies leading professionals to reinvent themselves, and to dare in communication by remote resources not used before, emphasizing the use of digital technologies.

Abstract: COVID-19 rapidly spread across the world in an unprecedented outbreak with a massive number of infected and fatalities. The pandemic was heavily discussed and searched on the internet, which generated big amounts of data related to it. This led to the possibility of attempting to forecast coronavirus indicators using the internet data. For this study, Google Trends statistics for 124 selected search terms related to pandemic were used in an attempt to find which keywords had the best Spearman correlations with a lag, as well as a forecasting model. It was found that keywords related to coronavirus testing among some others, such as “I have contracted covid”, had high correlations (≥0.7) with few weeks of lag (≤4 weeks). Besides that, the ARIMAX model using those keywords had promising results in predicting the increase or decrease of epidemiological indicators, although it was not able to predict their exact values. Thus, we found that Google Trends data may be useful for predicting outbreaks of coronavirus a few weeks before they happen, and may be used as an auxiliary tool in monitoring and forecasting the disease in Brazil.

Resumo Objetivo: analisar a estrutura, o funcionamento das intervenções para prevenção de agravos e a promoção da saúde do trabalhador no Brasil, segundo os critérios de sistematicidade, agência transformativa e transformação. Métodos: foi realizada uma revisão de escopo de estudos empíricos publicados entre 2010 e 2019. Para avaliar e interpretar os achados e discutir suas possibilidades e tendências de desenvolvimento, utilizaram-se os três critérios mencionados. Resultados: foram incluídos 147 estudos; observou-se que o objeto da intervenção é mais comum em elementos isolados do sistema de atividade produtiva do que sobre o conjunto completo; a agência transformativa dos atores envolvidos é pouco estimulada; a transformação efetiva das condições que deram origem às intervenções aparece com mais frequência nas situações em que se pretendia mudar apenas aspectos proximais aos agravos de saúde. Conclusão: embora parte dos estudos reporte mudanças implementadas, a maioria deles não refere intervenções sobre os determinantes de saúde e não envolve os trabalhadores como protagonistas das mudanças. Os achados permitiram discutir possibilidades de desenvolvimento e desafios para intervenções.

Abstract Objective: to analyze the structure and functioning of interventions for diseases prevention and workers’ health promotion in Brazil according to the criteria of systematicity, transformative agency and transformation. Methods: we carried out a scope review of empirical studies published between 2010 and 2019. To evaluate and interpret the findings and discuss their possibilities and development trends, the three mentioned criteria were used. Results: 147 articles were included. Isolated elements of the productive system are more often subject to intervention than the entire system. Workers’ transformative agency is little stimulated, and the effective transformation of the conditions targeted appears more frequently in situations focused on changing only proximal aspects to health issues. Conclusion: although some studies report implemented changes, most of them do not refer to interventions on health determinants and do not involve the workers as protagonists of changes. The findings allowed to discuss development possibilities and challenges for interventions.

Resumo Objetivo Esta meta-análise teve como objetivo avaliar a sensibilidade e especificidade da colonografia por tomografia computadorizada na detecção de pólipos colorretais. Métodos Foi realizada uma pesquisa bibliográfica nas bases de dados da PubMed e da Web of Science. Resultados Um total de 1.872 pacientes, 57,2% homens e 42,8% mulheres, com idades entre 49 a 82 anos de idade (média de 59,7 ± 5,3 anos) foram incluídos nesta meta análise. A sensibilidade da colonografia por tomografia computadorizada foi estimada em 88,4% (46,3-95,7%; coeficiente de variância [CV]=28,5%) e a especificidade em 73,6% (47,4%-100,0%; CV=37,5%). Para lesões de até 9mm, a sensibilidade foi de 82,5% (62,0-99,9%; CV=25,1%) e a especificidade de 79,2% (32,0-98,0%; CV=22,9%). Para lesõesmaiores que 9mm, a sensibilidade foi de 90,2% (64,0-100,0%; CV=7,4%) e a especificidade de 94,7% (80,0-100,0%; CV=6,2%). Não houve diferença estatisticamente significante entre as sensibilidades por tamanho da lesão (p=0,0958), porém a especificidade foi maior em lesões acima de 9mm (p<0,0001). Conclusão A maioria dos estudos analisados no presente trabalho foi realizada antes de 2010, cerca de uma década depois que a colonografia por tomografia computadorizada passou a ser indicada como método de triagem pelas diretrizes europeias e americanas. Portanto, são necessários mais estudos com o objetivo de analisar a técnica apósmaiores avanços tecnológicos, o que poderia levar ao desenvolvimento de dispositivos mais modernos.

Abstract Objective This metanalysis aimed to evaluate the sensitivity and specificity of computed tomography colonography in colorectal polyp detection. Methods A literature search was performed in the PubMed and Web of Science databases. Results A total of 1,872 patients (males 57.2%, females 42.8%) aged 49 to 82 years old (mean age 59.7 ± 5.3 years) were included in this metanalysis. The estimated sensitivity of computed tomography colonography was 88.4% (46.3-95.7%, coefficient of variation [CV]=28.5%) and the estimated specificity was 73.6% (47.4-100.0%, CV=37.5%). For lesions up to 9mm, the sensitivity was 82.5% (62.0-99.9%, CV =25.1%) and the specificity was 79.2% (32.0-98.0%, CV=22.9%). For lesions>9mm, the sensitivity was 90.2% (64.0-100.0%, CV=7.4%) and the specificity was 94.7% (80.0-100.0%, CV=6.2%). No statistically significant differences in sensitivity according to the size of the lesion were found (p=0.0958); however, the specificity was higher for lesions>9mm (p<0.0001). Conclusions Most of the studies analyzed in the present work were conducted before 2010, which is about a decade after computed tomography colonography started being indicated as a screening method by European and American guidelines. Therefore, more studies aimed at analyzing the technique after further technological advancements are necessary, which could lead to the development of more modern devices.