Resumo O artigo investiga a correlação entre engajamento e qualidade de vida no trabalho dos profissionais de enfermagem de um hospital público do interior do estado de São Paulo, no início da pandemia de COVID-19. Estudo transversal, descritivo e correlacional, com profissionais de enfermagem, realizado entre dezembro de 2020 e janeiro de 2021. Foram utilizadas as versões brasileiras da Utrecht Work Engagement Scale (UWES) e da Escala de Avaliação da Qualidade de Vida no Trabalho (QVT), segundo modelo de Walton. Os profissionais de enfermagem apresentaram correlação forte e positiva (r≥0.70) entre o domínio integração social da QVT e a dimensão vigor da UWES (r=0,88; p=<0,001); correlação positiva moderada (r≥0.40≤0.69) entre as condições de trabalho (QVT) e as dimensões vigor (r=0,40; p=<0,001), dedicação (r=0,40; p=<0,001) e escore geral (r=0,41; p=<0,001) da UWES. As correlações foram positivas e fracas (r≤0.39) para os demais domínios da QVT e as dimensões da UWES. Concluiu-se que os profissionais com níveis satisfatórios de qualidade de vida tendem a ter níveis mais altos de engajamento no trabalho. No início da pandemia de COVID-19, os profissionais de enfermagem estavam fortemente engajados e satisfeitos com sua qualidade de vida no trabalho.

Abstract This article investigates the correlation between work engagement and work-related quality of life among nursing staff at a public hospital in São Paulo State, at the onset of the COVID-19 pandemic. A descriptive, correlational, cross-sectional study of nursing personnel was conducted from December 2020 to January 2021, using the Brazilian versions of the Work & Well-being Survey (Utrecht Work Engagement Scale - UWES) and the Work-related Quality of Life (WRQoL) scale, following Walton’s model. Nursing staffs returned a strong positive correlation (r≥0.70) between the social integration domain of the WRQoL and the vigour dimension of the UWES (r=0.88; p=<0.001); a moderate positive correlation (r≥0.40≤0.69) between working conditions (WRQOL) and the vigour (r=0.40; p<0.001), dedication (r=0.40; p<0.001) and overall score (r=0.41; p<0.001) dimensions of the UWES. Correlations were positive and weak (r≤0.39) for the other WRQoL domains and the UWES dimensions. It was concluded that personnel with satisfactory levels of quality of life tend to show higher levels of engagement at work. At the onset of the COVID-19 pandemic, nursing professionals were strongly engaged and satisfied with their work-related quality of life.

Abstract This article investigates the correlation between work engagement and work-related quality of life among nursing staff at a public hospital in São Paulo State, at the onset of the COVID-19 pandemic. A descriptive, correlational, cross-sectional study of nursing personnel was conducted from December 2020 to January 2021, using the Brazilian versions of the Work & Well-being Survey (Utrecht Work Engagement Scale - UWES) and the Work-related Quality of Life (WRQoL) scale, following Walton’s model. Nursing staffs returned a strong positive correlation (r≥0.70) between the social integration domain of the WRQoL and the vigour dimension of the UWES (r=0.88; p=<0.001); a moderate positive correlation (r≥0.40≤0.69) between working conditions (WRQOL) and the vigour (r=0.40; p<0.001), dedication (r=0.40; p<0.001) and overall score (r=0.41; p<0.001) dimensions of the UWES. Correlations were positive and weak (r≤0.39) for the other WRQoL domains and the UWES dimensions. It was concluded that personnel with satisfactory levels of quality of life tend to show higher levels of engagement at work. At the onset of the COVID-19 pandemic, nursing professionals were strongly engaged and satisfied with their work-related quality of life.

Resumo O artigo investiga a correlação entre engajamento e qualidade de vida no trabalho dos profissionais de enfermagem de um hospital público do interior do estado de São Paulo, no início da pandemia de COVID-19. Estudo transversal, descritivo e correlacional, com profissionais de enfermagem, realizado entre dezembro de 2020 e janeiro de 2021. Foram utilizadas as versões brasileiras da Utrecht Work Engagement Scale (UWES) e da Escala de Avaliação da Qualidade de Vida no Trabalho (QVT), segundo modelo de Walton. Os profissionais de enfermagem apresentaram correlação forte e positiva (r≥0.70) entre o domínio integração social da QVT e a dimensão vigor da UWES (r=0,88; p=<0,001); correlação positiva moderada (r≥0.40≤0.69) entre as condições de trabalho (QVT) e as dimensões vigor (r=0,40; p=<0,001), dedicação (r=0,40; p=<0,001) e escore geral (r=0,41; p=<0,001) da UWES. As correlações foram positivas e fracas (r≤0.39) para os demais domínios da QVT e as dimensões da UWES. Concluiu-se que os profissionais com níveis satisfatórios de qualidade de vida tendem a ter níveis mais altos de engajamento no trabalho. No início da pandemia de COVID-19, os profissionais de enfermagem estavam fortemente engajados e satisfeitos com sua qualidade de vida no trabalho.

Abstract Objective Evaluate the effect of combined training on body image (BI), body composition and functional capacity in patients with breast cancer. As also the relationship of BI with body composition and functional capacity. Methods This was a Controlled Clinical Trial study, this study including 26 patients with breast cancer (30 to 59 years). The training group (n = 13) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20s. The Control Group (n = 13) received only the standard hospital treatment. Participants were evaluated at baseline and after 12 weeks. BI (primary outcomes) was assessed using the Body Image After Breast Cancer Questionnaire; Body composition was estimated with the indicators: Body mass index; Weight, Waist hip Ratio; Waist height ratio; Conicity index; Reciprocal ponderal index; Percentage of fat; Circumference of the abdomen and waist; Functional capacity by cardiorespiratory fitness (cycle ergometer) and strength (manual dynamometer). The statistic was performed in the Biostatistics and Stata 14.0 (α = 5%). Results The patients in the training group showed a reduction in the limitation dimension (p = 0.036) on BI, However, an increase in waist circumference was observed in both groups. In addition an increase in VO2max (p < 0.001) and strength in the right (p = 0.005) and left arms (p = 0.033). Conclusion Combined training demonstrates to be an effective and non-pharmacological strategy to patients with breast cancer, with improvement on BI and functional capacity, changing related variables negatively when there is no physical training.

Resumo Objetivo Avaliar o efeito do treinamento combinado na imagem corporal (IB), composição corporal e capacidade funcional em pacientes com câncer de mama. Assim como a relação do IB com a composição corporal e capacidade funcional. Métodos Este foi um estudo de Ensaio Clínico Controlado, este estudo incluiu 26 pacientes com câncer de mama (30 a 59 anos). O grupo de treinamento (n = 13) foi submetido a 12 semanas de treinamento, incluindo três sessões de 60 min de exercício aeróbio e treinamento de resistência, e duas sessões de treinamento de flexibilidade por semana; cada exercício de flexibilidade durou 20s. O Grupo Controle (n = 13) recebeu apenas o tratamento hospitalar padrão. Os participantes foram avaliados no início e após 12 semanas. O IB (desfechos primários) foi avaliado por meio do Body Image After Breast Cancer Questionnaire; A composição corporal foi estimada com os indicadores: índice de massa corporal; Peso, relação cintura-quadril; Relação da altura da cintura; Índice de conicidade; Índice ponderal recíproco; Porcentagem de gordura; Circunferência do abdômen e cintura; Capacidade funcional por aptidão cardiorrespiratória (cicloergômetro) e força (dinamômetro manual). A estatística foi realizada na Bioestatística e no Stata 14.0 (α = 5%). Resultados Os pacientes do grupo de treinamento apresentaram redução da dimensão da limitação (p = 0,036) no IB, porém, foi observado aumento da circunferência da cintura em ambos os grupos. Além disso, um aumento do VO2máx (p <0,001) e da força nos braços direito (p = 0,005) e esquerdo (p = 0,033). Conclusão O treinamento combinado demonstra ser uma estratégia eficaz e não farmacológica para pacientes com câncer de mama, com melhora do IB e da capacidade funcional, alterando variáveis relacionadas negativamente quando não há treinamento físico.

Objectives: Ketamine has a fast onset of action that may offer a paradigm change for depression management at the end of life. We aimed to synthesize evidence regarding the safety and efficacy of ketamine in depression treatment within a broad palliative care concept. Methods: We searched seven databases and included studies on the safety and efficacy of ketamine for depression treatment in patients diagnosed with any life-threatening disease. We also conducted a narrative review of the evidence. Results: Among 2,252 screened titles and abstracts, we included 32 studies in our final synthesis: 14 case reports, two case series, two quasi-experimental studies, and seven randomized clinical trials (RCTs), as well as data from three unpublished clinical trials and seven cases from four larger case series. Most case reports reported a robust effect; however, the larger studies reported conflicting findings. Five RCTs reported positive outcomes; however, four of them were focused on a perioperative setting. Two negative studies did not primarily focus on depression and did not apply severity cutoffs. Conclusion: Although ketamine is generally safe and potentially useful, its efficacy in palliative care settings remains unclear. It may be a reasonable alternative for perioperative depression in oncological patients.

Abstract Introduction Dysphonia and lower pitch after surgery of Reinke edema are common. They are caused especially due to chronic smoking but, probably, other factors should be associated. Objectives To evaluate the results of laryngeal microsurgery in patients with Reinke edema, following a standardized postoperative guidance protocol in our service. Methods Retrospective study. Thirty patients (3 males; 27 females) were included, 70% between 41 and 60 years old. The parameters analyzed in the pre- and postoperative (between 4 and 6 months) of patients undergoing laryngeal microsurgery for Reinke edema were: smoking, vocal symptoms, videolaryngostroboscopy, voice therapy, perceptual and acoustic vocal evaluation, histopathological report. Results Smoking was reported by 100% of the patients and maintained in the postoperative period by 80%. Complete improvement of symptoms in the postoperative period was reported by 43% of them, partial improvement by 40%, and maintenance by 17%. There was low adherence to voice therapy in the pre- and postsurgery. Postoperative videolaryngoscopy indicated congestion (19), atrophy and bowed vocal fold (1), subepithelial edema (2), and normal findings (8). The histological findings were subepithelial edema, enlargement of vessels, inflammation, epithelial hyperplasia, and thickening of the basement membrane. The perceptual and acoustic vocal analyzes indicated improvement of the analyzed parameters. Conclusions The maintenance of some vocal symptoms and laryngeal alterations in videolaryngoscopy after microsurgery of Reinke edema is frequent, even in patients who follow the recommendations of vocal rest and control of gastroesophageal reflux. Vocal symptoms are attributed to changes in the laryngeal mucosa caused by chronic smoking, aggravated by the maintenance of addiction in the postoperative period.

Abstract To evaluate time evolution of receiving advice on healthy habits among Brazilians with hypertension and diabetes mellitus. Cross-sectional study with data from the 2013 and 2019 National Health Survey. We used linear regression weighted by least squares of variance to verify time evolution of the outcome estimating the annual percentage change (APC) presented according to sex, skin color, age group, and quintiles of wealth index. The analytical sample in 2013 was 11,129 individuals with hypertension and 3,182 individuals with diabetes, and in 2019 19,107 individuals with hypertension and 6,317 individuals with diabetes. For those with hypertension, there were statistically significant reductions in receiving advice for not smoking (APC: -1.49), not drinking excessive alcoholic beverages (APC: -1.48), ingesting less salt (APC: -0.56), and for all healthy habits (APC: -1.17). For those with diabetes, statistically significant reductions were observed only for not smoking (APC: -1.13) and not drinking excessive alcoholic beverages (APC: -1.11). The results suggest a reduction in all types of advice on healthy habits evaluated for hypertension and diabetes, with greater magnitude among individuals belonging to the richest quintiles.

Resumo O objetivo foi avaliar a evolução temporal do recebimento de orientações sobre hábitos saudáveis entre brasileiros com hipertensão arterial e diabetes mellitus. Estudo transversal com dados da Pesquisa Nacional de Saúde de 2013 e 2019. Para verificar a evolução temporal das prevalências de orientações sobre hábitos saudáveis, realizadas por profissionais de saúde nos atendimentos para as morbidades, utilizou-se regressão linear ponderada pelos quadrados mínimos da variância, estimando a variação percentual anual (VPA) apresentada de acordo com sexo, cor da pele, faixa etária e quintis do índice de bens. A amostra analítica, em 2013, foi de 11.129 indivíduos com hipertensão e 3.182 com diabetes, e em 2019, de 19.107 indivíduos com hipertensão e 6.317 com diabetes. Para hipertensão, observou-se reduções nas orientações para não fumar (VPA: -1.49), não ingerir bebidas alcoólicas em excesso (VPA: -1.48), ingerir menos sal (VPA: -0.56) e, ainda, para todas as orientações (VPA: -1.17). Para diabetes, foram observadas reduções estatisticamente significativas apenas para não fumantes (APC: -1.13) e para os que não consomem bebidas alcoólicas em excesso (APC: -1.11). Os resultados sugerem redução de todas as orientações avaliadas para hipertensão e diabetes, com maior magnitude entre os indivíduos pertencentes aos quintis mais ricos.

RESUMO: Objetivou-se apresentar aspectos relevantes sobre o ambiente amazônico e como este impacta no conforto térmico de búfalos domésticos (Bubalus bubalis) criados na Amazônia Oriental. Adicionalmente, são apresentadas estratégias para monitoramento e mitigação do estresse térmico animal, a partir de resultados de pesquisa com a espécie. Apesar dos búfalos domésticos serem considerados animais adaptáveis, a exposição à intensa radiação solar provoca desconforto térmico. Essa condição é expressa em indicadores biofísicos, nas respostas metabólicas, endócrinas, comportamentais e nos padrões termográficos corporais. Assim, o monitoramento biometeorológico da produção é crucial para subsidiar tomadas de decisão em relação a estratégias de manejo ambiental, seleção genética de indivíduos termotolerantes e incremento do bem-estar animal. Por fim, o uso de sistemas silvipastoris pode auxiliar na oferta de maior conforto térmico, que é uma condição que impacta diretamente na produtividade de bubalinos de leite e carne, quando estes são criados em regiões tropicais, como na Amazônia Oriental.

ABSTRACT: This study presented relevant aspects about the Amazonian environment and how it impacts the thermal comfort of domestic buffaloes (Bubalus bubalis) raised in the Eastern Amazon. Furthermore, strategies for monitoring and mitigating animal heat stress are presented, based on research results with the species. Although domestic buffaloes are considered adaptable animals, exposure to intense solar radiation causes thermal discomfort. This condition is expressed in biophysical indicators, in metabolic, endocrine, behavioral responses, and in body thermographic patterns. Therefore, the biometeorological monitoring of production is crucial to support decision-making regarding environmental management strategies, genetic selection of thermotolerant individuals, and increase in animal welfare. Lastly, the use of silvopastoral systems can help to provide higher thermal comfort, which is a condition that directly impacts the productivity of milk and meat buffaloes when they are raised in tropical regions, such as in the Eastern Amazon.

Abstract To evaluate time evolution of receiving advice on healthy habits among Brazilians with hypertension and diabetes mellitus. Cross-sectional study with data from the 2013 and 2019 National Health Survey. We used linear regression weighted by least squares of variance to verify time evolution of the outcome estimating the annual percentage change (APC) presented according to sex, skin color, age group, and quintiles of wealth index. The analytical sample in 2013 was 11,129 individuals with hypertension and 3,182 individuals with diabetes, and in 2019 19,107 individuals with hypertension and 6,317 individuals with diabetes. For those with hypertension, there were statistically significant reductions in receiving advice for not smoking (APC: -1.49), not drinking excessive alcoholic beverages (APC: -1.48), ingesting less salt (APC: -0.56), and for all healthy habits (APC: -1.17). For those with diabetes, statistically significant reductions were observed only for not smoking (APC: -1.13) and not drinking excessive alcoholic beverages (APC: -1.11). The results suggest a reduction in all types of advice on healthy habits evaluated for hypertension and diabetes, with greater magnitude among individuals belonging to the richest quintiles.

Resumo O objetivo foi avaliar a evolução temporal do recebimento de orientações sobre hábitos saudáveis entre brasileiros com hipertensão arterial e diabetes mellitus. Estudo transversal com dados da Pesquisa Nacional de Saúde de 2013 e 2019. Para verificar a evolução temporal das prevalências de orientações sobre hábitos saudáveis, realizadas por profissionais de saúde nos atendimentos para as morbidades, utilizou-se regressão linear ponderada pelos quadrados mínimos da variância, estimando a variação percentual anual (VPA) apresentada de acordo com sexo, cor da pele, faixa etária e quintis do índice de bens. A amostra analítica, em 2013, foi de 11.129 indivíduos com hipertensão e 3.182 com diabetes, e em 2019, de 19.107 indivíduos com hipertensão e 6.317 com diabetes. Para hipertensão, observou-se reduções nas orientações para não fumar (VPA: -1.49), não ingerir bebidas alcoólicas em excesso (VPA: -1.48), ingerir menos sal (VPA: -0.56) e, ainda, para todas as orientações (VPA: -1.17). Para diabetes, foram observadas reduções estatisticamente significativas apenas para não fumantes (APC: -1.13) e para os que não consomem bebidas alcoólicas em excesso (APC: -1.11). Os resultados sugerem redução de todas as orientações avaliadas para hipertensão e diabetes, com maior magnitude entre os indivíduos pertencentes aos quintis mais ricos.

RESUMO Objetivos: analisar a cultura de segurança do paciente a partir da percepção dos profissionais de enfermagem de um hospital universitário, por meio da avaliação da convergência entre o Safety Attitudes Questionnaire e o Hospital Survey on Patient Safety Culture. Métodos: estudo transversal, com 434 profissionais de enfermagem. A coleta dos dados ocorreu mediante aplicação de ambos os instrumentos. Utilizou-se estatística descritiva e inferencial. Resultados: no Hospital Survey on Patient Safety Culture, a dimensão “trabalho em equipe no âmbito das unidades” foi considerada uma área forte da segurança do paciente. No Safety Attitudes Questionnaire, os domínios “satisfação no trabalho” e “percepção de estresse” atingiram o escore para boa cultura de segurança. A percepção de cultura de segurança do paciente se correlaciona, em ambos os instrumentos, com magnitude elevada. Conclusões: os dois instrumentos convergem para uma avaliação semelhante da cultura de segurança do paciente.

ABSTRACT Objectives: to analyze patient safety culture from nursing professionals’ perception at a university hospital, by assessing the convergence between the Safety Attitudes Questionnaire and the Hospital Survey on Patient Safety Culture. Methods: a cross-sectional study, with 434 nursing professionals. Data collection took place through the application of both instruments. Descriptive and inferential statistics were used. Results: in the Hospital Survey on Patient Safety Culture, the “teamwork within the units” dimension was considered a strong area of patient safety. In the Safety Attitudes Questionnaire, the “job satisfaction” and “perception of stress” domains reached the score for a good safety culture. Patient safety culture perception is correlated, in both instruments, with high magnitude. Conclusions: the two instruments converge towards a similar assessment of patient safety culture.

RESUMEN Objetivos: analizar la cultura de seguridad del paciente a partir de la percepción de los profesionales de enfermería de un hospital universitario, evaluando la convergencia entre el Safety Attitudes Questionnaire y el Hospital Survey on Patient Safety Culture. Métodos: estudio transversal, con 434 profesionales de enfermería. La recolección de datos se realizó mediante la aplicación de ambos instrumentos. Se utilizó estadística descriptiva e inferencial. Resultados: en la Encuesta Hospitalaria sobre Cultura de Seguridad del Paciente, la dimensión “trabajo en equipo dentro de las unidades” fue considerada un área fuerte de la seguridad del paciente. En el Hospital Survey on Patient Safety Culture, los dominios “satisfacción en el trabajo” y “percepción de estrés” alcanzaron el puntaje de una buena cultura de seguridad. La percepción de cultura de seguridad del paciente se correlaciona, en ambos instrumentos, con magnitud alta. Conclusiones: los dos instrumentos convergen hacia una evaluación similar de la cultura de seguridad del paciente.

Abstract Bacterial cellulose (BC) is promising as a wound dressing because it is non- toxic and maintains moisture in the wound. Although BC does not have antimicrobial activity, its structure allows the incorporation of antimicrobial compounds such as essential oils (EOs). This study aims to associate BC with rosemary, clove, eucalyptus, ginger, lavender and lemongrass EOs to obtain wound dressings. The Gas Chromatography-Mass Spectrometry and Fourier Transform Infrared Spectroscopy analyses showed characteristic compounds of EOs in the incorporated membranes. These compounds reduced the thermal stability of most samples due to their different degrees of volatility. The Scanning Electron Microscopy indicated that the EOs filled the membrane pores and coated the cellulose fibers. Samples incorporated with clove, ginger and lemongrass EOs inhibited Escherichia coli, Staphylococcus aureus and Candida albicans due to the presence of eugenol and citral. The results confirmed the incorporation method's effectiveness, maintaining the composition and antimicrobial characteristics of the EOs.

ABSTRACT Purpose to validate the CAP questionnaire in populations of pregnant women exposed to pesticides in the State of Paraná. Methods 382 pregnant women participated in the study, divided into two groups: Exposed to Pesticides (n = 320) and Not Exposed (n = 62). The validation process involved the validity of content, criteria and construct. The research stages were developed between August / 2018 to December / 2019 in the western and central-western regions of Paraná. Results the instrument demonstrated an acceptable agreement on the content validity through the evaluation of judges; the criterion validity through the established criterion showed no association; in the analysis of construct validity using the technique of known groups, it demonstrated homogeneity in the variables age, nationality and family income. Conclusion the developed analysis indicated that the psychometric properties of the validation of the Brazilian version of the scale are consistent and adequate, which allows the recommendation of the application of the instrument in a national context.

RESUMO Objetivo validar o questionário CAP em populações de gestantes expostas aos agrotóxicos no Estado do Paraná. Método participaram do estudo 382 gestantes, divididas em dois grupos: Expostas a Agrotóxicos (n=320) e Não Expostas (n=62). O processo de validação envolveu a validade de conteúdo, critério e constructo. As etapas da pesquisa foram desenvolvidas entre agosto/2018 a dezembro/2019 na região oeste e centro-oeste do Paraná. Resultados o instrumento demonstrou concordância aceitável na Validade de conteúdo por meio da avaliação de juízes; a Validade de critério por meio do critério estabelecido não apresentou associação; na análise da Validade de construto pela técnica de grupos conhecidos, demonstrou homogeneidade nas variáveis idade, nacionalidade e renda familiar. Conclusão a análise desenvolvida indicou que as propriedades psicométricas da validação da versão brasileira da escala são consistentes e adequadas, o que permite a recomendação da aplicação do instrumento em contexto nacional.

ABSTRACT Bacterial cellulose (BC) has stood out in the biomedical field for its biocompatibility, non-toxicity and high liquid absorption capacity. Thus, studies have been conducted aiming at the functionalization of BC with substances that add properties, such as anti-inflammatory and antimicrobial action. Hamamelis virginiana plant extract is known for its astringent, anti-inflammatory and antimicrobial properties. Thus, the present work aimed to incorporate aqueous (AE) and glycolic (GE) extracts of witch hazel in different concentrations to BC, aiming at its application as a curative. BC membranes incorporated with the extracts were characterized by thermogravimetric analysis (TGA), Fourier transforms infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and antimicrobial activity. The TGA results indicated a reduction in thermal stability and the appearance of a new stage of degradation in the samples that underwent incorporation. Furthermore, the FTIR showed the presence of aromatic compounds not found in the BC, corroborating the TGA. The micrographs revealed that the incorporation of the extracts resulted in the formation of a film on the surface of the membranes, covering the nanofibers. These results show that incorporating the aqueous and glycol extracts in the BC membrane was successful. However, despite the crude extracts’ antimicrobial potential, antimicrobial activity in the functionalized BC samples was not observed.

ABSTRACT Objective: To adapt the PROactive Physical Activity in COPD-clinical visit (C-PPAC) instrument to the cultural setting in Brazil and to determine the criterion validity, test-retest reliability agreement, and internal consistency of this version. Methods: A protocol for cultural adaptation and validation was provided by the authors of the original instrument and, together with another guideline, was applied in a Portuguese-language version developed by a partner research group from Portugal. The adapted Brazilian Portuguese version was then cross-sectionally administered twice within a seven-day interval to 30 individuals with COPD (57% were men; mean age was 69 ± 6 years; and mean FEV1 was 53 ± 18% of predicted) to evaluate internal consistency and test-retest reliability. Participants also completed the International Physical Activity Questionnaire (IPAQ), the modified Medical Research Council scale, the COPD Assessment Test, and Saint George’s Respiratory Questionnaire to evaluate criterion validity. Results: The C-PPAC instrument showed good internal consistency and excellent test-retest reliability: “amount” domain = 0.87 (95% CI, 0.73-0.94) and “difficulty” domain = 0.90 (95% CI, 0.76-0.96). Bland & Altman plots, together with high Lin’s concordance correlation coefficients, reinforced that agreement. Criterion validity showed moderate-to-strong correlations of the C-PPAC with all of the other instruments evaluated, especially with the IPAQ (rho = −0.63). Conclusions: The Brazilian Portuguese version of the C-PPAC is a reliable and valid instrument for evaluating the experience of Brazilian individuals with COPD with their physical activity in daily life.

RESUMO Objetivo: Adaptar o instrumento PROactive Physical Activity in COPD - clinical visit (C-PPAC) ao contexto cultural brasileiro e determinar a validade de critério, concordância da confiabilidade teste-reteste e consistência interna dessa versão. Métodos: Um protocolo de adaptação cultural e validação foi fornecido pelos autores do instrumento original e, juntamente com outra diretriz, foi aplicado em uma versão em português desenvolvida por um grupo de pesquisa parceiro de Portugal. A versão brasileira adaptada foi então aplicada transversalmente duas vezes, com intervalo de sete dias, em 30 indivíduos com DPOC (57% de homens; média de idade de 69 ± 6 anos; e média do VEF1 de 53 ± 18% do previsto) para avaliação da consistência interna e da confiabilidade teste-reteste. Os participantes também responderam ao International Physical Activity Questionnaire (IPAQ), à escala modificada do Medical Research Council, ao COPD Assessment Test e ao Saint George’s Respiratory Questionnaire para avaliação da validade de critério. Resultados: O instrumento C-PPAC apresentou boa consistência interna e excelente confiabilidade teste-reteste: domínio “quantidade” = 0,87 (IC95%: 0,73-0,94) e domínio “dificuldade” = 0,90 (IC95%: 0,76-0,96). As disposições gráficas de Bland-Altman, juntamente com os altos coeficientes de correlação de concordância de Lin, reforçaram essa concordância. A validade de critério mostrou correlações moderadas a fortes do instrumento C-PPAC com todos os outros instrumentos avaliados, principalmente com o IPAQ (rho = −0,63). Conclusões: A versão brasileira do instrumento C-PPAC é uma ferramenta confiável e válida para avaliar a experiência de indivíduos brasileiros com DPOC em relação à sua atividade física na vida diária.

Abstract Bacterial nanocellulose (BNC) membranes have interconnected porous nanostructures and excellent biocompatibility. Functionalizing these with calcium phosphate sources and metal ions confers optimized properties to the biomaterial. This study aims to synthesize BNC membranes, functionalize them with copper and magnesium apatites, characterize and evaluate their cytotoxicity and antimicrobial potential. Membranes were synthesized for 8 days in Mannitol Medium. The biocomposite production was by immersion cycles. The biocomposites were characterized by porosity and swelling capacity, Fourier transforms infrared spectroscopy (FTIR), scanning electron microscopy (SEM), thermogravimetric analysis (TGA), antimicrobial properties and cytotoxicity assays. The FTIR and SEM results showed that phosphate groups were incorporated into the BNC. The TGA analysis also indicated the incorporation of the inorganic phase. The membrane functionalization with Cu promoted the antimicrobial properties of the biomaterial. However, functionalization with Mg had a more positive behavior on cell viability, proving to be more suitable for use as an implantable material.

Abstract Background Systemic inflammation, documented before rheumatoid arthritis (RA) diagnosis, is associated with accelerated atherosclerosis. We aimed to compare the prevalence of carotid plaque (CP) in RA patients in the first five years since diagnosis and healthy controls, and to determine disease characteristics associated with the presence of subclinical atherosclerosis in RA patients. Methods This was a cross-sectional study. We recruited 60 RA patients in the first five years since diagnosis and 60 matched healthy controls. Carotid ultrasound was performed to detect the presence of CP and measure carotidintima media thickness (cIMT). Subclinical atherosclerosis was considered as the presence of CP and/or increased cIMT. Distribution was evaluated with the Kolmogorov-Smirnov test. Comparisons were made with Chi-square or Fisher's exact test for qualitative variables and Student's t or Mann-Whitney's U test for quantitative variables. A p-value < 0.05 was considered significant. Results There were no differences in the demographic characteristics between RA patients and controls. The mean disease duration was 2.66 ± 1.39 years. A higher prevalence of CP (30.0% vs. 11.7%, p = 0.013), bilateral CP (18.3% vs. 3.3%, p = 0.008), increased cIMT (30.0% vs. 6.7%, p = 0.001), and subclinical atherosclerosis (53.3% vs. 18.3%, p = < 0.001) was found in RA patients. RA patients with subclinical atherosclerosis were older (56.70 years vs. 50.00 years, p = 0.002), presented a higher prevalence of dyslipidemia (53.1% vs. 14.3%, p = 0.002), and higher prevalence of classification in moderate-high disease activity category measured by DAS28-CRP (68.8% vs. 35.7%, p = 0.010). The latter variable persisted independently associated with subclinical atherosclerosis in the binary logistic regression (OR 6.11, 95% CI 1.51–24.70, p = 0.011). Conclusions In the first five years since diagnosis, higher prevalence of subclinical atherosclerosis, including CP was found in RA patients. Carotid ultrasound should be considered part of the systematic CVR evaluation of RA at the time of diagnosis.