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ABSTRACT The objective of this study is to present the protocol of a cluster randomized clinical trial to be conducted through the TeleICU project - Qualification of Intensive Care by Telemedicine. The study will consist of a cluster randomized clinical trial, open label, in pediatric intensive care units, with an allocation ratio of 1:1, to compare the intervention group (support of Telemedicine for patients admitted to the pediatric intensive care unit) with a control group (pediatric intensive care unit usual care). The study proposed to select 16 pediatric intensive care units, including 100 participants per site, with a total of 1,600 participants. The intervention group will receive telerounds from Monday to Friday and will have specialists and continuing education activities available. The primary outcome measure will be the length of stay in the pediatric intensive care unit, defined as the difference between the date of discharge of the participant and the date of admission to the intensive care unit. The secondary outcomes will be mortality rate, invasive mechanical ventilation-free days, days using antibiotics, days using vasoactive drugs and days using sedoanalgesia. This study will be conducted in accordance with Resolution 466/12 of the National Health Council, with approval by the Research Ethics Committee of the institutions involved. The present study has the potential to reproduce studies on Telemedicine in intensive care and may make important contributions to care in intensive care units in Brazil and other settings. If Telemedicine shows positive clinical care results compared to conventional treatment, more pediatric patients may benefit. ClinicalTrials.gov registry: NCT05260710

RESUMO O objetivo deste estudo será apresentar o protocolo de um ensaio clínico randomizado em cluster a ser realizado por meio do projeto TeleUTI - Qualificação da Assistência em Terapia Intensiva por Telemedicina. O estudo consistirá em um ensaio clínico randomizado por cluster, open label, em unidades de terapia intensiva pediátricas, com proporção de alocação de 1:1, com o intuito de comparar o grupo de intervenção (apoio da telemedicina para os pacientes internados na unidade de terapia intensiva pediátrica) com um grupo controle (cuidados habituais da unidade de terapia intensiva pediátrica). O estudo se propõe a selecionar 16 unidades de terapia intensiva pediátricas, incluindo 100 participantes por local, com o total de 1.600 participantes. O grupo intervenção receberá telerounds de segunda-feira a sexta-feira e terá à disposição especialistas e atividades de educação continuada. O desfecho primário a ser avaliado será o tempo de permanência nas unidades de terapia intensiva pediátricas, definido pela diferença entre a data de alta do participante com a data de admissão na unidade de terapia intensiva. Os desfechos secundários serão: taxa de mortalidade; dias livres de ventilação mecânica, dias de uso de antibióticos, dias de uso de drogas vasoativas e dias de uso de sedoanalgesia. Este estudo será conduzido em conformidade com a resolução 466/12 do Conselho Nacional de Saúde, com aprovação pelo Comitê de Ética em Pesquisa das instituições hospitalares envolvidas. O trabalho tem o potencial de reproduzir estudos sobre Telemedicina em cuidados intensivos, podendo trazer contribuições importantes ao atendimento em unidades de terapia intensiva no Brasil e em outras realidades. Se a Telemedicina mostrar resultados clínicos assistenciais positivos em relação ao tratamento convencional, mais pacientes pediátricos poderão ser beneficiados. Registro ClinicalTrials.gov: NCT05260710

https://doi.org/10.5935/2965-2774.20230223-en

The II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia
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Falavigna, Maicon

; Araujo, Cintia Laura Pereira de

; Barbosa, Alexandre Naime

; Belli, Karlyse Claudino

; Colpani, Verônica

; Dal-Pizzol, Felipe

; Silva, Rosemeri Maurici da

; Azevedo, Luciano César Pontes de

; Dias, Maria Beatriz Souza

; Amaral, José Luiz Gomes do

; Dorneles, Gilson Pires

; Ferreira, Juliana Carvalho

; Freitas, Ana Paula da Rocha

; Gräf, Débora Dalmas

; Guimarães, Hélio Penna

; Lobo, Suzana Margareth Ajeje

; Machado, Flávia Ribeiro

; Nunes, Michelle Silva

; Oliveira, Maura Salaroli de

; Parahiba, Suena Medeiros

; Rosa, Regis Goulart

; Santos, Vania Cristina Canuto

; Sobreira, Marcone Lima

; Veiga, Viviane Cordeiro

; Xavier, Ricardo Machado

; Zavascki, Alexandre Prehn

; Stein, Cinara

; Carvalho, Carlos Roberto Ribeiro de

Critical Care Science

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sep 2023, Volume 35 N. 3 Pages 243 - 255

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Objective: To update the recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Twenty-one recommendations were generated, including strong recommendations for the use of corticosteroids in patients using supplemental oxygen and conditional recommendations for the use of tocilizumab and baricitinib for patients on supplemental oxygen or on noninvasive ventilation and anticoagulants to prevent thromboembolism. Due to suspension of use authorization, it was not possible to make recommendations regarding the use of casirivimab + imdevimab. Strong recommendations against the use of azithromycin in patients without suspected bacterial infection, hydroxychloroquine, convalescent plasma, colchicine, and lopinavir + ritonavir and conditional recommendations against the use of ivermectin and remdesivir were made. Conclusion: New recommendations for the treatment of hospitalized patients with COVID-19 were generated, such as those for tocilizumab and baricitinib. Corticosteroids and prophylaxis for thromboembolism are still recommended, the latter with conditional recommendation. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and to promote resource economy.

RESUMO Objetivo: Atualizar as recomendações para embasar as decisões para o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: A elaboração desta diretriz foi feita por especialistas, incluindo representantes do Ministério da Saúde e metodologistas. O método utilizado para o desenvolvimento rápido de diretrizes baseou-se na adoção e/ou adaptação de diretrizes internacionais existentes (GRADE ADOLOPMENT) e contou com o apoio da plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Chegaram-se a 21 recomendações, incluindo recomendações fortes quanto ao uso de corticosteroides em pacientes em uso de oxigênio suplementar e recomendações condicionais para o uso de tocilizumabe e baricitinibe, em pacientes com oxigênio suplementar ou ventilação não invasiva, e de anticoagulantes, para prevenção de tromboembolismo. Devido à suspensão da autorização de uso, não foi possível fazer recomendações para o tratamento com casirivimabe + imdevimabe. Foram feitas recomendações fortes contra o uso de azitromicina em pacientes sem suspeita de infecção bacteriana, hidroxicloroquina, plasma convalescente, colchicina e lopinavir + ritonavir, além de recomendações condicionais contra o uso de ivermectina e rendesivir. Conclusão: Foram criadas novas recomendações para o tratamento de pacientes hospitalizados com COVID-19, como as recomendações de tocilizumabe e baricitinibe. Ainda são recomendados corticosteroides e profilaxia contra tromboembolismo, esta em caráter condicional. Vários medicamentos foram considerados ineficazes e não devem ser usados, no intuito de proporcionar o melhor tratamento segundo os princípios da medicina baseada em evidências e promover a economia de recursos.

https://doi.org/10.5935/2965-2774.20230136-en

Saúde mental de agentes comunitários de saúde no contexto da COVID-19
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Vieira-Meyer, Anya Pimentel Gomes Fernandes

; Farias, Sidney Feitoza

; Forte, Franklin Delano Soares

; Costa, Milena Silva

; Guimarães, José Maria Ximenes

; Morais, Ana Patrícia Pereira

; Oliveira, André Luiz Sá de

; Silva Júnior, Fernando José Guedes da

; Nascimento, Elaine Ferreira do

; Vasconcelos, Maristela Inês Osawa

; Dias, Maria Socorro de Araújo

; Oliveira, Felipe Proenço de

; Machado, Maria de Fátima Antero Sousa

; Castro, Marcia C.

; Yousafzai, Aisha Khizar

Ciência & Saúde Coletiva

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2023, Volume 28 N. 8 Pages 2363 - 2376

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O objetivo deste estudo foi analisar os fatores relacionados à saúde mental dos agentes comunitários de saúde (ACS) no contexto da COVID-19. Participaram 1.935 ACS de quatro capitais nordestinas e de quatro cidades do interior do Ceará. Foram coletados dados sociodemográficos e profissiográficos; SRQ-20; WHOQOL-Bref; exposição à violência; Escala de Autoeficácia Geral (EAEG); Escala Multidimensional de Suporte Social Percebido (MSPSS); informações relacionadas à COVID-19 e Escala de Ansiedade para Coronavírus (EAC). 40,5% exibiram SRQ > 7, sinalizando altos níveis de transtornos mentais comuns (TMC)/problemas de saúde mental. Utilizou-se a regressão linear múltiplas (backward). Observou-se que o aumento de risco de TCM foi influenciado pelos seguintes fatores: exposição à violência; EAC; não saber se teve COVID-19; desconhecer as variáveis que diminuíam o risco; os domínios físico e psicológico do WHOQOL-Bref; não ter aumento da jornada de trabalho; e não ter tido COVID-19. Os dados revelam a dinâmica multidimensional da saúde mental e ajudam a compreender a relação entre violência comunitária, COVID-19, qualidade de vida, idade e tempo de atuação na ESF com a saúde mental dos ACS.

Abstract This study aimed to analyze the factors related to the mental health of Community Health Workers (ACS) in the COVID-19 context. A total of 1,935 ACS from four Northeastern capitals and four cities in the inland region of Ceará participated. The following data were collected: sociodemographic; professional; SRQ-20; WHOQOL-Bref, exposure to violence, General Self-Efficacy Scale (EAEG), Multidimensional Scale of Perceived Social Support (MSPSS), COVID-19-related information, and the coronavirus anxiety scale (EAC). Approximately 40.5% had SRQ > 7, signaling high levels of Common Mental Disorders (CMD)/mental health issues. We adopted the Multiple linear (backward) regression. We observed that the increased risk of CMD was influenced by exposure to violence, EAC, not knowing they had COVID-19, not knowing the variables that reduced the risk, the physical and psychological domains of the WHOQOL-Bref, not having increased working hours, and not having had COVID-19. The data reveal the multidimensional dynamics of mental health and help understand the relationship between community violence, COVID-19, quality of life, age, and ESF working time with the mental health of ACS.

https://doi.org/10.1590/1413-81232023288.06462023

Fortalecimento da governança regional e da rede de atenção à saúde em municípios pequenos no Brasil
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Silva, João Felipe Marques da

; Pantaleão, Cristiane Martins

; Santos, Clodoaldo Fernandes dos

; Leles, Fernando Antônio Gomes

; Rocha, Karen Patrícia Wilke Pereira

; Giacometti, Luana Carla Tironi de Freitas

; Terabe, Sandro Haruyuki

; Galiano, Socorro Gross

; Neto, Valdeni Alexandre Ciconello

Revista Panamericana de Salud Pública

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2023, Volume 47 elocation e120

Abstract: Pt Es En | Text: Pt Es En | PDF: Pt | PDF: Es | PDF: En

RESUMO No Brasil, 67,7% dos municípios têm menos de 20 mil habitantes, sendo caracterizados como de pequeno porte. O objetivo do presente artigo é sistematizar a experiência e identificar os desafios e as lições aprendidas na implantação do modelo de fortalecimento da governança regional e da organização da rede de atenção à saúde (RAS) em uma região do Brasil composta por esses municípios, que apresentam baixa capacidade técnica e orçamentária, além de fragilidades diversas relacionadas à organização da RAS. Na perspectiva do fortalecimento da governança regional e da organização do processo de trabalho da atenção primária em saúde (APS) e, por consequência, dos fluxos com os outros níveis de atenção, foi proposta a estratégia intitulada Mais Cuidado Mais Saúde, desenvolvida em parceria com a Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) e o Ministério da Saúde. O projeto foi executado por meio de processos de educação permanente em saúde e fortalecimento de capacidades institucionais na região de Ivaiporã/Paraná, com oficinas descentralizadas, contemplando três eixos prioritários: integração da RAS, formação de capacidades e gestão da informação. O público-alvo foram as equipes de APS ampliada. O projeto permitiu desenvolver capacidades locais e de governança regional por meio de reflexões conjuntas a respeito do modelo de atenção à saúde, de seus componentes e das mudanças necessárias nos processos de trabalho para a promoção de saúde com foco na qualidade de vida dos usuários. Por se tratar de uma experiência que considera as fragilidades, necessidades e autonomia dos atores locais, o projeto tem alto poder de replicação e customização para outras regiões com características similares dentro e fora do Brasil.

RESUMEN En Brasil, 67,7% de los municipios se clasifican como pequeños, puesto que tienen menos de 20 000 habitantes. El objetivo de este artículo es sistematizar la experiencia adquirida y determinar cuáles son los desafíos y las enseñanzas extraídas en la implementación del modelo de fortalecimiento de la gobernanza regional y de la organización de la red de atención de salud en una región de Brasil compuesta por municipios de este tipo, que tienen poca capacidad técnica y presupuestaria y diversas debilidades relacionadas con la organización de dicha red. Desde la perspectiva del fortalecimiento de la gobernanza regional y de la organización del proceso de trabajo en el campo de la atención primaria de salud y, por consiguiente, de los flujos asistenciales con los demás niveles de atención, se propuso la estrategia Más cuidado, más salud, formulada junto con la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) y el Ministerio de Salud. El proyecto se ejecutó por medio de procesos de educación permanente en salud y fortalecimiento de las capacidades institucionales en la región de Ivaiporã, Estado de Paraná, con talleres descentralizados, dentro de tres ejes prioritarios, a saber, integración de red de atención de salud, capacitación y gestión de la información. El público destinatario fueron los equipos de atención primaria de salud ampliada. El proyecto permitió el desarrollo de las capacidades locales y la gobernanza regional por medio de reflexiones conjuntas sobre el modelo de atención de salud, sus elementos constitutivos y los cambios necesarios en los procesos de trabajo para impulsar la promoción de la salud centrada en la calidad de vida de los usuarios. Por tratarse de una experiencia en la cual se tienen en cuenta las debilidades, las necesidades y la autonomía de los actores locales, el proyecto tiene un alto poder de repetición y adaptación en otras regiones con características similares dentro y fuera de Brasil.

ABSTRACT In Brazil, 67.7% of the municipalities are characterized as small, with a population of less than 20 thousand. The objective of this article is to systematize the experience and identify the challenges and lessons learned in the implementation of the model for strengthening regional governance and organizing the health care network (HCN) in a region of Brazil composed of these municipalities, which present low technical and budgetary capacity, in addition to various fragilities related to the organization of the HCN. With a view to strengthening regional governance and the organization of the primary health care (PHC) work process and, consequently, the workflow with other levels of care, a strategy entitled More Care More Health (Mais Cuidado Mais Saúde) was proposed, developed in partnership with the Pan American Health Organization/World Health Organization (PAHO/WHO) and the Ministry of Health. The project was developed through permanent health education and institutional capacity building in the region of Ivaiporã, state of Paraná, based on workshops and addressing three priority axes: HCN integration, capacity building and information management. The target audience were the extended PHC teams. The project made it possible to develop local and governance capacities through joint reflections on the health care model, its components and the necessary changes in work processes for health promotion with a focus on the quality of life of users. Because it is an experience that considers the weaknesses, needs and autonomy of local actors, the project has a high potential for replication and customization for other regions with similar characteristics inside and outside Brazil.

https://doi.org/10.26633/rpsp.2023.120

Role of the NF-kB/parkin/vegfr-1 pathway associated with hypoxic-ischemic insult in germinal matrix samples of newborn infants
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Ghirelli, Eliane Amaral

; Silva, Felipe Paes Gomes da

; Oricil, Alessandro Gonçalves Gomes

; Paula, Caroline Busatta Vaz de

; Nagashima, Seigo

; Oldenburg Neto, Carlos Frederico

; Storti, Eduardo

; Sakiyama, Fernando Yochiteru Rolim

; Kayano, Rafael Martins

; Sakiyama, Renata Rolim

; Moreira, Vinícius da Silva

; Sotomaior, Vanessa Santos

; Noronha, Lucia de

Revista Paulista de Pediatria

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2023, Volume 41 elocation e2022034

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Objective: Given the high proliferative activity of germinal matrix and its direct correlation with hypoxemia, it is necessary to investigate the possible molecular regulation pathways, to understand the existing clinical relationship between the hypoxic-ischemic insult and the biomarkers NF-kB, AKT-3, Parkin, TRK-C and VEGFR-1. Methods: A hundred and eighteen germinal matrix samples of the central nervous system of patients who died in the first 28 days of life were submitted to histological and immunohistochemistry analysis to identify the tissue immunoexpression of those biomarkers related to asphyxia, prematurity, and death events within 24h. Results: A significantly increased tissue immunoexpression of NF-kB, AKT-3 and Parkin was observed in the germinal matrix of preterm infants. In addition, significantly decreased tissue immunoexpression of VEGFR-1 and NF-kB was observed in patients who experienced asphyxia followed by death within 24 hours. Conclusions: The results suggest a direct involvement between the hypoxic-ischemic insult and NF-kB and VEGFR-1 markers since a decreased immunoexpression of these biomarkers was observed in asphyxiated patients. Furthermore, it is suggested that there was not enough time for VEGFR-1 to be transcribed, translated and expressed on the surface of the plasma membrane. This temporality can be observed in the relationship between NF-kB expression and the survival time of individuals who died within 24 hours, suggesting that this factor is essential for the production of VEGFR-1 and, therefore, to carry out the necessary remodeling effect to neovascularize the affected region.

RESUMO Objetivo: Dada a alta atividade proliferativa da matriz germinativa e sua correlação direta com a hipoxemia, é necessário investigar as possíveis vias de regulação molecular para entender a relação clínica existente entre o insulto hipóxico-isquêmico e os biomarcadores NF-kB, AKT -3, Parkina, TRK-C e VEGFR-1. Métodos: Cento e dezoito amostras de matriz germinativa do sistema nervoso central de pacientes que faleceram nos primeiros 28 dias de vida foram submetidas a análise histológica e imuno-histoquímica para identificar a imunoexpressão tecidual desses biomarcadores relacionados a eventos de asfixia, prematuridade e óbito em 24 horas. Resultados: Observou-se uma imunoexpressão tecidual significativamente aumentada de NF-kB, AKT-3 e Parkin na matriz germinativa de prematuros. Além disso, constatou-se uma imunoexpressão tecidual significativamente diminuída de VEGFR-1 e de NF-kB em pacientes que apresentaram asfixia seguida de morte em 24 horas. Conclusões: Os resultados sugerem o envolvimento direto entre o insulto hipóxico-isquêmico e os marcadores NF-kB e VEGFR-1, visto que se observou uma imunoexpressão diminuída destes biomarcadores nos pacientes asfixiados. Além disso, sugere-se que não houve tempo suficiente para que o VEGFR-1 fosse transcrito, traduzido e expresso na superfície da membrana plasmática. Essa temporalidade pode ser observada na relação entre a expressão de NF-kB e o tempo de vida dos indivíduos que morreram em 24 horas, o que sugere que esse fator é essencial para a produção do VEGFR-1 e, portanto, para realizar o efeito remodelador necessário para neovascularizar a região afetada.

https://doi.org/10.1590/1984-0462/2023/41/2022034

Threshold of motion and orientation of bivalve shells under current flow
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Silva, Felipe Rafael Secco da

; Borges, Ana Luiza de Oliveira

; Toldo Jr., Elírio Ernestino

; Fick, Cristiano

; Puhl, Eduardo

; Oliveira, Vinícius Carbone Bernades

; Cruz, Francisco Eduardo Gomes da

Brazilian Journal of Geology

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2023, Volume 53 N. 1 elocation e20220080

Abstract: En | Text: En | PDF: En

Abstract Disarticulated shells of three bivalve mollusk species (Anomalocardia brasiliana, Codakia orbicularis, and Divaricella quadrisulcata) were experimentally tested in laboratory flumes to determine the threshold of motion and final orientation of the valves. A total of 150 current flow experiments were conducted on single shells resting on a fixed sand bed. This study demonstrated that shells in the convex-up position are more resistant to flow when the umbo is pointing downstream rather than upstream. Moreover, species with higher frontal areas were more likely to be entrained at lower flow velocities. Results of dimensionless shear stress exhibited values far below the threshold of grains movement for beds of uniform roughness (Shields curve). It was observed that circular shells in convex-up positions were mostly orientated with the umbo pointing downstream. Conversely, elliptical shells in convex-up position tended to align their longer axis parallel to the flow with the posterior side of the valve pointing downstream. These results are not only directly applicable in interpretations of incipient shell motions and in paleocurrent analyses from field and sample data, but also support construction of accurate geological models.

https://doi.org/10.1590/2317-4889202320220080

Uma Revisão sobre Instrumentos de Avaliação do Burnout na Segurança Pública
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Esteves, Germano Gabriel Lima

; Zanini, Daniela Sacramento

; Melo, Giulia Veiga de Leite Ribeiro

; Pereira Júnior, Sebastião Venâncio

; Oliveira, Sérgio Eduardo Silva de

; Corrêa, Felipe Minotto

; Fonseca, Wladimir Rodrigues da

; Nascimento, Thiago Gomes

; Barbosa, Lara Letícia Pinto

; Macedo, Francisco Guilherme Lima

; Faiad, Cristiane

Psico-USF

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2023, Volume 28 N. 2 Pages 281 - 294

Abstract: En Es Pt | Text: En Es Pt | PDF: En | PDF: Es | PDF: Pt

Abstract Aimed to map the instruments used in evaluating Burnout syndrome in public security professionals, indicating the psychometric aspects, samples, and associated variables. Nineteen studies were selected from the searched databases (PsycINFO, PubMED and Google Scholar). Results indicated that the instruments MBI-GS, MBI-HSS, BM-S, CBI and CESQT, but only one of the instruments showed evidence of validity in this context. Burnout was associated with personal, organizational, and specific variables. Comparison of studies and Burnout indices was limited due to the lack of standardization. The absence of evidence of validity and standardization of results leads to problems such as the lack of empirical support for the scores and difficulty in comparing studies. The data reveal limitations in the assessment of burnout levels used in the context of public safety, as the measures do not present validity evidence for this context, pointing to the need for research in the area.

Resumen El objetivo fue mapear los instrumentos utilizados en la evaluación del síndrome de Burnout en profesionales de la seguridad pública, indicando los aspectos psicométricos, muestras y variables asociadas. Se seleccionaron diecinueve estudios de las bases de datos buscadas (PsycINFO, PubMED y Google Scholar). Los resultados indicaron el uso de los instrumentos MBI-GS, MBI-HSS, BM-S, CBI y CESQT, pero solo uno de los instrumentos mostró evidencia de validez en este contexto. El Burnout se encuentra asociado con variables personales, organizacionales y específicas. La comparación de estudios e índices fue limitada debido a la falta de estandarización. La ausencia de evidencia de validez y estandarización de resultados conduce a problemas como la falta de soporte empírico para las puntuaciones y la dificultad para comparar estudios. Los datos revelan limitaciones en la evaluación de los niveles de burnout utilizados en el contexto de la seguridad pública, ya que las medidas no presentan evidencia de validez para este contexto, lo que apunta a la necesidad de realizar investigaciones en el área.

Resumo Objetivou-se mapear os instrumentos utilizados na avaliação da síndrome de Burnout em profissionais da segurança pública, indicando os aspectos psicométricos, amostras e variáveis associadas. Foram selecionados 19 estudos nas bases de dados pesquisadas (PsycINFO, PubMED e Google Scholar). Os resultados indicaram a utilização dos instrumentos MBI-GS, MBI-HSS, BM-S, CBI e CESQT, mas apenas um dos instrumentos apresentou evidência de validade nesse contexto. Constatou-se a associação do Burnout com variáveis pessoais, organizacionais e específicas. A comparação dos estudos e dos índices de Burnout foi limitada devido à falta de padronização. A ausência de evidências de validade e de padronização dos resultados acarreta problemas como a falta de suporte empírico das pontuações e dificuldade na comparação dos estudos. Os dados revelam limitações na avaliação dos níveis de Burnout utilizadas no contexto de segurança pública, uma vez que as medidas não apresentam evidências de validade para esse contexto, indicando a necessidade de pesquisas na área.

https://doi.org/10.1590/1413-82712023280206

Changes in sperm motility of amazonian fish Tambaqui Colossoma macropomum (Cuvier 1816) (Characiformes: Serrasalmidae) exposed to two pesticides
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Santos, Jadson Pinheiro

; Almeida, Simone de Jesus Melo

; Costa, Claryce Cunha

; Ferreira, Achilles Nina Santos

; Teixeira, Erivânia Gomes

; Guimarães, Erick Cristofore

; Brito, Pâmella Silva de

; Ottoni, Felipe Polivanov

; Carvalho-Neta, Raimunda Nonata Fortes

Biota Neotropica

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2023, Volume 23 N. 2 elocation e20221471

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract The great biodiversity of neotropical fish species that have external fertilization as a reproductive strategy, like the tambaqui, requires more careful analyzes in toxicological tests of the various pesticides implemented in Brazilian agriculture over the last few years. In this context, the objective of the present work was to evaluate possible sperm alterations in tambaqui (Colossoma macropomum) semen exposed to two different pesticide residues. Seminal samples of sexually mature tambaqui males from a local fish farm were used. Semen was collected eight hours after hormone induction into graduated glass tubes. After initial assessment of the lack of prior activation, the experiment was carried out in a factorial scheme, testing two pesticides widely used in agricultural systems (glyphosate and fenitrothion). For each pesticide, five concentrations were tested (6, 12, 24, 120 and 240 mg/L), with motility analysis at times 0, 30 and 60 seconds after activation. As a control, activation with 0.9% NaCl solution and motility analysis at the same times described for pesticides were used. Results indicate that in natura samples exhibited initial motility of 89.2 ± 4.9% and mean duration of 100 seconds (up to 10% sperm motility). The reduction in sperm motility occurred significantly (p < 0.05) after 30 seconds in all concentrations tested, except for the concentration of 240 mg/L because no activation was observed. The tests described here demonstrate that tambaqui semen was sensitive to the process of exposure to pesticide residues, and can be used in biomonitoring analyzes of the aforementioned agricultural pesticides.

Resumo A grande biodiversidade das espécies de peixes neotropicais que possuem a fertilização externa como estratégia reprodutiva, a exemplo do tambaqui, exige análises mais criteriosas em testes toxicológicos dos diversos defensivos agrícolas implementados na agricultura brasileira ao longo dos últimos anos. Nesse contexto, o objetivo do presente trabalho foi avaliar possíveis alterações espermáticas no sêmen de tambaqui (Colossoma macropomum) exposto a resíduos de dois diferentes pesticidas. Foram utilizadas amostras seminais de machos de tambaqui sexualmente maduros provenientes de uma piscicultura local. O sêmen foi coletado oito horas pós indução hormonal em tubos de vidro graduados. Após avaliação inicial de inexistência de ativação prévia, foi realizado o experimento em esquema fatorial, sendo testados dois pesticidas muito utilizados em sistemas agrícolas (glifosato e fenitrotiona). Para cada pesticida foram testadas cinco concentrações (6, 12, 24, 120 e 240 mg/L), com análise da motilidade nos tempos 0, 30 e 60 segundos pós ativação. Como controle, foi utilizada a ativação com solução de NaCl a 0,9% e análise da motilidade nos mesmos tempos descritos para os pesticidas. Resultados indicam que as amostras in natura exibiram motilidade inicial de 89,2 ± 4,9% e tempo de duração médio de 100 segundos (até 10% de motilidade espermática). A redução da motilidade espermática ocorreu de forma significativa (p < 0,05) após 30 segundos em todas as concentrações testadas, exceto na concentração de 240 mg/L por não ter sido observada ativação. Os testes aqui descritos demonstram que o sêmen de tambaqui se mostrou sensível ao processo de exposição aos resíduos de pesticidas, podendo ser utilizado em análises de biomonitoramento dos referidos defensivos agrícolas.

https://doi.org/10.1590/1676-0611-bn-2023-1471

Phosphorus fractions and microbiological indicators in vineyards soils of a tropical semiarid setting in Brazil
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Fracetto, Giselle Gomes Monteiro

; Freitas, Eliabe de Morais

; Nascimento, Clístenes Williams Araújo do

; Silva, Davi José da

; Medeiros, Erika Valente de

; Fracetto, Felipe José Cury

; Silva, Fernando Bruno Vieira da

; Buzó, Lucia Helena Nunez

; Silva, William Ramos da

Bragantia

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2023, Volume 82 elocation e20220232

Abstract: En | Text: En | PDF: En

ABSTRACT Brazilian semi-arid tropical is responsible for the production and export of fine table grapes, but the demand for phosphate fertilizers and other agricultural inputs increases the cost of production and threatens local water bodies by leaching of phosphorus (P). The objectives of this study were to quantify the organic and inorganic fractions of P and to determine chemical and microbiological attributes related to its mineralization in soils cultivated with vines in São Francisco Valley. It was hypothesized that P fractions and microbial activity would increase in areas fertilized with phosphate. Soil samples from vines were collected in cultivated areas and in fallow systems. P fractionation, macro-elements analysis, microbial biomass phosphorus (Pmic), and phosphatase enzyme activity were determined and correlated with each other and with the total proportion of synthesized glomalin. In both treatments, the inorganic P fractions exceeded the organic ones, and the total phosphorus available in those soils was associated with the most recalcitrant fractions, reducing risks of leaching of this element and contamination of water bodies. Pmic was higher in the winery areas due to the presence of phosphate fertilizers and organic matter, hence the activity of alkaline phosphatase enzymes and the production of total glomalin increased respectively in three and four evaluated areas, indicating that P-mineralized bacteria and arbuscular mycorrhizal fungi have been positively affected by the current agricultural system.

https://doi.org/10.1590/1678-4499.20220232

10.

Saúde mental de agentes comunitários de saúde no contexto da COVID-19
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Vieira-Meyer, Anya Pimentel Gomes Fernandes

; Farias, Sidney Feitoza

; Forte, Franklin Delano Soares

; Costa, Milena Silva

; Guimarães, José Maria Ximenes

; Morais, Ana Patrícia Pereira

; Oliveira, André Luiz Sá de

; Silva Júnior, Fernando José Guedes da

; Nascimento, Elaine Ferreira do

; Vasconcelos, Maristela Inês Osawa

; Dias, Maria Socorro de Araújo

; Oliveira, Felipe Proenço de

; Machado, Maria de Fátima Antero Sousa

; Castro, Marcia C.

; Yousafzai, Aisha Khizar

Ciência & Saúde Coletiva

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2023, Volume 28 N. 8 Pages 2363 - 2376

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

https://doi.org/10.1590/1413-81232023288.06462023

11.

Obstructive sleep apnea screening in different age groups: performance of the Berlin, STOP-Bang questionnaires and Epworth Sleepiness Scale
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Silva, Daniel Villela e

; Alves, Davi da Silveira Barroso

; Nóbrega, Mariana da Rocha Rodrigues

; Ribeiro, Felipe Braga Coelho Gomes

; Franco, Leandro Yukio Yatabe

; Silva, Isadora Rodrigues da

; Joffily, Lucia

; Rocha, Maira da

; Godoy, Paulo Henrique

Brazilian Journal of Otorhinolaryngology

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2023, Volume 89 N. 4 elocation 101283

Abstract: En | Text: En | PDF: En

Abstract Objective To evaluate the performance of the Berlin Questionnaire, the STOP-Bang Questionnaire, and the Epworth Sleepiness Scale in screening for the disease in adults of different age groups by comparing them with polysomnography. Methods Cross-sectional study with prospective patient allocation, in which individuals underwent a medical interview, completion of the three screening instruments, and polysomnography. Individuals were categorized into three age groups: 18-39, 40-59, and ≥60 years. The results of the screening instruments were compared to the diagnostic criteria of the International Classification of Sleep Disorders—third edition. Performance was assessed using 2 × 2 contingency tables, estimating sensitivity, specificity, predictive value, likelihood ratio, and accuracy. Receiver Operating Characteristic curves were also constructed and the area under the curve was estimated for each instrument by age group. Results We obtained a sample with 321 individuals suitable for analysis. The mean age was 50 years, with a predominance of females (56%). The prevalence of the disease in the overall sample was 79%, more prevalent in males in any age group and more frequent in the middle age group. The analyzes revealed that STOP-Bang performed better, both for the overall sample and for all age groups, followed by Berlin Questionnaire and Epworth Sleepiness Scale. Conclusion In an outpatient setting with individuals with characteristics similar to those in this study, it seems sensible to choose the STOP-Bang as a screening tool for the disease, regardless of age group. Level of evidence according the guide for authors: level 2.

https://doi.org/10.1016/j.bjorl.2023.101283

12.

Ethanol from maize hybrids in Brazil
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Eckert, Caroline Thaís

; Frigo, Elisandro Pires

; Albrecht, Leandro Paiola

; Albrecht, Alfredo Junior Paiola

; Silva, Andre Felipe Moreira

; Santos, Weslei Gomes dos

; Cesco, Victor José Salomão

; Dieter, Jonathan

; Piccin, Emanuele Scapin

Crop Breeding and Applied Biotechnology

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2023, Volume 23 N. 2 elocation e44732328

Abstract: En | Text: En | PDF: En

Abstract The aim was to investigate the differences between maize hybrids for their agronomic yield and their agro-energy potential. The study was conducted in Palotina and Assis Chateaubriand, Paraná, Brazil. The treatments were composed of 10 maize hybrids (DKB290 [non-GMO], DKB315, DKB340, DKB290, Formula, Defender, Status, 2B810, 30F53, BG7330), which were evaluated for grain moisture and yield, starch content, total soluble solids content, ethanol content in the juice and ethanol yield. The important factors for the result are related to grain yield and the quality of the harvested grains, and agronomic performance of these hybrids may differ according to each crop year. Hybrid 30F53 stood out positively for all variables. Hybrid DKB315 showed the highest ethanol yield and high grain yield, and insignificant grain quality was not enough to result in a decline in ethanol yield.

https://doi.org/10.1590/1984-70332023v23n2a20

13.

Combined BLUP selection indexes with parents and F2 populations in soybean (Glycine max) breeding
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Bezerra, André Ricardo Gomes

; Resende, Marcos Deon Vilela de

; Silva, Felipe Lopes da

; Sediyama, Tuneo

; Cruz, Cosme Damião

; Silva, Francisco Charles dos Santos

; Silva, Amilton Ferreira da

Crop Breeding and Applied Biotechnology

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2023, Volume 23 N. 4 elocation e45412346

Abstract: En | Text: En | PDF: En

Abstract This study aimed to apply selection indexes in situations in which F2 populations and their parents are evaluated simultaneously in field trials to predict population genotypic values and selecting the best populations. Fifteen F2 soybean populations were evaluated for number of days to flowering and to maturity and grain yield. The data was analyzed using restricted maximum likelihood/best linear unbiased prediction (REML/BLUP) to obtain genotypic effects, variance components and accuracies. Four selection methods were compared: genotypic values of the F2 populations (gF2), combined index with the mean genotypic value of parents and F2 population (Ia) and two indexes that add (to gF2 and to Ia) and consider genetic variability within populations (Ib and Ic). The index Ia presented a result similar to that obtained with the gF2 selection method. Selection indexes (Ib and Ic) based on several sources of information were more efficient than selection based on gF2 values only.

https://doi.org/10.1590/1984-70332023v23n4a41

14.

Initial performance and genetic diversity of coffee trees cultivated under contrasting altitude conditions
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Senra, João Felipe de Brites

; Silva, Josimar Aleixo da

; Ferreira, Adésio

; Esposti, Marlon Dutra Degli

; Ferrão, Maria Amélia Gava

; Fassarella, Kamila Machado

; Silva, Uliana Ribeiro

; Milheiros, Idalina Sturião

; Silva, Fernanda Gomes da

Scientia Agricola

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2023, Volume 80 elocation e20220163

Abstract: En | Text: En | PDF: En

ABSTRACT This work evaluated the initial performance and genetic diversity of Coffea canephora genotypes cultivated in environments at contrasting altitudes. Fourteen morphophysiological traits and seven descriptors of the genus Coffea spp. of coffee trees cultivated at altitudes of 140 m and 700 m were evaluated. The design used was Federer’s augmented block in a 2 × 112 factorial scheme with six blocks. The first factor was the two environments, and the second was the 112 genotypes, with eight common treatments, being five conilon coffee clones and three arabica coffee cultivars. The data were analyzed by the method of REML/BLUP and genetic correlation method. Genetic diversity was evaluated by estimating the distance matrix, applying the Gower methodology followed by the clustering method by Tocher and UPGMA. The phenotypic means were higher in the environment at an altitude of 700 m, except for plant height, number of leaves, and canopy height (CH). Genotypic effects were significant for most traits except for leaf width, CH, unit leaf area, and total leaf area. A wide genetic diversity was verified, with distances varying from 0.037 to 0.593 for the pairs of genotypes 26 × 93 and T7 × 76, respectively. Most of the traits studied showed high genotypic correlation with the environment and expressive genetic correlation between the evaluated traits thereby demonstrating the possibility of indirect selection. There is an adaptation of conilon coffee genotypes to high altitudes and the possibility of developing a specific cultivar for the southern state of Espírito Santo.

https://doi.org/10.1590/1678-992x-2022-0163

15.

Morphophysiological responses of Conilon coffee matrix plants in a super-dense clonal garden
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Silva, Josimar Aleixo da

; Esposti, Marlon Dutra Degli

; Senra, João Felipe de Brites

; Comério, Marcone

; Conceição, Amanda Oliveira da

; Zacarias, Alex Justino

; Milheiros, Idalina Sturião

; Silva, Uliana Ribeiro

; Silva, Fernanda Gomes da

; Raimundo, Eduarda Gonçalves

Pesquisa Agropecuária Brasileira

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2023, Volume 58 elocation e03078

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract The objective of this work was to evaluate the morphophysiological responses and cutting production of clones of Conilon coffee (Coffea canephora) cultivars in a super-dense clonal garden in the state of Espírito Santo, Brazil. The super-dense clonal garden was built in 2019 using 39 clones: 9, 9, 9, and 12 of cultivars Centenária ES8132, Diamante ES8112, ES8122 (Jequitibá), and Marilândia ES8143, respectively. The experiment was carried out in a randomized complete block design, with three replicates. Cutting production and the following morphophysiological traits were evaluated at 9 and 18 months after planting: chlorophyll index, normalized difference vegetation index, plant height, canopy height, canopy diameter, number of shoots, number of viable cuttings, number of leaves, fresh leaf mass, and plant fresh and dry matter mass. The super-dense clonal garden caused different morphophysiological responses among the studied clones. In general, clones C2, C5, C6, C8, D1, D8, D9, J8, M2, M9, M10, and M12 showed a higher mean cutting production, whereas C4, J1, J4, M4, and M5 were the most sensitive to the super-dense regime. Under these conditions, it is recommended to increase the proportion of matrix plants of the latter clones.

Resumo O objetivo deste trabalho foi avaliar as respostas morfofisiológicas e a produção de estacas de clones de cultivares de café conilon (Coffea canephora) em jardim clonal superadensado, no estado do Espírito Santo, Brasil. O jardim clonal superadensado foi implantado em 2019, com 39 clones: 9, 9, 9 e 12 das cultivares Centenária ES8132, Diamante ES8112, ES8122 (Jequitibá) e Marilândia ES8143, respectivamente. O experimento foi realizado em delineamento em blocos ao acaso, com três repetições. A produção de estacas e as seguintes características morfofisiológicas foram avaliadas aos 9 e 18 meses após o plantio: índice de clorofila, índice de vegetação por diferença normalizada, altura da planta, altura da copa, diâmetro da copa, número de brotações, número de estacas viáveis, número de folhas, massa fresca de folhas, e massa fresca e seca da planta. O jardim clonal superadensado promoveu diferentes respostas morfofisiológicas entre os clones estudados. Em geral, os clones C2, C5, C6, C8, D1, D8, D9, J8, M2, M9, M10 e M12 apresentaram maior produção média de estacas, enquanto C4, J1, J4, M4 e M5 foram os mais sensíveis ao regime superdenso. Nessas condições, recomenda-se aumentar a proporção de plantas matrizes destes clones.

https://doi.org/10.1590/s1678-3921.pab2023.v58.03078

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