Abstract Bovine trypanosomosis, caused by Trypanosoma vivax, is a disease that originated in Africa and currently affects cattle in several South American countries, including almost all Brazilian states. Despite the reports on T. vivax infection in southern Brazil, data on its circulation status is currently unavailable. In this study, we aimed to detect anti-Trypanosoma spp. IgG antibodies in cattle from Rio Grande do Sul and suggest areas with T. vivax transmission risk. A total of 691 serum samples from cattle in the intermediate regions of Rio Grande do Sul were analyzed using indirect immunofluorescence assay (IFA). The overall seroprevalence of anti-Trypanosoma antibodies in cattle was 24.6% (170/691). The detection rate ranged from 0-37.3%, with a high prevalence in the intermediate regions of Ijuí (37.3%), Uruguaiana (30.7%), and Passo Fundo (28.9%). Thus, these regions were suggested as possible bovine trypanosomosis risk areas due to the high seroprevalence. This is the first serological study to determine Trypanosoma spp. infection status in cattle from Rio Grande do Sul, providing data on the epidemiology of trypanosomosis in the state.

Resumo A tripanossomose bovina, causada por Trypanosoma vivax, é uma doença que teve origem na África, e atualmente, afeta bovinos em diversos países da América do Sul, incluindo quase todos os estados brasileiros. Apesar dos relatos de infecção por T. vivax, no sul do Brasil, dados sobre seu status de circulação não estão disponíveis atualmente. Neste estudo, o objetivo foi detectar anticorpos IgG anti-Trypanosoma spp. em bovinos do Rio Grande do Sul e sugerir possíveis áreas de risco de transmissão de T. vivax. Foi analisado um total de 691 amostras de soro de bovinos, das regiões intermediárias do Rio Grande do Sul, usando-se o ensaio de imunofluorescência indireta (IFA). A soroprevalência geral de anticorpos anti-Trypanosoma em bovinos foi de 24,6% (170/691). A taxa de detecção variou de 0 a 37,3%, com uma alta prevalência nas regiões intermediárias de Ijuí (37,3%), Uruguaiana (30,7%) e Passo Fundo (28,9%). Portanto, essas regiões foram sugeridas como possíveis áreas de risco para a tripanossomose bovina, devido à alta soroprevalência. Este é o primeiro estudo sorológico a determinar o status de infecção por Trypanosoma spp., em bovinos do Rio Grande do Sul, fornecendo dados sobre a epidemiologia da tripanossomose no estado.

Characterized by symptoms that remain or appear for the first time within three months of SARS-CoV-2 infection, long COVID can manifest itself in different ways, including in non-hospitalized or asymptomatic cases. Thus, this study offers an overview of long COVID in Brazil, especially of its diagnosis, symptoms, and challenges for new health management. Data from a study that investigated long COVID in people affected by COVID-19 were used. These original data stem from a survey with adult Brazilians (aged 18 years or older) who had COVID-19 that collected information from March 14 to April 14, 2022, by a questionnaire on social media. The questionnaire addressed sociodemographic characteristics, history of COVID-19 infections, vaccination against the disease, investigation of health status and quality of life before and after COVID-19, and search and access to treatment. Of the 1,728 respondents, 720 were considered eligible for analysis, of which 496 (69%) had long COVID. Individuals with long COVID reported clinical manifestations such as anxiety (80%), memory loss (78%), generalized pain (77%), lack of attention (75%), fatigue (73%), hair loss (71%), sleep changes (70%), mood swings (62%), malaise (60%), and joint pain (59%). Most sought health services during and after the acute phase of COVID-19 (94 and 80%, respectively), representing the need to structure the healthcare system for these patients.

Caracterizado por síntomas que permanecen o aparecen por primera vez dentro de los tres meses posteriores a la infección por SARS-CoV-2, la COVID larga puede manifestarse de diferentes formas, incluso entre casos no hospitalizados o asintomáticos. En este sentido, este artículo presenta un panorama la COVID larga en Brasil, con énfasis en el diagnóstico, los síntomas y los desafíos para la nueva gestión de la salud. Se utilizaron datos de una encuesta realizada para investigar la COVID larga en personas afectadas por COVID-19. Se trata de datos originales de una encuesta con individuos brasileños adultos (18 años o más), que tuvieron COVID-19, con datos recolectados entre el 14 de marzo y el 14 de abril de 2022, por medio de un cuestionario divulgado en las redes sociales. El cuestionario abordó características sociodemográficas, historial de infecciones por COVID-19, vacunación contra la enfermedad, investigación de la situación de salud y de la calidad de vida antes y después de COVID-19, además de la búsqueda y acceso a tratamiento. De los 1.728 encuestados, 720 fueron considerados elegibles para el análisis. De ellos, 496 (69%) tenían COVID larga. Las personas con COVID larga informaron manifestaciones clínicas como ansiedad (80%), pérdida de memoria (78%), dolor generalizado (77%), falta de atención (75%), fatiga (73%), pérdida de cabello (71%), cambios en el sueño (70%), cambios de humor (62%), malestar (60%) y dolor en las articulaciones (59%). La mayoría recurrió a los servicios de salud durante y después de la fase aguda de COVID-19 (94% y 80%, respectivamente), lo que representa la necesidad de estructurar el sistema de salud para atender a estos pacientes.

Caracterizada por sintomas que permanecem ou aparecem pela primeira vez em até três meses após a infecção pelo SARS-CoV-2, a COVID longa pode se manifestar de diferentes formas, inclusive entre casos não hospitalizados ou assintomáticos. Nesse sentido, este artigo apresenta um panorama da COVID longa no Brasil, com ênfase no diagnóstico, nos sintomas e nos desafios para a nova gestão da saúde. Foram utilizados dados de um estudo realizado com objetivo de investigar a COVID longa em pessoas acometidas pela COVID-19, com dados originais de um inquérito com indivíduos brasileiros adultos (18 anos ou mais) que tiveram COVID-19, coletados entre 14 de março e 14 de abril de 2022, por meio de questionário divulgado em redes sociais. O questionário abordou características sociodemográficas, histórico de infecções por COVID-19, vacinação contra a doença, investigação da situação de saúde e da qualidade de vida antes e após a COVID-19, além da busca e acesso a tratamento. Dos 1.728 respondentes, 720 foram considerados elegíveis para a análise. Desses, 496 (69%) tiveram COVID longa. Os indivíduos com COVID longa reportaram manifestações clínicas como ansiedade (80%), perda de memória (78%), dor generalizada (77%), falta de atenção (75%), fadiga (73%), queda de cabelo (71%), alterações de sono (70%), alterações de humor (62%), indisposição (60%) e dor nas articulações (59%). A maioria procurou os serviços de saúde durante e após a fase aguda de COVID-19 (94% e 80%, respectivamente), o que representa a necessidade de estruturar o sistema de saúde para atender esses pacientes.

ABSTRACT The present research aimed to compare the HRV of people living with HIV (PLWH) with non-infected individuals in aquatic and dryland environments. Twenty participants were divided into two groups. PLWH composed the experimental group (EG), and seronegative participants composed the control group (CG). In dryland, HRV was measured in time and frequency domains, as follows: 10 minutes in rest (RES), 20 minutes of moderate and intense aerobic exercise (EXE), and 30 minutes post-exercise recovery (REC). After 72 hours, the same procedures were repeated in the aquatic environment. HRV analysis demonstrated significant differences in Mean r-r (Δ%= 3.5%, p< 0.01) and rMSSD (Δ%= −19.4%, p< 0.05) when compared dryland vs aquatic environment in RES. We observed similar results in rMSSD (Δ%= 49.2%, p< 0.01), pNN50(%) (Δ%= 79.1%, p< 0.01), and SD1 (Δ%= 49.3%, p< 0.01), during REC. Significant differences (p< 0.01) were also demonstrated for the HF during RES (Δ%= −43.4%) and REC (Δ%= −28.8%). However, the EG intra-group analysis showed no significant differences. The inter-group analysis at RES in dryland demonstrated significant differences in rMSSD (Δ%= −36.5%, p< 0.05), pNN50(%) (Δ%= −54.8%, p< 0.05), and SD1 (Δ%= 46.5%, p< 0.05). We also observed significant differences in mean R-R intervals (Δ%= −17.8%, p< 0.01), SDNN (Δ%= −41.2%, p< 0.01), rMSSD (Δ%= −50.5%, p< 0.01), pNN50 (Δ%= −73.6%, p< 0.001), and SD1 (Δ%= −50.4%, p< 0.001) during water immersion as well as the HF (Δ%= −67.6%, p< 0.01). The mean R-R interval (Δ%= −16.3%, p< 0.01), SDNN (Δ%= −46.4%, p< 0.001), rMSSD (Δ%= −57.0%, p< 0.001), pNN50 (Δ%= −73.1, p< 0.001), and SD1 (Δ%= −57.1, p< 0.001) also showed significant differences during REC. Water immersion increases the CG vagal modulation as expected. However, without any influence in EG. The results indicate a decreased vagal modulation in PLHIV in ART, indicating a possible autonomic dysfunction over the heart for this group.

Abstract Objective We aim to describe an experimental model for studying femoral fractures in rats after exposure to ionizing radiation, demonstrating a way to apply a substance for analysis, the method for patterning fracture and irradiation, and how to evaluate its effectiveness based on radiographic studies. Methods We used 24 rats divided into 2 groups of 12 animals each. The STUDY group was exposed to ionizing radiation and treated with saline solution, and the CONTROL group was not exposed to radiation and was treated with saline solution. All animals were subjected to standardized fracture of the right femur that was fixed with intramedullary wire. The efficiency of the bone union was assessed by radiographic exam. Results Fracture healing was more efficient in bones not exposed to ionizing radiation (p = 0.012). All fractures met the criteria of being simple, diaphyseal, transverse or short oblique. Conclusion The experimental model presented is an efficient alternative for the study of fractures in irradiated bones in rats.

Resumo Objetivo Nosso objetivo é descrever um modelo experimental para estudo de fraturas de fêmur em ratos após exposição a radiação ionizante, demonstrando uma forma de aplicação de uma substância para análise, o método de padronização de fratura e irradiação e a forma de avaliação de sua eficácia com base em estudos radiográficos. Métodos Utilizamos 24 ratos divididos em dois grupos de 12 animais cada. O grupo ESTUDO foi exposto à radiação ionizante e tratado com soro fisiológico, enquanto o grupo CONTROLE não foi exposto à radiação e foi tratado com soro fisiológico. Todos os animais foram submetidos à fratura padronizada do fêmur direito e sua fixação com fio intramedular. A eficácia da consolidação óssea foi determinada por exame radiográfico. Resultados A cicatrização de fraturas foi mais eficiente em ossos não expostos à radiação ionizante (p = 0,012). Todas as fraturas atenderam aos critérios de serem simples, diafisárias, transversas ou oblíquas curtas. Conclusão O modelo experimental apresentado é uma boa alternativa para o estudo de fraturas em ossos irradiados em ratos.

Abstract This study investigates the disposition effect with regard to Brazilian investors, with focus on the year 2020. The database is composed by more than 12,000 trades by 274 investors. We follow the method of Odean (1998) to estimate the proportions of gains and losses realized and test the null hypothesis of equality of these proportions in each portfolio. The results suggest that Brazilian investors behave in line with the disposition effect. They sell winning stocks too early and hold losing stocks too long. A stock that is gaining value is more likely to be sold from day to day compared to a stock that is losing value. The disposition effect was not found in March, which suggests that investors employed a loss-limit during periods of market stress, no matter if the stock went up or down.

Resumo Este trabalho investiga a presença do efeito disposição em investidores brasileiros no ano de 2020. A base de dados compreende 274 investidores distintos que, em conjunto, realizaram mais de 12 mil transações. Aplica-se a metodologia utilizada por Odean (1998). A partir das carteiras de investimento de cada indivíduo, estima-se a proporção de ganhos e de perdas realizadas e testa-se a hipótese de igualdade dessas proporções. O estudo identificou que os investidores brasileiros estão propícios à influência dessa anomalia comportamental nas suas decisões, ou seja, vendem seus investimentos com ganhos mais rapidamente e mantêm seus investimentos perdedores por mais tempo e que uma posição com lucro possui mais chance de ser vendida do que uma posição com prejuízo. Os resultados não indicam efeito disposição no mês de março, e isso sugere que, em momentos de maior incerteza, investidores buscam limitar perdas, independentemente do lucro ou prejuízo auferido com o ativo.

ABSTRACT The order Plecoptera comprises nearly 4,400 species of freshwater insects known for their specific temperature requirements. In Brazil, there are 207 valid extant species, with 172 (83%) being endemic, and particularly the genus Anacroneuria is well-represented. This study aims to present a comprehensive overview of the taxonomy of Brazilian Plecoptera using a scientometric approach. Initially, European authors dominated the taxonomy, describing 67 species by the mid-20th century, but Brazilian researchers, notably Claudio Gilberto Froehlich, have made significant contributions, describing 82 species. Type-specimens of Brazilian species are mostly held in Brazilian institutions, with the MZSP in São Paulo housing the majority (79.8%). São Paulo is the state with the highest number of species (67), followed by Rio de Janeiro (47) and Santa Catarina (47). The states of Alagoas, Paraíba, and Rio Grande do Norte have no recorded Plecoptera species. Among Brazilian terrestrial biomes, the Atlantic Forest exhibits the highest number of species, with 140 known species, followed by the Brazilian Savanna (57). The Hydrographic Region of Southeast Atlantic is that with the largest number of species (82). Limited data exist on the immature stages of Plecoptera across most genera, representing only a quarter of the current diversity in Brazil. Additionally, only 9.7% of the species have available molecular sequence data. Despite these challenges, the Plecoptera in Brazil demonstrate remarkable species diversity, with a significant proportion of endemism. Both European and Brazilian researchers have played crucial roles in advancing the taxonomy and understanding of this fascinating group of insects.

Abstract Accumulated evidence has shown that the oral cavity may be an important reservoir for SARS-CoV-2. Some authors have suggested that the use of mouthrinses could reduce SARS-CoV-2 viral load in the saliva. Thus, the aim of this review was to synthesize evidence about the efficacy of mouthrinses in reducing the salivary viral load of SARS-CoV-2. 2. Nine randomized controlled trials (RCTs) have investigated the efficacy of different mouthrinses in reducing salivary SARS-CoV-2 loads. Various active ingredients have been tested in these trials: 0.5%,1% and 2% povidone-iodine, 0.2% and 0.12% chlorhexidine (CHX), 0.075% cetylpyridinium chloride (CPC), 0.075% CPC with Zinc lactate, 1% and 1.5% hydrogen peroxide (HP), 1.5% HP + 0.12% CHX and ß-cyclodextrin and citrox. The studies reported an intra-group reduction in the salivary levels of the virus, when compared with the baseline. However, the majority of these trials failed to demonstrate a significant inter-group difference between active groups and the control group relative to the decrease in salivary SARS-CoV-2 loads. Although promising, these results should be confirmed by larger trials.

Alkali-activated binders (AAB) are inorganic materials produced by a mixture between a solid precursor and an alkaline activator, wherein, the reaction results in a material with properties similar to Portland cement hydration. The advantages of AAB over Portland cement are the possibility of using alternative materials, demanding low energy and low CO2 emission. The primary objective of this study was to produce an alkali-activated binder (AAB) using calcined wood waste ash (CWWA) as a solid precursor due to its beneficial properties. CWWA was obtained by burning wood wastes in a furnace, then calcined in a laboratory oven at 600 °C to remove unburned particles. Afterward, the ash was milled and then physiochemically characterized by chemical composition, X-ray diffraction (XRD), particle size distribution, and scanning electron microscopy (SEM). The milled CWWA was employed in AAB mortars and pastes activated with sodium hydroxide (NaOH) to assess the influence of alkaline activator concentration. In this work, the Na+ concentrations varied in the 6.5-12.5 mol.kg-1 range. Mortars were assessed by compressive strength, whereas pastes were analyzed by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDS) for samples cured after 7 days at 60 °C. Results showed that the CWWA is mainly composed of SiO2 (67.9 wt%) and the presence of an amorphous phase and quartz as the main crystalline phase (XRD). The compressive strength of mortars showed that the CWWA activated with a Na+ concentration of 6.5 ml.kg-1 achieved the highest compressive strength (23.2 ± 1 MPa). Microstructural studies of pastes showed the formation of sodium carbonate (XRD) and reaction products (FTIR) in a dense microstructure (SEM/EDS). Hence, the key findings suggest that employing CWWA as a solid precursor offers a viable choice for producing a more sustainable AAB.

Abstract The Brazilian Society of Angiology and Vascular Surgery has set up a committee to provide new evidence-based recommendations for patient care associated with chronic venous insufficiency. Topics were divided in five groups: 1. Classification, 2. Diagnosis, 3. Conservative or non-invasive treatment, 4. Invasive treatment and 5. Treatment of small vessels. This last series is closely related to the activities of Brazilian angiologists and vascular surgeons, who are heavily involved in the treatment of small superficial veins. These guidelines are intended to assist in clinical decision-making for attending physicians and health managers. The decision to follow a guideline recommendation should be made by the responsible physician on a case-by-case basis taking into account the patient's specific condition, as well as local resources, regulations, laws, and clinical practice recommendations.

Resumo A Sociedade Brasileira de Angiologia e de Cirurgia Vascular organizou uma comissão para fornecer novas recomendações baseadas em evidências sobre questões críticas de atendimento ao paciente com insuficiência venosa crônica. São abordados aqui os temas de classificação, diagnóstico, tratamento conservador, tratamento invasivo e tratamento de pequenos vasos. Esta última série está muito relacionada à atividade de angiologistas e cirurgiões vasculares, que possuem forte atuação no tratamento de pequenas veias superficiais. Estas diretrizes destinam-se a auxiliar na tomada de decisões clínicas de médicos assistentes e gestores de saúde. A decisão de seguir uma recomendação de diretriz deve ser feita pelo médico responsável caso a caso, levando em consideração a condição específica do paciente, bem como recursos locais, regulamentos, leis e recomendações de prática clínica.

Resumo Fundamento As artérias coronárias tendem a ser mais tortuosas que outras artérias e acompanham os movimentos repetidos de flexão e relaxamento que ocorrem durante o ciclo cardíaco. A Tortuosidade das artérias Coronárias (TCor) causa alterações no fluxo coronariano, com uma redução na pressão de perfusão distal, o que pode levar à isquemia miocárdica. Objetivo Avaliar a associação entre TCor e isquemia miocárdica. Métodos Entre janeiro de 2015 e dezembro de 2017, 57 pacientes com angina e doença arterial coronariana não obstrutiva pela angiografia coronária invasiva (ACI) foram incluídos retrospectivamente. Variáveis angiográficas foram analisadas para avaliar a presença e grau de tortuosidade e correlacionadas com seus respectivos territórios vasculares na cintilografia de perfusão miocárdica com estresse. A TCor foi definida como artérias coronárias com três ou mais curvaturas com ângulos ≤ 90o, medidos durante diástole. Um nível de 5% foi estabelecido como estatisticamente significativo. Um nível de 5% foi definido como estatisticamente significativo. Resultados Um total de 17 homens e 40 mulheres foram incluídos (idade média de 58,3 anos). A TCor foi observada em 16 pacientes (28%) e em 24 das 171 artérias. Observou-se uma associação significativa entre TCor e isquemia na análise por artéria (p<0,0001). O fator angiográfico mais associado com isquemia foi o número de curvaturas em uma artéria epicárdica medido na sístole (p=0,021). Conclusão Este estudo mostrou uma associação da TCor com isquemia miocárdica em pacientes com artérias coronárias não obstruídas e angina. Observou-se uma relação entre número aumentado de curvaturas na artéria coronária medido por angiografia durante sístole e isquemia.

Abstract Background Coronary arteries tend to be more tortuous than other arteries and follow the repeated flexion and relaxation movements that occur during the cardiac cycle. Coronary tortuosity (CorT) leads to changes in coronary flow with a reduction in distal perfusion pressure, which could cause myocardial ischemia. Objective To assess the association between CorT and myocardial ischemia. Methods Between January 2015 and December 2017, 57 patients with angina and nonobstructive coronary artery disease detected by invasive coronary angiography (ICA) were retrospectively enrolled. Angiographic variables were analyzed to assess the presence and degree of tortuosity and correlated with their respective vascular territories on stress myocardial perfusion imaging (MPI). CorT was defined as coronary arteries with three or more bend angles ≤90°, measured during diastole. Statistical significance was determined at the 5% level. Results A total of 17 men and 40 women were enrolled (mean age 58.3 years). CorT was observed in 16 patients (28%) and in 24 of 171 arteries. There was a significant association between CorT and ischemia when analyzed per artery (p<0.0001). The angiographic factor most associated with ischemia was the number of bend angles in an epicardial artery measured at systole (p=0.021). Conclusion This study showed an association of CorT and myocardial ischemia in patients with unobstructed coronary arteries and angina. An increased number of coronary bend angles measured by angiography during systole was related to ischemia.

Abstract Objective Describe the epidemiology of deaths in children not submitted to CPR, compare to a CPR group and evaluate patients’ medical records of those not submitted to CPR. Methods Observational cross-sectional study assessing deaths between 2015 and 2018 in a pediatric tertiary hospital, divided into two groups: CPR and no- CPR. The source of data included the cardiorespiratory arrest register, based on Utstein style. Children's medical records in no-CPR group were researched by hand. Results 241 deaths were included, 162 in CPR group and 79 in the no-CPR group. Preexisting diseases were observed in 98.3% of patients and prior advanced intervention in 78%. Of the 241 deaths, 212 (88%) occurred in the PICU, being 138/162 (85.2%) in CPR group and 74/79 (93.7%) in no-CPR group (p= 0.018). Bradycardia as the initial rhythm was five times more frequent in the CPR group (OR 5.06, 95% CI 1.94-13,19). There was no statistically significant difference regarding age, gender, preexisting diseases, and period of the day of the occurrence of death. Medical records revealed factors related to the family decision-making process or the suitability of therapeutic effort. Discrepancies between the practice of CPR and medical records were identified in 9/79 (11,4%) records allocated to the no-CPR group. Conclusion Most deaths with CPR and with the no-CPR occurred in the PICU. Bradycardia as the initial rhythm was five times more frequent in the CPR group. Medical records reflected the complexity of the decision not to perform CPR. Discrepancies were identified between practice and medical records in the no-CPR group.

Abstract Aim: The present study aimed to screen for differences in isokinetic peak torque, hamstrings-to-quadriceps ratio, and proprioception within the lower limbs of female handball athletes. Methods: Twelve college-level female handball athletes with no previous experience with resistance training performed five maximal isokinetic contractions of the knee extensors and knee flexors to determine isokinetic peak torque and hamstring-to-quadriceps ratios. Proprioception was determined by assessing passive position sense on an isokinetic dynamometer. Results: The athletes presented significantly greater (p < 0.01) knee extensors isometric peak torque for the jumping limb (144.9 ± 23.1) when compared to the non-jumping limb (132.9 ± 21.5). The Hamstrings-to-quadriceps ratio was below 0.6 for both limbs, being significantly greater (p < 0.01) for the non-jumping limb (0.56 ± 0.08) when compared to the jumping limb (0.50 ± 0.08). Conclusion: Female handball athletes that do not engage in resistance training can experience functional bilateral asymmetries in the knee extensors and knee-joint instability, as assessed by the hamstrings-to-quadriceps ratio due to the asymmetric characteristics of handball. Regular strength training might correct such asymmetries and instabilities.

Resumo: Este estudo apresenta formas alternativas de se calcular a taxa de prêmio do seguro de receita, tomando como exemplo o caso da soja em Campo Mourão e Toledo. O seguro de receita garante proteção contra os riscos de preço e produtividade. A taxa é um dos elementos centrais no desenvolvimento de produtos de seguro, razão pela qual o estudo debruçou-se. Duas abordagens foram apresentadas: a univariada e a bivariada. Os resultados mostraram diferenças significativas quando se comparam as metodologias. O seguro de receita situou-se em patamar mais elevado quando comparado ao seguro de produtividade, possivelmente inflacionada pelo efeito do risco de preço.

Abstract: This work aimed to study the alternative ways of calculating the revenue insurance premium rate, taking as an example the case of soybeans in Campo Mourão and Toledo. Revenue insurance guarantees protection against price and yield risks. The premium rate is one of the central elements in the development of insurance products. Two approaches were presented: the univariate and the bivariate. The results showed significant differences when comparing the methodologies. Revenue insurance was at a higher level than the yield insurance, possibly inflated by the effect of price risk.

Resumo Objetivo: avaliar a efetividade das intervenções direcionadas à prevenção e redução da violência no trabalho sofrida por profissionais de saúde e apoio. Método: revisão sistemática com metanálise realizada em oito bases de dados e na literatura cinzenta. O risco de viés foi realizado por meio das ferramentas da Cochrane e a certeza da evidência pelo Grading of Recommendations Assessment, Development and Evaluation. A análise foi realizada de forma descritiva e pela metanálise, incluindo avaliação da heterogeneidade. Resultados: 11 estudos aleatorizados e quasi-aleatorizados foram elegíveis, dos quais seis estudos (54,5%) implementaram habilidades individuais, quatro multiabordagem (36,4%) e um (9,1%) ações governamentais. Quatro estudos (36,4%) tiveram efeito positivo e significativo na redução da violência. O risco de viés foi classificado como alto ou incerto. A metanálise foi realizada com dois estudos que testaram habilidade individual (grupo intervenção) versus habilidade individual (grupo comparador), porém não houve evidência científica (IC 95%: -0,41 a 0,25, p=0,64) para o desfecho prevenção/redução da violência. Conclusão: esta revisão não obteve alta evidência na prevenção ou redução da violência no trabalho. O número reduzido de ensaios aleatorizados, a falta de estudos com baixo risco de viés e a alta consistência podem ter sido fatores dificultadores para recomendar intervenções efetivas.

Abstract Objective: to assess the effectiveness of the interventions targeted at preventing and reducing the workplace violence suffered by health and support professionals. Method: a systematic review with meta-analysis conducted in eight databases and in the gray literature. Risk of bias was assessed by means of the Cochrane tools and certainty of the evidence, through Grading of Recommendations Assessment, Development and Evaluation. The analysis was performed in a descriptive manner and through the meta-analysis, including a heterogeneity assessment. Results: a total of 11 randomized and quasi-randomized studies were eligible, of which six (54.5%) implemented individual skills, four used a multiple approach (36.4%) and one (9.1%) resorted to governmental actions. Four studies (36.4%) exerted a positive and significant effect on reducing violence. Risk of bias was classified as high or uncertain. The meta-analysis was performed with two studies that tested individual skill (intervention group) versus individual skill (comparator group), although there was no scientific evidence (95% CI: -0.41 - 0.25, p=0.64) for the violence prevention/reduction outcome. Conclusion: this review did not obtain a high level of evidence in the prevention or reduction of workplace violence. The reduced number of randomized trials, the lack of studies with low risk of bias and the high consistency may have been factors that hindered recommending effective interventions.

Resumen Objetivo: evaluar la efectividad de las intervenciones dirigidas a prevenir y reducir la violencia laboral que sufren los profesionales de la salud y de apoyo. Método: revisión sistemática con metanálisis realizada en ocho bases de datos y en la literatura gris. El riesgo de sesgo se evaluó mediante herramientas Cochrane y la certeza de la evidencia mediante el Grading of Recommendations Assessment, Development and Evaluation. El análisis se realizó de forma descriptiva y por metanálisis, e incluyó la evaluación de la heterogeneidad. Resultados: fueron elegibles 11 estudios aleatorios y cuasialeatorios, de los cuales seis estudios (54,5%) implementaron habilidades individuales, cuatro multienfoque (36,4%) y uno (9,1%) acciones gubernamentales. Cuatro estudios (36,4%) tuvieron un efecto positivo y significativo en la reducción de la violencia. El riesgo de sesgo se clasificó como alto o incierto. El metanálisis se realizó con dos estudios que evaluaron la capacidad individual (grupo de intervención) versus la capacidad individual (grupo de comparación), pero no se encontró evidencia científica (IC del 95 %: -0,41 a 0,25, p = 0,64) para el resultado prevención/reducción de la violencia. Conclusión: esta revisión no obtuvo alta evidencia sobre la prevención o reducción de la violencia laboral. El número reducido de ensayos aleatorios, la falta de estudios con bajo riesgo de sesgo y la alta consistencia pueden haber sido factores que dificultaron la recomendación de intervenciones efectivas.