El Sector Metalúrgico: Relaciones Sindicales, Motivación y Significados del Trabajo

En este estudio se describen las relaciones de trabajo en el sector metalúrgico brasileño, así como los significados y la motivación hacia el trabajo. Se desarrolló una investigación documental, aplicando la técnica de análisis de contenido categórica a boletines sindicales, acuerdos y convenciones colectivas (2009 a 2012) y a sitios electrónicos que abordan el contexto de trabajo de los metalúrgicos. Los resultados mostraron que la movilización de los trabajadores se ha realizado en torno a un amplio abanico de reivindicaciones, traspasando los ítems económicos. Se presentan hipótesis acerca de los significados y la motivación de los trabajadores y se expresan las tendencias de las relaciones de trabajo en este sector.Este estudio describió las relaciones de trabajo en el sector metalúrgico, enfocando a los trabajadores como actores y buscando reflexionar sobre los significados y la motivación para el trabajo. Se desarrolló una investigación documental, aplicando la técnica de análisis de contenido categórica en boletines sindicales, acuerdos y convenciones colectivas (2009 a 2012) y sitios electrónicos que abordan el contexto de trabajo de los metalúrgicos. Los resultados muestran que la movilización de los trabajadores se ha realizado en torno a un amplio abanico de reivindicaciones, ultrapasando los ítems económicos. Al final, se presentan hipótesis acerca de los significados y de la motivación, expresando las tendencias de las relaciones de trabajo

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

El Sector Metalúrgico: Relaciones Sindicales, Motivación y Significados del Trabajo

The study describes labor relations in the Brazilian metals sector, as well as work motivation and work meaning in this context. A review of multiple documents was conducted, developing a set of categories from content analysis of union bulletins, agreements, and collective agreements (2009 to 2012) and of websites that address the metal workers’ context. Results showed that workers’ mobilizations have revolved around a broad range of claims that go beyond merely economic ones. The article sets forth hypotheses regarding the meanings of work and the work motivation, and describes the trends in labor relations in the sector.Neste estudo, descrevem-se as relações de trabalho no setor metalúrgico brasileiro, bem como os significados e a motiva- ção sobre o trabalho. Desenvolveu-se uma pesquisa documental, que aplica a técnica de análise de conteúdo categórica a boletins sindicais, acordos e convenções coletivas (2009 a 2012) e a sites que abordam o contexto de trabalho dos metalúrgicos. Os resultados mostraram que a mobilização dos trabalhadores tem sido realizada em torno de um amplo leque de reinvindicações, mais além dos itens econômicos. Apresentam-se hipóteses sobre os significados e a motivação dos trabalhadores e expressam-se as tendências das relações de trabalho nesse setor.En este estudio se describen las relaciones de trabajo en el sector metalúrgico brasileño, así como los significados y la motivación hacia el trabajo. Se desarrolló una investigación documental, aplicando la técnica de análisis de contenido categórica a boletines sindicales, acuerdos y convenciones colectivas (2009 a 2012) y a sitios electrónicos que abordan el contexto de trabajo de los metalúrgicos. Los resultados mostraron que la movilización de los trabajadores se ha realizado en torno a un amplio abanico de reivindicaciones, traspasando los ítems económicos. Se presentan hipótesis acerca de los significados y la motivación de los trabajadores y se expresan las tendencias de las relaciones de trabajo en este sector

El Sector Metalúrgico: Relaciones Sindicales, Motivación y Significados del Trabajo/ The Metals Sector: Labor Union Relations, Motivation, and Meanings of Work/ O Setor Metalúrgico: Relações Sindicais, Motivação e Significados do Trabalho

En este estudio se describen las relaciones de trabajo en el sector metalúrgico brasileño, así como los significados y la motivación hacia el trabajo. Se desarrolló una investigación documental, aplicando la técnica de análisis de contenido categórica a boletines sindicales, acuerdos y convenciones colectivas (2009 a 2012) y a sitios electrónicos que abordan el contexto de trabajo de los metalúrgicos. Los resultados mostraron que la movilización de los trabajadores se ha realizado en torno a un amplio abanico de reivindicaciones, traspasando los ítems económicos. Se presentan hipótesis acerca de los significados y la motivación de los trabajadores y se expresan las tendencias de las relaciones de trabajo en este sector

Investigation of pathology associated with Chlamydia pecorum infection in the male reproductive tract, and the effect on spermatogenesis and semen quality in the koala (Phascolarctos cinereus)

There is growing evidence that Chlamydia pecorum infection of the male koala reproductive tract causes inflammation and pathology of the urogenital tract. Previous studies have revealed that male koalas exhibiting severe clinical signs of urogenital chlamydial disease had an increased incidence of sperm DNA fragmentation and abnormal sperm morphology, suggestive of chronic exposure to C. pecorum infection and/or inflammation in the testis and epididymis, with residual pathology and lesions disrupting spermatogenesis and maturation of spermatozoa. This study specifically aimed to determine whether pathology associated with chlamydial infection in different regions of the male koala reproductive tract had an adverse effect on classical seminal parameters, sperm DNA quality and endocrine function (testosterone secretion) of naturally infected males. Semen from 58 sexually mature male koalas deemed not suitable for rehabilitation or treatment was assessed, in addition to undertaking a GnRH challenge to determine the androgenic capacity of the testis. Following euthanasia, tissue samples from testes, epididymis and prostate were evaluated for histopathology and real time polymerase chain reaction (qPCR). A significant difference in sperm concentration was observed between males with unilateral and bilateral testicular atrophy and C. pecorum infection (P = 0.011); and between males with unilateral atrophy and C. pecorum infection in one testis and bilateral normal testes with no C. pecorum infection (P = 0.008). No significant association was found for any other semen parameters when categorised by histopathology and C. pecorum tissue presence within the testes, epididymis and prostate. Plasma testosterone concentrations did not significantly differ between testicular histopathology diagnosis and/or C. pecorum infection status. This study suggests Chlamydia infection and inflammation may not be the predominant reason of disruption to spermatogenesis in the wild koala but rather testicular degeneration and atrophy, irrespective of Chlamydia infection, appears to be the primary reason of decreased sperm concentration.</p