Vivências subjetivas de profissionais que realizam Vigilância em Saúde do Trabalhador

This study aims to understand the subjective mobilization that arises in the work activity of professionals who perform Worker Health Surveillance (WHS). In total, five workers of all genders from a Worker Health Reference Center (WHRC) in a capital city of a Northeastern state in Brazil participated in this study. They were interviewed in January and February 2020. The materials produced were analyzed in light of Work Psychodynamics. Results show that their source of suffering is linked to what they experience in companies undergoing WHS, whose precarization-related problems often remain unresolved. In addition to this, those who perform WHS also often perceive themselves as in precarious situations regarding their salaries, job security, and working conditions. Finally, the lack of structure and investment in workers’ health and legislation (particularly at the municipal level) pose significant challenges for them to carry out their work.Este artigo objetiva compreender a mobilização subjetiva que surge na atividade de trabalho de profissionais que realizam Vigilância em Saúde do Trabalhador (Visat). Participaram deste estudo cinco trabalhadores, de ambos os sexos, de um Centro de Referência em Saúde do Trabalhador (Cerest) da capital de um estado do Nordeste do Brasil, os quais foram entrevistados nos meses de janeiro e fevereiro de 2020. Os materiais produzidos foram analisados à luz da Psicodinâmica do Trabalho. Os resultados mostram que sua fonte de sofrimento está ligada ao que é vivido pelos trabalhadores das empresas que passam por Visat, cujos problemas relacionados à precarização muitas vezes ficam sem solução. Ao lado disso, aqueles que fazem Visat também se percebem muitas vezes precarizados em seus salários, vínculos e condições de trabalho. Finalmente, a falta de estrutura e investimento em saúde do trabalhador, assim como a legislação, em especial a municipal, deixa-os com grandes dificuldades de realizar o seu trabalho

Narcisismo, pró-sociabilidade e agressão: o papel mediador da empatia

This study aimed to investigate the mediating role of empathy, considering narcissism as a predictor variable in two different models, with pro-sociality as the dependent variable in the first and dimensions of agression in the second. The sample was composed of 205 respondents from João Pessoa (M = 27.43, SD = 9.13). We used the Single-Item Narcissism Scale, the Multidimensional Interpersonal Reactivity Scale, the Pro-Sociability Scale, the Aggression Questionnaire, and a sociodemographic questionnaire. The data were processed using IBM SPSS and AMOS through descriptive and inferential analyses (correlations and mediation). The main results pointed to negative direct effects of narcissism on empathy and pro-social behavior and to direct positive effects on aggression. Furthermore, it was confirmed that empathy has a mediating role in the relation between narcissism and pro-sociability, which was not found for the relation between narcissism and aggression. These findings corroborate previous studies and contribute to the comprehension of the interrelationships of the studied constructs.El presente estudio tuvo como objetivo investigar el papel mediador de la empatía, teniendo en cuenta el narcisismo como variable predictora en dos modelos diferentes, con la prosociabilidad como variable dependiente en el primero y las dimensiones de agresión en el segundo. Para ello, se contó una muestra de 205 encuestados de la ciudad de João Pessoa (M = 27.43; SD = 9.13). Se utilizó la Escala de Narcisismo de Ítem Único, la Escala de Reactividad Interpersonal Multidimensional, la Escala de Prosociabilidad, el Cuestionario de Agresión y un cuestionario sociodemográfico. Los datos fueron procesados con la ayuda de IBM SPSS y AMOS, a través de análisis descriptivos e inferenciales (correlaciones y mediación). Los resultados apuntaron a efectos negativos directos del narcisismo sobre la empatía y el comportamiento prosocial, y a efectos directos positivos sobre la agresión. Además, se verificó el papel mediador de la empatía en la relación entre narcisismo y prosociabilidad, lo que no se encontró en la relación entre narcisismo y agresión. Estos hallazgos corroboran estudios previos, además de contribuir a la comprensión de las interrelaciones de los constructos estudiados.O presente estudo objetivou investigar o papel mediador da empatia, tomando em conta o narcisismo como variável preditora em dois diferentes modelos, tendo a pró-sociabilidade como variável dependente no primeiro e as dimensões de agressão no segundo. Para isso, contou-se com uma amostra de 205 participantes da cidade de João Pessoa (M = 27.43; DP = 9.13). Utilizou-se a Single-Item Narcissism Scale, a Escala Multidimensional de Reatividade Interpessoal, a Escala de Pró-sociabilidade, o Questionário de Agressão e um questionário sociodemográfico. Os dados foram processados com o auxílio do IBM SPSS e AMOS através das análises descritivas e inferenciais (correlações e mediação). Os resultados apontaram para efeitos diretos negativos do narcisismo na empatia e no comportamento pró-social; e efeitos diretos positivos na agressão. Além disso, verificou-se o papel mediador da empatia na relação entre o narcisismo e a pró-sociabilidade, não encontrado na relação narcisismo e agressão. Esses achados corroboram estudos prévios, bem como contribuem para o entendimento das inter-relações dos construtos estudados

Integrated genomic characterization of oesophageal carcinoma

Oesophageal cancers are prominent worldwide; however, there are few targeted therapies and survival rates for these cancers remain dismal. Here we performed a comprehensive molecular analysis of 164 carcinomas of the oesophagus derived from Western and Eastern populations. Beyond known histopathological and epidemiologic distinctions, molecular features differentiated oesophageal squamous cell carcinomas from oesophageal adenocarcinomas. Oesophageal squamous cell carcinomas resembled squamous carcinomas of other organs more than they did oesophageal adenocarcinomas. Our analyses identified three molecular subclasses of oesophageal squamous cell carcinomas, but none showed evidence for an aetiological role of human papillomavirus. Squamous cell carcinomas showed frequent genomic amplifications of CCND1 and SOX2 and/or TP63, whereas ERBB2, VEGFA and GATA4 and GATA6 were more commonly amplified in adenocarcinomas. Oesophageal adenocarcinomas strongly resembled the chromosomally unstable variant of gastric adenocarcinoma, suggesting that these cancers could be considered a single disease entity. However, some molecular features, including DNA hypermethylation, occurred disproportionally in oesophageal adenocarcinomas. These data provide a framework to facilitate more rational categorization of these tumours and a foundation for new therapies

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Compreendendo o papel da cooperação nos casos de afastamento do trabalho por motivo de doença

According to the Annual Management Report of the Regional Reference Center on Workers' Health (a) of 2015 (City Hall of João Pessoa, 2015) in 2013 in the State of Paraíba, 5,016 notifications of occupational accidents were recorded, with 19 deaths, based on data presented in the Statistical Yearbook Of Social Security. It is even more problematic to think that such data only communicate about workers entering the formal market, governed by the Consolidation of Labor Laws (CLT) and who reported their accident through the Work Accident Notice, so that 53% of the population Economically Active (PEA) of the State of Paraíba is presented in the informal labor market and is not part of the official statistics of occupational accidents, and that are attended by the Unified Health System-SUS. Therefore, the main purpose of the present study was to understand the role of cooperation, or lack thereof, in the health / disease relationship in the work environment. In order to analyze the complex relationship between cooperation, health, work, illness and retirement due to illness, the Psychodynamics of Work was adopted as a theoretical contribution. With regard to the method, the qualitative approach was favored, making use of two instruments: a socio-demographic questionnaire and a semi-structured interview. Ten workers of both sexes ranging from 27 to 54 years old participated in this study. The data analysis was conducted through a hermeneutic approach from the Work Psychodynamics. It has been found that the emphasis on productivity and management by goals have generated competitiveness among workers, as well as the weakening of ties of solidarity in work environments, so that this individualism has generated illness and, in fact, it becomes necessary to discuss about The role of cooperation in the reality of sick leave. It was also observed that even in clear conditions of suffering, workers still point to recognition as a way of fighting for health, and their absence is a source of suffering and illness. It was also verified that the majority of the interviewees did not obtain benefit of the INSS, even with medical examinations that accounted for pathologies, which became even more problematic for cases of mental disorders. It was noted the cooperation of family and friends as a prime factor for the subject to remain fighting for his health.NenhumaDe acordo com o Relatório anual de gestão do Centro Regional de Referência em Saúde do Trabalhador (a) de 2015 (Prefeitura Municipal de João Pessoa, 2015), em 2013 no Estado da Paraíba foram registradas 5.016 notificações de acidentes de trabalho, apresentando 19 óbitos, a partir dos dados apresentados no Anuário Estatístico da Previdência Social. Torna-se ainda mais problemático pensar que tais dados apenas comunicam sobre os trabalhadores inseridos no mercado formal, regidos pela Consolidação das Leis Trabalhistas (CLT) e que notificaram o seu acidente através da Comunicação de Acidente de Trabalho, de maneira que 53% da População Economicamente Ativa (PEA) do Estado da Paraíba apresenta-se no mercado informal de trabalho e não fazem parte das estatísticas oficiais de acidentes de trabalho, e que são atendidos pelo Sistema Único de Saúde-SUS. Logo, o presente estudo teve por objetivo geral: compreender o papel da cooperação, ou da falta dela, na relação saúde/doença nos meios de trabalho. Para analisar a complexa relação entre cooperação, saúde, trabalho, adoecimento e afastamento por motivo de doença adotou-se a Psicodinâmica do Trabalho como aporte teórico. Com relação ao método, foi privilegiada a abordagem qualitativa, fazendo uso de dois instrumentos: um questionário sócio demográfico e uma entrevista semiestruturada. Participaram deste estudo 10 trabalhadores de ambos os sexos com idades variando de 27 a 54 anos. A análise dos dados foi conduzida através de uma abordagem hermenêutica a partir da Psicodinâmica do Trabalho. Verificou-se que a ênfase na produtividade e gestão por metas têm gerado competitividade entre os trabalhadores, bem como a fragilização dos laços de solidariedade nos ambientes de trabalho, de maneira que esse individualismo tem gerado adoecimento e, de fato, se torna necessário discutir acerca do papel da cooperação na realidade de afastamento por motivo de doença. Observou-se ainda que mesmo em nítidas condições de sofrimento, os trabalhadores ainda apontam o reconhecimento enquanto via de luta pela saúde e sua ausência é fonte de sofrimento e adoecimento. Verificou-se ainda que a maioria dos entrevistados não conseguiu obtenção de benefício pelo INSS, mesmo com exames médicos que acusavam patologias, o que se tornou ainda mais problemático para os casos de patologias do âmbito mental. Notou-se a cooperação da família e amigos enquanto fator primordial para o sujeito permanecer lutando por sua saúde

Containment measures

OBSOLETE (project finished) - Description of containment measures during COVID'19 lockdown, in the context of SIlent Cities project. Please request access to Silent Cities if neede

Archived - General Information (DO NOT USE)

DO NOT USE - The goal of this component was to document the data collection process of the Silent Cities Dataset. This component is just left for archive

Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19

International audienc