Resumen Introducción: la lepra afecta a millones de personas deteriorando la salud física y mental, generando complicaciones como síntomas depresivos que pueden afectar la calidad de vida. Objetivo: estimar la prevalencia de síntomas depresivos en una agremiación de pacientes y expacientes con enfermedad de Hansen de una ciudad del Caribe colombiano. Materiales y métodos: estudio descriptivo con muestreo no probabilístico en miembros de una agremiación de pacientes y ex-pacientes con enfermedad de Hansen de una ciudad del Caribe colombiano. Los síntomas depresivos fueron estimados mediante test de Beck I y los resultados se contrastaron con variables sociodemográficas y clínicas mediante análisis bivariado. Resultados: participaron 51 personas, con una edad promedio de 52 años (IC 35,7-68,5), y predominio del sexo masculino (57%). El 39% de la población cursó bachillerato, el 25% se encontraban en tratamiento al momento de la encuesta y el 33% presentaban algún grado de discapacidad. El 27%, 16% y 2% de la población presentó depresión leve, moderada y severa respectivamente. El síntoma depresivo más frecuentemente descrito fue la fatiga (13%) seguido de cambios en el apetito (84,2%), llanto (81,6%), y tristeza (79%). No se encontró relación estadísticamente significativa entre presencia de síntomas depresivos y características sociodemográficas, el tratamiento y la discapacidad. Conclusiones: el 35% de los encuestados con el test de Beck I obtuvo calificaciones compatibles con depresión, se recomienda incluir manejo especializado en salud mental dentro del abordaje integral del paciente y expaciente con enfermedad de Hansen.

ABSTACT Introduction: Leprosy affects millions of people, impairing both physical and mental health and giving rise to complications such as depressive symptoms that can impact the quality of life. Objective: To estimate the prevalence of depressive symptoms in an association of patients and former patients with Hansen's disease in a city in the Colombian Caribbean. Materials and methods: A descriptive study with non-probabilistic sampling was conducted among members of an association of patients and former patients with Hansen's disease in a city in the Colombian Caribbean. Depressive symptoms were assessed using the Beck Depression Inventory, and the results were compared with sociodemographic and clinical variables through bivariate analysis. Results: Fifty-one individuals participated, with an average age of 52 years (CI 35.7-68.5), and a male predominance (57%). Thirty-nine percent of the population had completed high school, 25% were undergoing treatment at the time of the survey, and 33% had some degree of disability. Twenty-seven percent, 16%, and 2% of the population exhibited mild, moderate, and severe depression, respectively. The most frequently reported depressive symptom was fatigue (13%), followed by changes in appetite (84.2%), crying (81.6%), and sadness (79%). No statistically significant relationship was found between the presence of depressive symptoms and sociodemographic characteristics, treatment, or disability. Conclusions: It is evident that 35% of respondents scored in the range indicative of depression on the Beck Depression Inventory. Specialized mental health management is recommended to be included in the comprehensive care of patients and former patients with Hansen's disease.

SUMMARY OBJECTIVE: This study was conducted to determine the effect of relaxation exercise on fatigue symptoms in hemodialysis patients. METHODS: This is a meta-analysis study. The literature review was carried out by searching studies published between 2011 and 2020. This meta-analysis was recorded on PROSPERO in the National Health Research Institute (Registration no: CRD42022313646). RESULTS: Seven studies meeting the inclusion criteria were included in the meta-analysis. The effect size of the studies included in the meta-analysis was found to be g=1.232 (p=0.028), which indicated a "huge effect size." The scale used in the subgroup analyses, the application time of the relaxation exercise, and the number of relaxation exercise applications were evaluated, and a significant difference was found at p<0.05. CONCLUSION: Relaxation exercises can be used as an effective method for reducing fatigue in hemodialysis patients. OBJECTIVE patients METHODS metaanalysis meta analysis 201 2020 Registration no CRD42022313646. CRD42022313646 CRD . CRD42022313646) RESULTS metaanalysis. analysis. g1232 g 1 232 g=1.23 p=0.028, p0028 p p=0.028 , 0 028 (p=0.028) huge size. analyses evaluated p005 05 p<0.05 CONCLUSION 20 202 CRD4202231364 g123 23 g=1.2 p002 p=0.02 02 (p=0.028 p00 p<0.0 2 CRD420223136 g12 g=1. p=0.0 (p=0.02 p0 p<0. CRD42022313 g1 g=1 p=0. (p=0.0 p<0 CRD4202231 g= p=0 (p=0. p< CRD420223 p= (p=0 CRD42022 (p= CRD4202 (p CRD420 CRD42 CRD4

A previously healthy 35-year-old male belonging to the men who have sex with men (MSM) community, practising both penetrative and receptive anal sex for the past 10 years, and with no travel history outside South Africa, presented initially with a prodrome of fever, sore throat, night sweats, myalgia and fatigue. A week after the onset of these nonspecific symptoms, the patient noted painless, non-pruritic skin lesions measuring 2 - 15 mm in diameter on the dorsum of his hands. Three days later he developed rigors, watery diarrhoea and similar lesions on his genital and perianal areas. A week later, the patient presented to the emergency department with extensive lesions encompassing almost his entire body. He was admitted with suspected mpox infection. Imaging showed extensive lymphadenopathy, and the diagnosis was confirmed by mpox polymerase chain reaction testing. During the admission, he was also newly diagnosed with HIV infection. Treatment with tecovirimat was initiated, and the patient recovered, albeit with significant depigmentation and scarring.

SUMMARY BACKGROUND: Cancer-related fatigue is a pervasive symptom, affecting up to 90% of cancer patients throughout their illness, and can persist well after treatment has ended. Despite its prevalence, no definitive evidence-based treatment exists, leading to an abundance of proposed alternatives, including natural supplements. To further explore the potential effects of guaraná on cancer-related fatigue, a systematic review with meta-analysis was conducted and registered on the International Prospective Register of Systematic Reviews (CRD42023484144). METHODS: A thorough search of PubMed/MEDLINE and Cochrane Library was conducted using MeSH terms and related keywords for cancer-related fatigue and guaraná. Eligible studies were selected according to predetermined criteria and assessed for quality in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. Data extraction was independently performed by two reviewers, with any discrepancies resolved by a third researcher. RESULTS: In total, 4 full articles and 1 abstract, encompassing a total of 229 patients from 2009 to 2023, were included in the meta-analysis. Despite high heterogeneity between studies (I2=78%, ꭓ2=18.51, df=4, p=0.0010), the analysis revealed a significant benefit of using guaraná to alleviate cancer-related fatigue, with a standard mean difference of −0.77 (95%CI −1.34, −0.21) and a test for the overall effect of Z=2.68 (p=0.007). CONCLUSION: This meta-analysis provides support for the use of guaraná in the treatment of cancer-related fatigue. However, further investigation through larger prospective randomized controlled trials is necessary to validate these findings. BACKGROUND Cancerrelated Cancer symptom 90 illness ended prevalence evidencebased evidence based exists alternatives supplements cancerrelated metaanalysis meta CRD42023484144. CRD42023484144 CRD . (CRD42023484144) METHODS PubMedMEDLINE PubMed MEDLINE Interventions reviewers researcher RESULTS abstract 22 200 2023 metaanalysis. analysis. I2=78%, I278 I I2 78 (I2=78% ꭓ21851 ꭓ ꭓ2 18 51 ꭓ2=18.51 df4 df df=4 p=0.0010, p00010 p p=0.0010 , 0 0010 p=0.0010) 077 77 −0.7 95%CI 95CI CI 95 134 34 −1.34 −0.21 021 21 Z268 Z 2 68 Z=2.6 p=0.007. p0007 p=0.007 007 (p=0.007) CONCLUSION However findings 9 CRD4202348414 (CRD42023484144 20 202 I2=78% I27 7 (I2=78 ꭓ2185 5 ꭓ2=18.5 df= p0001 p=0.001 001 07 −0. 13 3 −1.3 −0.2 02 Z26 6 Z=2. p000 p=0.00 00 (p=0.007 CRD420234841 (CRD4202348414 I2=78 (I2=7 ꭓ218 ꭓ2=18. −0 −1. Z2 Z=2 p00 p=0.0 (p=0.00 CRD42023484 (CRD420234841 I2=7 (I2= ꭓ21 ꭓ2=18 − −1 Z= p0 p=0. (p=0.0 CRD4202348 (CRD42023484 I2= (I2 ꭓ2=1 p=0 (p=0. CRD420234 (CRD4202348 (I ꭓ2= p= (p=0 CRD42023 (CRD420234 (p= CRD4202 (CRD42023 (p CRD420 (CRD4202 CRD42 (CRD420 CRD4 (CRD42 (CRD4 (CRD

A Performance Grade (PG) Bitumen Specification, SATS-3208 (SATS 2019), was developed in South Africa during the period up to 2019. Since that time a period of implementation has begun on selected projects in South Africa. The implementation activities have included testing of data in accordance with the final anticipated standards. Formulation of a national standard is in the final stages and is expected to be published towards the end of 2024. The PG grade is specified using a high temperature number and a minimum temperature number that indicate the climate range within which a bitumen would be expected to perform. For example, a PG64-22 has a high temperature of 64°C and a minimum temperature of -22°C, from which intermediate and low operating temperatures are derived. A material meeting this grade will always have a performance range which is, ideally, just bigger than the specification grade and this is typically referenced as the continuous grade. A further definition is the difference between the two continuous grade numbers, referenced as the "Useful Temperature Interval" or UTI. As part of this implementation, it is required to determine the continuous grade for bitumen, including for modified binders, to ensure compliance with the specification. The UTI must be equal to or greater than 80°C. This technical note has been developed to demonstrate correct procedure to determine the continuous grade and UTI.

Abstract Introduction Teachers are a high-risk group for the development of vocal dysfunction, as they use voice extensively in their profession. Objective To know the prevalence and risk factors associated with voice strain in teachers. Methods A cross-sectional study was conducted among schoolteachers in Chitwan, Nepal. The Voice Handicap Index questionnaire was used as a survey tool. Result A total of 315 teachers were enrolled in the study. The mean age of the participants was of 36.7 years. Teachers from public schools, primary grade classes, > 50 pupils in the classroom, > 24 hours of classes per week, dust in class, and recurrent tonsil problems were associated with various degrees of vocal handicap. Conclusion There is a high prevalence of voice disorder among teachers. A holistic approach, which includes teacher education regarding voice care during their work and management of their voice handicap by taking into consideration different risk factors, must be adopted. highrisk dysfunction profession crosssectional cross sectional Chitwan Nepal tool 31 367 36 7 36. years schools 5 classroom 2 week class approach adopted 3

Abstract Long COVID is a condition following the acute Covid-19 infection, with persistence of symptoms for a long time or the worsening or emergence of other complications. Despite the recurrence of this phenomenon, there is a diagnostic invisibility. This essay aims to analyze, from the point of view of the medical epistemology, the uncertainties surrounding this phenomenon from its recognition as a disease, as well as its nonspecific symptoms, especially fatigue, which ultimately influence its diagnostic invisibility. This type of analysis is a proposal in tune with the Socio-anthropological approach to health and disease and the Anthropology of Biomedicine. As it is a global health issue that translates into a temporary or permanent disabling condition, understanding the reasons for its diagnostic invisibility from the point of view of the Western biomedicine can help to better understand it and manage its care. Covid19 Covid 19 Covid-1 infection complications analyze epistemology fatigue Socioanthropological Socio anthropological Biomedicine care Covid1 1 Covid-

Resumo A Covid longa é uma condição subsequente da infecção aguda pela Covid-19 com persistência dos sintomas por longo tempo ou agravamento ou surgimento de outras complicações. Apesar da recorrência desse fenômeno há uma invisibilidade diagnóstica. Este ensaio objetiva analisar, sob o ponto de vista da epistemologia médica, as incertezas que circundam esse fenômeno desde a sua atribuição como doença e os sintomas inespecíficos, sobretudo a fadiga, que terminam por influenciar a sua invisibilidade diagnóstica. Esse tipo de análise é uma proposta sintonizada com a abordagem socioantropológica da saúde e doença e da antropologia da biomedicina. Por tratar-se de um problema de saúde global e que se traduz em uma condição incapacitante temporária ou permanente, compreender as razões de sua invisibilidade diagnóstica do ponto de vista da biomedicina ocidental pode auxiliar na sua melhor compreensão e na gestão do seu cuidado. Covid19 19 Covid-1 complicações analisar médica inespecíficos fadiga tratarse tratar permanente cuidado Covid1 1 Covid-

Abstract Problem: Traditionally, both the environment and other animals have been excluded from the sphere of moral consideration, even though humans’ positive relationship with them brings benefits for the health of both creatures and promotes the development of empathy and the display of prosocial behaviors (Ngai, Yu, Chau, Lee & Wong, 2021). In fact, in recent decades there have been cases of zoonoses, inappropriate use of resources, deterioration of the environment and an increase in recorded cases of animal abuse. Animal abuse, a complex and multi-determined phenomenon, frequently works as a precursor or indicator of other behaviors classified as “antisocial”, violent and non-violent. There is conflicting evidence regarding the role that empathy plays in the emission or inhibition of aggressive behaviors and how generalizable interspecies empathy is. In this respect, three phenomena of interest stand out: empathic erosion, progressive desensitization to violence and compassion fatigue. Objective: To determine whether the levels of empathy, the willingness to behave abusively against other animals, and actual animal abuse behavior are related to the context of pre-professional training, self-perceived gender, and current and/or previous ownership of other companion animals in university students who are in the final stage of their training to obtain their university degree in Psychology. Methodology: Retrospective ex post facto single case design (N=241). A self-administered questionnaire was applied that included the Interpersonal Reactivity Index, the Animal Empathy Scale, the Animal Abuse Proclivity Scale and the quantity and frequency of effective animal abuse behaviors. Contribution: the contribution of self-perceived gender to the relationship between various measures of empathy and abuse towards other animals is evidenced, and the thesis of the non-generalizability of interspecies empathy is reinforced.

Resumen Problema: tradicionalmente se ha excluido de la esfera de consideración moral tanto al ambiente como a otros animales, aun cuando una relación positiva con ellos reporta beneficios para la salud de unas y otras criaturas y promueve el desarrollo de empatía y la emisión de conductas prosociales (Ngai, Yu, Chau, Lee y Wong, 2021). De hecho, en las últimas décadas se han observado casos de zoonosis, uso inadecuado de recursos, deterioro del ambiente y un aumento de casos registrados de abuso animal. El abuso animal, fenómeno complejo y multideterminado, frecuentemente funciona como precursor o indicador de otras conductas calificadas como “antisociales”, violentas y no violentas. Respecto del rol que juega la empatía en la emisión o inhibición de conductas agresivas y de cuán generalizable es la empatía interespecie, existe evidencia contradictoria y se resaltan aquí tres fenómenos de interés: erosión empática, desensibilización progresiva a la violencia y fatiga por compasión. Objetivo: determinar si los niveles de empatía, la disposición a comportarse de manera abusiva contra otros animales y la conducta efectiva de abuso animal se relacionan con el contexto de formación preprofesional, el género autopercibido y la tenencia actual y/o previa de animales de compañía en estudiantes universitarios que cursan el tramo final de la Licenciatura en Psicología. Metodología: diseño ex post facto retrospectivo de grupo único (N = 241). Se aplicó un cuestionario autoadministrado que incluyó el Interpersonal Reactivity Index, la Animal Empathy Scale, la Animal Abuse Proclivity Scale y la cantidad y frecuencia de conductas efectivas de abuso animal. Contribución: se evidencia sobre el aporte del género autopercibido a la relación entre diversas medidas de empatía y el abuso hacia otros animales y se refuerza la tesis de la no generalizabilidad de la empatía interespecie.

Abstract Introduction: Community-acquired pneumonia (CAP) is one of the most common diagnoses in clinical practice, an important reason for unscheduled consultations in primary health care and emergency departments, with an increasing incidence in recent years. In patients with chronic comorbidities, the suspicion threshold should be even lower, as the form of presentation is often different from the classic one. Case description: We present the case of a 39-year-old man with a previous history of diabetes and cardiovascular disease, who attended the emergency department for low back pain and fever and was diagnosed with renal colic. He subsequently consulted his primary care physician, to obtain a prescription for an imaging examination. However, due to persistent low back pain, fatigue, dyspnea, and crackles in the left lung base, we considered the alternative diagnostic hypothesis of community-acquired pneumonia. The patient was treated empirically with amoxicillin 1000 mg every 8 hours for seven days, together with azithromycin 500 mg 1 id for five days, and a chest X-ray was ordered. The patient had no complaints at the reassessment visit and was clinically stable. Comment: The main goal of this case report is to raise awareness of the less common presentations of pneumonia in primary healthcare and to state the importance of quality post-hospital care follow-up, which works as a safety net, ensuring favorable clinical outcomes and early detection of possible complications.

Resumo Introdução: A pneumonia adquirida na comunidade (PAC) é um dos diagnósticos mais frequentes na prática clínica e um motivo frequente de consultas não programadas nos cuidados de saúde primários (CSP) e serviços de urgência. No caso dos doentes com patologia crónica, o índice de suspeição deve ser ainda mais elevado já que a forma de apresentação é muitas vezes diferente da clássica. Descrição do caso: É descrito o caso de um homem de 39 anos com antecedentes de diabetes e doença cardiovascular, que recorreu ao serviço de urgência por dor lombar e febre, tendo sido diagnosticada cólica renal. Posteriormente dirigiu-se aos CSP com o objetivo de obter requisição para exame imagiológico. No entanto, por manutenção da lombalgia, cansaço, sensação de falta de ar e presença de fervores na base esquerda à auscultação pulmonar foi proposta a hipótese diagnóstica alternativa de pneumonia adquirida na comunidade. Foi instituída antibioterapia com amoxicilina 1000 mg de 8 em 8 horas por sete dias, juntamente com azitromicina 500 mg 1 id durante cinco dias e requisitada radiografia torácica. Na consulta de reavaliação, o doente apresentava-se sem queixas e clinicamente melhorado. Comentário: Este relato de caso tem como objetivo principal sensibilizar para apresentações menos comuns de pneumonia nos CSP, relembrar o papel indispensável do exame objetivo e reforçar a importância do seguimento pós-hospitalar atento e cuidado nos CSP, que funcionam como uma rede de segurança, permitindo confirmar diagnóstico hospitalar, assegurar a evolução clínica favorável e detetar precocemente eventuais complicações.

ABSTRACT Introduction/framework/objectives: The use of this equipment is increasingly common in various professional sectors and for longer periods, whether within a work shift or throughout life. Thus, their interaction with workers' health becomes increasingly relevant, resulting in the need to research what has been described on this topic. This review aims to summarize the most relevant information published, so that professionals in the Health and Safety teams have more tools to guide the matter and so that the workers themselves better understand what could be at stake and are more receptive to protective measures that may be proposed. Methodology: This is a Bibliographic Review, initiated through research carried out in april of 2023, in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”. Content: Acoustic shock can be secondary to an intense and unexpected noise and its prevalence can vary between 13 and 22%; however, it is a complex and controversial concept. It is eventually characterized by otalgia, tinnitus, vertigo, a burning sensation near the ear and anxiety. Acoustic shocks can cause cochlear trauma. The use of Headsets does not seem to cause more fatigue than noise from other sources, as long as it is of the same intensity. Most Call Centers operators work in an open space, with colleagues, which increases exposure to noise. The higher this is, the higher the eqquipment is placed. Susceptibility to hearing loss presents individual variability and interaction with some comorbidities (such as smoking, high blood pressure, diabetes and dyslipidemia); as well as gender and age. Most of these operators listen well; even if they report difficulty in perceiving words with ambient noise and tinnitus. Discussion and Conclusions: Although it is quite common for Call Centers workers to mention, during Occupational Medicine consultations, complaints that they associate with overall noise (especially that produced by Headsets); in reality, the bibliography on the topic is scarce and not very robust. Even so, it describes some very brief instructions to try to minimize the damage and enhance the well-being, satisfaction and productivity of professionals who use this type of equipment. It would be interesting to investigate the subject a little better, better understand the national panorama and publicize this in scientific publications.

RESUMO Introdução/enquadramento/objetivos: O uso deste equipamento é cada vez mais frequente em diversos setores profissionais e por períodos mais prolongados, quer dentro de um turno de trabalho, quer ao longo da vida. Assim, a interação destes com a saúde dos trabalhadores fica cada vez mais relevante, surgindo a necessidade de pesquisar o que se tem descrito sobre este tema. Esta revisão pretende resumir o que de mais pertinente se publicou, de forma que os profissionais das equipas de Saúde e Segurança tenham mais ferramentas para orientar o assunto e para que os próprios trabalhadores percebam melhor o que poderá estar em causa e estejam mais recetivos a medidas de proteção eventualmente propostas. Metodologia: Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em abril de 2023 nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Conteúdo: O choque acústico pode ser secundário a um ruido intenso e inesperado e a sua prevalência pode variar entre 13 a 22%; contudo, trata-se de um conceito complexo e controverso. Carateriza-se eventualmente por otalgia, zumbido, vertigem, sensação de queimadura próxima ao ouvido e ansiedade. Os choques acústicos podem causar trauma coclear. O uso de Headsets não parece causar mais fadiga que ruido com outras origens, desde que com a mesma intensidade. A maioria dos operadores de Call Center trabalha em espaço aberto, com colegas, o que potencia a exposição ao ruído. Quanto mais elevado este for, mais alto é colocado o som do equipamento, para conseguir ouvir a chamada. A suscetibilidade à perda de audição apresenta variabilidade individual e interação com algumas comorbidades (como tabagismo, hipertensão arterial, diabetes e dislipidemia); bem como sexo e idade. A maioria dos operadores de Call Center ouve bem; apesar de mencionarem dificuldade em perceber as palavras com o ruído ambiente e zumbido. Discussão e Conclusões: Ainda que seja bastante frequente estes trabalhadores referirem, durante as consultas de Medicina do Trabalho, queixas que associam ao ruido global (com destaque pelo produzido pelos Headsets); na realidade, a bibliografia sobre o tema é escassa e pouco robusta. Ainda assim, nela estão descritas algumas indicações muito sumárias para tentar minorar os danos e potenciar o bem-estar, satisfação e produtividade dos profissionais que usam este tipo de equipamento. Seria interessante investigar um pouco melhor o assunto, perceber melhor o panorama nacional e divulgar tal em publicações científicas.

ABSTRACT Introduction: Although most individuals recover after acute infection by SARS-CoV-2, others may suffer from persistent symptoms with potential medium and long-term consequences on the performance of activities and participation, with possible implications for their fitness for work. Objective: To analyze the persistence of symptoms twelve months after SARS-CoV-2 infection, and the perception of the performance level in activities and participation in life situations, of workers in a company of the industrial sector in the Aveiro Region. Methodology: An observational study, developed in an Occupational Health Service of an industrial company in the region of Aveiro, including workers with positive SARS-COV-2 RT-PCR/TRAg test, between October/2020-January/2022. After signaling the infection, the Occupational Health Team applied a questionnaire collecting sociodemographic variables, a list of common symptoms during the acute phase of infection by SARS-COV-2, and the perceived functionality assessed by the Portuguese version of WHODAS 2.0-PT12 (where '12 points' means the most functionality). At twelve months, they filled out another list of persistent symptoms after SARS-CoV-2 infection and again WHODAS 2.0-PT12. Data analysis included descriptive statistics and univariate and multivariate linear regression. The analysis was conducted with the software JASP 0.16.3. Results: Eighty-five workers were infected with SARS-CoV-2, with a mean age of 36.1± 9.8years, 77.7% were male, 36.7% had higher education and 17.7% reported at least one chronic condition. At twelve months, thirty workers (35.3%) reported persistent symptoms, with fatigue (27.7%) and arthralgia (14.4%) being the most mentioned. The mean WHODAS 2.0 in the two evaluation moments was 19.2±8.0 vs 15.7±5.0. Significant associations between WHODAS 2.0 items and persistent symptoms of fatigue, headache, cough, myalgia, arthralgia, and previous chronic disease were found. Conclusions: Persistent symptoms twelve months after acute SARS-CoV-2 infection have repercussions on workers' self-perception of performance in some activities and participation in life situations. The occupational health team can implement continuous surveillance of the infected worker's health, assess the presence of persistent symptoms of this infection, and implement an individualized rehabilitation program, which minimizes the impact of the persistence of symptoms on their work performance, and in activities and participation in life situations.

RESUMO Introdução: Embora a maioria dos indivíduos recupere após a infeção aguda por SARS-CoV-2, outros podem apresentar sintomas persistentes com potenciais consequências a médio e longo prazo no desempenho de atividades e participação, com eventuais implicações na sua aptidão para o trabalho. Objetivo: Analisar a persistência de sintomas aos doze meses após infeção por SARS-CoV-2 e perceção do nível de desempenho em atividades e participação em situações de vida de trabalhadores do setor industrial numa empresa da Região de Aveiro. Metodologia: Estudo observacional, desenvolvido num Serviço de Saúde Ocupacional de uma empresa industrial da região de Aveiro, incluindo trabalhadores com teste SARS-COV-2 RT-PCR/TRAg positivo, entre outubro/2020-janeiro/2022. Após sinalização da infeção, a Equipa de Saúde Ocupacional aplicou um questionário recolhendo as variáveis sociodemográficas, uma lista de sintomas comuns durante a fase aguda da infeção por SARS-COV-2 e a funcionalidade percebida avaliada pela versão portuguesa da WHODAS 2.0-PT12 (onde '12 pontos' significa a maior funcionalidade). Aos doze meses, preencheram outra lista de sintomas persistentes após a infeção por SARS-CoV-2 e novamente a WHODAS 2.0-PT12. A análise dos dados incluiu estatística descritiva e regressão logística univariada e multivariada. A condução da análise foi realizada com o software JASP 0,16.3. Resultados: Oitenta e cinco trabalhadores encontravam-se infetados com SARS-CoV-2, com idade média de 36,1±9,8anos, 77,7% eram do sexo masculino, 36,7% possuíam escolaridade superior e 17,7% relataram pelo menos uma condição crónica. Aos doze meses, trinta trabalhadores (35,3%) relataram sintomas persistentes, sendo a fadiga (27,7%) e artralgia (14,4%) os mais mencionados. A média da WHODAS 2.0 nos dois momentos de avaliação foi 19,2±8,0 vs 15,7±5,0. Foram encontradas associações significativas entre os itens da WHODAS 2.0 e os sintomas persistentes fadiga, cefaleia, tosse, mialgia, artralgia e doença crónica prévia. Conclusões: Os sintomas persistentes doze meses após a infeção aguda por SARS-CoV-2 têm repercussão na autoperceção do desempenho em algumas atividades e participação em situações de vida dos trabalhadores. A equipa de saúde ocupacional deve realizar a vigilância contínua da saúde do trabalhador infetado, avaliando a presença de sintomas persistentes desta infeção e poderá implementar um programa de intervenção individualizado, que minimize o impacto da persistência dos sintomas no seu desempenho laboral, assim como, em atividades e participação em situações de vida.

Abstract In recent years, the South Korean philosopher living in Germany, Byung-Chul Han, has been setting new paths for philosophical reflection using the theoretical potential that arises from the understanding of the new social, political and economic realities that mark this era of neoliberal evolution and of technological development in the context of the Fourth Industrial Revolution. Thus, topics such as the transformation of biopolitics into psycho-politics become a very relevant point for the analysis of current societies and their drifts. With this background of thought, this article aims to delve into Han’s arguments, exploring the crucial role that emotions play in societies of performance, fatigue and lack of democracy, resorting to the metaphor of the “hamster wheel” as an image evocative of the dynamics of current societies. In this way, an innovative perspective of the complexity of the 21st Century is presented by delving into certain nuances of Han’s thought in connection with the palpable reality of the emotions that act as the fuel that propels each individual in their own “existential wheel”. This articulation with emotional experiences contributes significantly to contemporary discussions about human nature in contexts of technological innovation.

Resumen En los últimos años, el filósofo surcoreano radicado en Alemania, Byung-Chul Han, viene marcando nuevos derroteros para la reflexión filosófica usando el potencial teórico que surge de la comprensión de las nuevas realidades sociales, políticas y económicas, que marcan esta época de evolución neoliberal y de desarrollo tecnológico, en el contexto de la cuarta Revolución Industrial. Así, temas como la transformación de la biopolítica en psicopolítica se convierten en un punto muy relevante para el análisis de las sociedades actuales y sus derivas. Con este trasfondo de pensamiento, el presente artículo tiene por objetivo sumergirse en las argumentaciones de Han, explorando el papel crucial que desempeñan las emociones en las sociedades del rendimiento, del cansancio y de la infocracia, acudiendo a la metáfora de la “rueda del hámster” como imagen evocadora de las dinámicas de las sociedades actuales. De esta forma, se presenta una perspectiva innovadora de la complejidad del siglo XXI, al adentrarnos en determinados matices del pensamiento de Han, en conexión con la realidad palpable de las emociones, que actúan como el combustible que impulsa a cada individuo en su propia “rueda existencial”. Esta articulación con las experiencias emocionales contribuye de manera significativa a las discusiones contemporáneas acerca de la naturaleza humana en contextos de innovación tecnológica.

Resumen La democracia en la era digital trae consigo nuevas preocupaciones en medio de la atmósfera de desconfianza, la crisis de la representación y la fatiga democrática que contribuye a elevar los zumbidos y profundiza la confusión, especialmente en época electoral. En tal sentido, la aldea digital introduce nuevas prácticas que deben ser entendidas y debatidas al girar en torno a un individualismo hiperinformado manipulado que afecta la democracia liberal. El debate público en clave con la comunicación pública virtual y, al mismo momento, los colaterales para el proyecto democrático debe ser objeto de reflexión ante la abierta manipulación buscando la frontera entre el ejercicio de la libertad de expresión y la censura previa.

Resumo A democracia na era digital traz consigo novas preocupações no meio da atmosfera de desconfiança, da crise de representação e da fadiga democrática que contribui para aumentar o burburinho e aprofundar a confusão, especialmente em tempo de eleições. Neste sentido, a aldeia digital introduz novas práticas que devem ser compreendidas e debatidas, uma vez que gira em torno de um individualismo manipulado e hiper-informado que afecta a democracia liberal. O debate público em termos de comunicação pública virtual e, ao mesmo tempo, os danos colaterais ao projeto democrático devem ser objeto de reflexão face à manipulação aberta, procurando a fronteira entre o exercício da liberdade de expressão e a censura prévia.

Abstract Democracy in the digital age brings with it new concerns amid the atmosphere of mistrust, the crisis of representation and democratic fatigue that contributes to heightened buzz and deepens confusion, especially in electoral times. In this sense, the digital village introduces new practices that must be understood and debated as they revolve around a manipulated hyper-informed individualism that affects liberal democracy. The public debate in key with virtual public communication and, at the same time, the collaterals for the democratic project must be the object of reflection before the open manipulation seeking the border between the exercise of freedom of expression and prior censorship.

ABSTRACT The objective was to investigate the working conditions and physical and mental health of health professionals working on the front lines of COVID-19 in urgent, emergency, and intensive care services in Brazil, in the second year of the pandemic. Cross-sectional study, using an electronic questionnaire, through which data on working conditions, and physical and mental health were collected, in addition to the Depression, Anxiety and Stress Scale (DASS-21) instrument. The sample (n=209) included nurses (28.7%), nursing technicians (30.1%), physiotherapists (33%), and physicians (8.2%). The professionals had an average age of 34.6 years and reported an average workload of 53.5 hours/week. There was an increase in hours worked (62%) and in the number of patients (84%). Most reported a good relationship with their boss (89%) and job satisfaction (87%). The prevalence of symptoms of stress, anxiety, and depression was greater than 45%, with a predominance of severe or extremely severe symptoms. The prevalence of musculoskeletal pain and fatigue was 84.7% and 83.3%, respectively. Health professionals showed an increase in workload and demand during the COVID-19 pandemic. There was also intense damage to the physical and mental health of these workers. COVID19 COVID 19 COVID-1 urgent emergency Brazil pandemic Crosssectional Cross sectional study questionnaire collected Depression DASS21 DASS 21 (DASS-21 instrument n=209 n209 n 209 (n=209 28.7%, 287 28.7% , 28 7 (28.7%) 30.1%, 301 30.1% 30 1 (30.1%) 33%, 33 33% (33%) 8.2%. 82 8.2% . 8 2 (8.2%) 346 34 6 34. 535 53 5 53. hoursweek week hours/week 62% 62 (62% 84%. 84 84% (84%) 89% 89 (89% 87%. 87 87% (87%) stress anxiety 45 45% 847 84.7 833 83 3 83.3% respectively workers COVID1 COVID- DASS2 (DASS-2 n=20 n20 20 (n=20 28.7 (28.7% 30.1 (30.1% (33% 8.2 (8.2% (62 (84% (89 (87% 4 84. 83.3 (DASS- n=2 n2 (n=2 28. (28.7 30. (30.1 (33 8. (8.2 (6 (84 (8 (87 83. (DASS n= (n= (28. (30. (3 (8. ( (n (28 (30 (2

RESUMO Objetivou-se investigar as condições de trabalho e a saúde física e mental de profissionais de saúde atuantes na linha de frente da covid-19 em serviços de urgência, emergência e terapia intensiva no Brasil, no segundo ano da pandemia. Estudo transversal, com uso de questionário eletrônico, por meio do qual coletaram-se dados sobre condições de trabalho, saúde física e mental, além do instrumento Depression, Anxiety and Stress Scale (DASS-21). A amostra (n=209) incluiu enfermeiros (28,7%), técnicos de enfermagem (30,1%), fisioterapeutas (33%) e médicos (8,2%). Os profissionais possuíam idade média de 34,6 anos e relataram uma carga horária média de 53,5 horas/semana. Verificou-se aumento das horas trabalhadas (62%) e da quantidade de pacientes (84%). A maioria relatou bom relacionamento com o chefe (89%) e satisfação com o trabalho (87%). A prevalência de sintomas de estresse, ansiedade e depressão foi superior a 45%, com predomínio de sintomas graves ou extremamente graves. A prevalência de dor musculoesquelética e fadiga foi de 84,7% e 83,3%, respectivamente. Os profissionais de saúde apresentaram aumento de volume de trabalho e de exigência durante a pandemia de covid-19. Observou-se, ainda, intenso prejuízo à saúde física e mental desses trabalhadores. Objetivouse Objetivou se covid19 covid 19 covid-1 urgência Brasil transversal eletrônico coletaramse coletaram Depression DASS21. DASS21 DASS 21 . (DASS-21) n=209 n209 n 209 (n=209 28,7%, 287 28,7% , 28 7 (28,7%) 30,1%, 301 30,1% 30 1 (30,1%) 33% 33 (33% 8,2%. 82 8,2% 8 2 (8,2%) 346 34 6 34, 535 53 5 53, horassemana semana horas/semana Verificouse Verificou 62% 62 (62% 84%. 84 84% (84%) 89% 89 (89% 87%. 87 87% (87%) estresse 45 45% 847 84,7 833 83 3 83,3% respectivamente covid19. 19. Observouse, Observouse Observou se, Observou-se ainda trabalhadores covid1 covid- DASS2 (DASS-21 n=20 n20 20 (n=20 28,7 (28,7% 30,1 (30,1% (33 8,2 (8,2% (62 (84% (89 (87% 4 84, 83,3 (DASS-2 n=2 n2 (n=2 28, (28,7 30, (30,1 (3 8, (8,2 (6 (84 (8 (87 83, (DASS- n= (n= (28, (30, ( (8, (DASS (n (28 (30 (2

ABSTRACT The objective was to investigate the working conditions and physical and mental health of health professionals working on the front lines of COVID-19 in urgent, emergency, and intensive care services in Brazil, in the second year of the pandemic. Cross-sectional study, using an electronic questionnaire, through which data on working conditions, and physical and mental health were collected, in addition to the Depression, Anxiety and Stress Scale (DASS-21) instrument. The sample (n=209) included nurses (28.7%), nursing technicians (30.1%), physiotherapists (33%), and physicians (8.2%). The professionals had an average age of 34.6 years and reported an average workload of 53.5 hours/week. There was an increase in hours worked (62%) and in the number of patients (84%). Most reported a good relationship with their boss (89%) and job satisfaction (87%). The prevalence of symptoms of stress, anxiety, and depression was greater than 45%, with a predominance of severe or extremely severe symptoms. The prevalence of musculoskeletal pain and fatigue was 84.7% and 83.3%, respectively. Health professionals showed an increase in workload and demand during the COVID-19 pandemic. There was also intense damage to the physical and mental health of these workers.

RESUMO Objetivou-se investigar as condições de trabalho e a saúde física e mental de profissionais de saúde atuantes na linha de frente da covid-19 em serviços de urgência, emergência e terapia intensiva no Brasil, no segundo ano da pandemia. Estudo transversal, com uso de questionário eletrônico, por meio do qual coletaram-se dados sobre condições de trabalho, saúde física e mental, além do instrumento Depression, Anxiety and Stress Scale (DASS-21). A amostra (n=209) incluiu enfermeiros (28,7%), técnicos de enfermagem (30,1%), fisioterapeutas (33%) e médicos (8,2%). Os profissionais possuíam idade média de 34,6 anos e relataram uma carga horária média de 53,5 horas/semana. Verificou-se aumento das horas trabalhadas (62%) e da quantidade de pacientes (84%). A maioria relatou bom relacionamento com o chefe (89%) e satisfação com o trabalho (87%). A prevalência de sintomas de estresse, ansiedade e depressão foi superior a 45%, com predomínio de sintomas graves ou extremamente graves. A prevalência de dor musculoesquelética e fadiga foi de 84,7% e 83,3%, respectivamente. Os profissionais de saúde apresentaram aumento de volume de trabalho e de exigência durante a pandemia de covid-19. Observou-se, ainda, intenso prejuízo à saúde física e mental desses trabalhadores.