OBJECTIVE:To identify combinations of two models of psychosocial stress at work among nursing teams and their associations with self-rated health. METHODS:This was a cross-sectional study among workers at three public hospitals in the municipality of Rio de Janeiro, Southeastern Brazil (N = 1307). In 2006, a multidimensional questionnaire including two scales for measuring stress at work (demand-control and effort-reward imbalance models) was administered. Partial and complete (including social support at work) demand-control models were considered, along with partial and complete (including excessive commitment to work) effort-reward models. Multiple logistic regression models were used to estimate adjusted odds ratios and their respective 95% confi dence intervals. RESULTS:The dimensions of both models were independently associated with self-rated health, with odds ratios between 1.70 and 3.37. The partial demandcontrol model was less associated with health (OR = 1.79; 95%CI 1.26;2.53) than was the partial effort-reward imbalance model (OR = 2.27; 95%CI 1.57;3.30). Incorporation of social support and excessive commitment to work increased the strength of the demand-control and effort-reward imbalance models, respectively. Increased strength of association was observed when the two partial models were combined. CONCLUSIONS:The results indicate that the effort-reward imbalance model performed better for this specifi c group and for the outcome evaluated, and that there was an advantage in using complete models or combinations of partial models.

Based on interviews in a hospital in Rio de Janeiro, the authors analyze strategies, interests, assumptions, and concerns among producers of patient information leaflets on infectious diseases. Most such publications followed a linear communications model, according to which health messages produce a sole and single effect on their audience. Visual communications are seen as a field of knowledge over which physicians have no "command", but which raises great expectations on their part, principally in light of the limits of written language for an illiterate patient population. The most frequent concerns relate to the "adequacy of the language" (a denotative, non-semantic function of language) and on the increase in "dissemination". Leaflets are generally linked to the professional experience of providing health care, but the lack of pertinent research prior to the production of such publications leads to simplifications and generalizations concerning the patients' most common doubts and questions, reinforcing the stereotyping of the clientele based on their lacks and needs. In two exceptional leaflets, interaction with the clientele appears and expands the relationship between the health care professionals and the values and decisions made in distinct sociocultural contexts.

BackgroundOne of the major challenges of the Brazilian Ministry of Health is to foster interest in breast cancer screening (BCS), especially among women at high risk. Strategies have been developed to promote the early identification of breast cancer mainly by Pink October campaigns. The massive number of queries conducted through Google creates traffic data that can be analyzed to show unrevealed interest cycles and their seasonalities.ObjectivesUsing Google Trends, we studied cycles of public interest in queries toward mammography and breast cancer along the last 5 years. We hypothesize that these data may be correlated with collective interest cycles leveraged by national BCS campaigns such as Pink October.MethodsGoogle Trends was employed to normalize traffic data on a scale from 0 (<1% of the peak volume) to 100 (peak of traffic) presented as weekly relative search volume (RSV) concerning mammography and breast cancer as search terms. A time series covered the last 261 weeks (November 2011 to October 2016), and RSV of both terms were compared with their respective annual means. Polynomial trendlines (second order) were employed to estimate overall trends.ResultsWe found an upward trend for both terms over the 5 years, with almost parallel trendlines. Remarkable peaks were found along Pink October months— mammography and breast cancer searches were leveraged up reaching, respectively, 119.1% (2016) and 196.8% (2015) above annual means. Short downward RSVs along December-January months were also noteworthy along all the studied period. These trends traced an N-shaped pattern with higher peaks in Pink October months and sharp falls along subsequent December and January.ConclusionsConsidering these findings, it would be reasonable to bring Pink October to the beginning of each year, thereby extending the beneficial effect of the campaigns. It would be more appropriate to start screening campaigns at the beginning of the year, when new resolutions are taken and new projects are added to everyday routines. Our work raises attention to the study of traffic data to encourage health campaign analysts to undertake better analysis based on marketing practices.

Resumo: Desde o início do surto da COVID-19, percebe-se uma crescente tensão provocada pela dimensão pandêmica de uma doença que trouxe severos impactos epidemiológicos e desdobramentos socioculturais e políticos. Em condições ideais de comunicação pública as autoridades deveriam alinhar-se a um regime de total transparência com informações abundantes e de compreensão facilitada para gerar credibilidade, confiança e parceria com as mídias. Nos hiatos de versões aceitáveis e em meio a indeterminações, os indivíduos tornam-se experts de si mesmos, consumindo fake news e reproduzindo narrativas de risco falaciosas com consequências desastrosas. Discutem-se diversos aspectos ligados às fake news e ao uso da razão comunicativa por autoridades públicas, citando o caso do Irã e estabelecendo paralelos com o fenômeno da antivacinação e suas consequências. Descreve-se o desafio do direcionamento coordenado da sociedade por meio de informações, competindo com pastiches pseudo-científicos que proliferam em ritmo frenético na vacuidade de dados oficiais. Levanta-se, assim, a seguinte questão: quais modelos comunicativos deveriam pautar a narrativa oficial para gerar condições de colaboração e parceria com as mídias? Que impactos tais modelos teriam na proliferação das narrativas enganosas às quais recorrem os cidadãos em crise de orientações pertinentes? Conclui-se que é também papel do governo lançar mão de sua ampla visibilidade para gerar referências de segurança sob o primado da razão comunicativa sensível às genuínas interrogações da sociedade. Em síntese, produzir em escala monumental referenciais responsáveis, norteados por elementos de ética da responsabilidade alinhados ao bem comum.

Data on the association between shift work and hypertension are controversial. Sleep restriction is hypothesized to be involved in this relationship. Since on-shift nap can partly compensate for sleep deprivation among night workers, this investigation is aimed at (i) comparing the prevalence of hypertension among workers considering both current and former night work, (ii) testing the association between on-shift naps and hypertension among night workers, and (iii) analyzing the influence of sleep complaints in the association between on-shift nap and hypertension. Nap was defined as a sleep episode with duration shorter than the average nighttime sleep. A cross-sectional study was performed at the 18 largest public hospitals in Rio de Janeiro, Brazil, in 2010-2011 (N = 2588 female registered nurses). Nurses were informally allowed to nap for up to three consecutive hours during working nights. Workers completed a multidimensional questionnaire including self-reported information on physician diagnosis of hypertension, napping, and sleep complaints (insomnia, diurnal sleepiness, and non-satisfactory sleep). Epidemiological and statistical treatment of data included binomial logistic regression and interaction tests. Higher chances of hypertension were observed for both current and former night workers compared with workers with no previous experience in night work, i.e. exclusive day workers (OR = 1.68; CI95% 1.22-2.33 and OR = 1.40; CI95% 1.01-1.96, respectively) after adjustment for age, race/ethnicity, physical activity, smoking, alcohol consumption, insomnia, weekly work hours, and BMI. Compared with exclusive day workers, both non-nappers and nappers were at a higher likelihood of reporting hypertension (OR = 1.93 CI95% 1.35-2.79 and OR = 1.41 CI95% 1.08-2.20, respectively). An interaction was observed between napping behavior and insomnia (p = 0.037). In the whole sample of night workers, the lower OR for nappers was confirmed when they were directly compared with non-nappers (OR = 0.76 CI95% 0.59-0.98). Analysis of night workers stratified by insomnia showed a significant reduction in OR for nappers (compared to non-nappers) only among insomniacs (OR = 0.58). Napping during night work may be a protective factor for hypertension, particularly among insomniacs. Factors related to melatonin secretion, blood pressure control, and blood pressure dipping patterns are likely to be involved in the relationship between on-shift napping and blood pressure.

BackgroundThe aims of the present study were to identify and analyse the Diseases Neglected by the Media (DNMs) via a comparison between the most important health issues to the population of Espírito Santo, Brazil, from the epidemiological perspective (health value) and their effective coverage by the print media, and to analyse the DNMs considering the perspective of key journalists involved in the dissemination of health topics in the state media.MethodologyMorbidity and mortality data were collected from official documents and from Health Information Systems. In parallel, the diseases reported in the two major newspapers of Espírito Santo in 2011–2012 were identified from 10,771 news articles. Concomitantly, eight interviews were conducted with reporters from the two newspapers to understand the journalists’ reasons for the coverage or neglect of certain health/disease topics.Principal FindingsQuantitatively, the DNMs identified diseases associated with poverty, including tuberculosis, leprosy, schistosomiasis, leishmaniasis, and trachoma. Apart from these, diseases with outbreaks in the period evaluated, including whooping cough and meningitis, some cancers, respiratory diseases, ischaemic heart disease, and stroke, were also seldom addressed by the media. In contrast, dengue fever, acquired immune deficiency syndrome (AIDS), diabetes, breast cancer, prostate cancer, tracheal cancer, and bronchial and lung cancers were broadly covered in the period analysed, corroborating the tradition of media disclosure of these diseases. Qualitatively, the DNMs included rare diseases, such as amyotrophic lateral sclerosis (ALS), leishmaniasis, Down syndrome, and verminoses. The reasons for the neglect of these topics by the media included the political and economic interests of the newspapers, their editorial line, and the organizational routine of the newsrooms.ConclusionsMedia visibility acts as a strategy for legitimising priorities and contextualizing various realities. Therefore, we propose that the health problems identified should enter the public agenda and begin to be recognized as legitimate demands.

Realizou-se revisão da literatura sobre publicações que descrevem experiências com material impresso distribuído ao público leigo em instituições hospitalares. Excluindo impressos para profissionais ou portadores de incapacidades, dentre 146 trabalhos, foram obtidos 75 artigos que ilustram o padrão atual de racionalidade da produção, uso e avaliação deste tipo de recurso. Esses artigos investem no poder da "informação impressa ideal" para alinhar comportamentos à agenda biomédica hospitalar. A racionalidade instrumental que os permeia percebe o "pacote informativo perfeito" como aquele que explicita eficientemente seus conteúdos técnicos, para fins de convencimento unilateral, atualizado segundo escalas de legibilidade, adornado por projeto gráfico e enfatizando prioridades definidas pelos profissionais. Tais "próteses de comunicação" seriam passíveis de validação eletrônica, por intermédio de softwares competentes em adequar "doses" e conteúdos. Discute-se a informação como fármaco, o cognitivismo, a ausência de pesquisas de recepção e a necessidade da ação comunicativa, para desconstrução de tais sistemas de pensamento fechados no ambiente hospitalar.

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