A comprehensive evaluation of heat stress and heat strain in a sample of sugarcane cutters in Brazil.

Sugarcane cutters are vulnerable to extreme heat and are at risk for heat-related illness and chronic kidney disease, potentially due to high heat strain. We performed a comprehensive assessment of the physiological demands of sugarcane cutters via measurements of metabolic, thermal, and cardiovascular responses. In addition, we assessed cross-shift changes in markers of kidney function.

The impact of religion on changes in end-of-life practices in European intensive care units: a comparative analysis over 16 years.

Purpose: Religious beliefs affect end-of-life practices in intensive care units (ICUs). Changes over time in end-of-life practices were not investigated regarding religions.

Methods: Twenty-two European ICUs (3 regions: Northern, Central, and Southern Europe) participated in both Ethicus-1 (years 1999-2000) and Ethicus-2 studies (years 2015-2016).

Global Comparison of Communication of End-of-Life Decisions in the ICU.

Background: Prolonging life in the ICU increasingly is possible, so decisions to limit life-sustaining therapies frequently are made and communicated to patients and families or surrogates. Little is known about worldwide communication practices and influencing factors.

Research Question: Are there regional differences in end-of-life communication practices in ICUs worldwide?

Study Design And Methods: This analysis of data from a prospective, international study specifically addressed end-of-life communications in consecutive patients who died or had limitation of life-sustaining therapy over 6 months in 199 ICUs in 36 countries, grouped regionally.

Changes in communication of end-of-life decisions in European ICUs from 1999 to 2016 (Ethicus-2) - a prospective observational study.

Purpose: We investigated changes in communication practice about end-of-life decisions in European ICUs over 16 years.

Materials And Methods: This prospectively planned secondary analysis of two observational studies in 22 European ICUs in 1999-2000 (Ethicus-1) and 2015-16 (Ethicus-2) included consecutive patients who died or with limitation of life-sustaining therapy. ICUs were grouped into North, Central and South European regions.

Heat stress monitoring based on heart rate measurements.

Currently, occupational heat exposure is usually measured using environmental variables such as the wet bulb globe temperature index. The costs of heat stress monitoring include the acquisition of specialized equipment and the recruitment of trained personnel. In rapidly changing environments, such as outdoor settings, these assessments must be conducted on a daily basis.

A Preliminary Evaluation of the Kidney Function of Sugarcane Cutters From Brazil.

Objective: To evaluate clinical parameters, markers of kidney function, and skeletal muscle damage in a group of sugarcane cutters during harvesting season.

Methods: Seventeen volunteers were assessed for anthropometrics and cardiorespiratory fitness. Blood and urine samples were collected 48-hours after the last work session.

[Risk of exposure to heatstroke in sugarcane workers in São Paulo State, Brazil].

Environmental heat is an aggravating factor for sugarcane workers, and manual cane cutting is one of the heavy work activities that favor the generation of metabolic heat. This can combine with other precarious working conditions to produce heatstroke, potentially leading to serious complications and even death. The study aimed to quantify the risk of overheating in sugarcane cutters in São Paulo, Brazil.

Wet-bulb globe temperature index estimation using meteorological data from São Paulo State, Brazil.

It is well known that excessive heat exposure causes heat disorders and can lead to death in some situations. Evaluation of heat stress on workers performing indoor and outdoor activities is, nowadays, conducted worldwide by wet-bulb globe temperature (WBGT) index, which calculation parameters are dry-bulb, natural wet-bulb, and globe temperatures, which must be measured at the same time and in location where the worker is conducting his/her activities. However, for some activities performed in large outdoor areas such as those of agricultural ones, it is not feasible to measure directly those temperatures in all work periods and locations where there are workers.

Are religion and religiosity important to end-of-life decisions and patient autonomy in the ICU? The Ethicatt study.

Purpose: This study explored differences in end-of-life (EOL) decisions and respect for patient autonomy of religious members versus those only affiliated to that particular religion (affiliated is a member without strong religious feelings).

Methods: In 2005 structured questionnaires regarding EOL decisions were distributed in six European countries to ICUs in 142 hospital ICUs. This sub-study of the original data analyzed answers from Protestants, Catholics and Jews.

[Analysis of the contribution of meteorological variables to thermal stress associated with death among sugarcane cutters].

Sugarcane cutters perform heavy work under adverse conditions. Environmental factors can be an aggravating factor for thermal stress among these workers. This study analyzed the atmospheric conditions on the day of death of 14 sugarcane cutters in São Paulo State, Brazil.

Perceptions of appropriateness of care among European and Israeli intensive care unit nurses and physicians.

Context: Clinicians in intensive care units (ICUs) who perceive the care they provide as inappropriate experience moral distress and are at risk for burnout. This situation may jeopardize patient quality of care and increase staff turnover.

Objective: To determine the prevalence of perceived inappropriateness of care among ICU clinicians and to identify patient-related situations, personal characteristics, and work-related characteristics associated with perceived inappropriateness of care.