Residing in socioeconomically deprived neighborhoods may pose substantial physiological stress, which can then lead to higher allostatic load (AL), a marker of biological wear and tear that precedes disease. The aim of the present study was to map the current evidence about the relationship between neighborhood socioeconomic deprivation and AL. A scoping review approach was chosen to provide an overview of the type, quantity, and extent of research available. The review was conducted using three bibliographic databases (PubMed, SCOPUS, and Web of Science) and a standardized protocol. Fourteen studies were identified. Studies were predominantly from the USA, cross-sectional, focused on adults, and involved different races and ethnic groups. A wide range of measures of AL were identified: the mode of the number of biomarkers per study was eight but with large variability (range: 6–24). Most studies (n = 12) reported a significant association between neighborhood deprivation and AL. Behaviors and environmental stressors seem to mediate this relationship and associations appear more pronounced among Blacks, men, and individuals with poor social support. Such conclusions have important public health implications as they enforce the idea that neighborhood environment should be improved to prevent physiological dysregulation and consequent chronic diseases.

Bullying is defined as systematic exposure to humiliation as well as hostile and violent behaviors against one or more individuals. These behaviors are a serious, growing problem, which affects a significant proportion of health care professionals. To support the hospital's risk management policy, a cross-sectional study was undertaken to determine the prevalence of bullying in this institution and identify the determinants of bullying. Bullying was measured using the Negative Acts Questionnaire-Revised, Portuguese version (NAQ-R), a self-administered tool. The questionnaire was made available in digital format on the hospital's internal network (Intranet) and in hard copy; questionnaires were returned via nonidentified internal mail addressed to the occupational health unit or deposited in suggestion boxes located throughout the hospital. Multiple questionnaire delivery methods guaranteed data anonymity and confidentiality. The prevalence of bullying in this hospital was 8% (95% confidence interval [CI] = [6.2, 10.2]). Reported bullying was predominantly vertical and more frequently occurring among nurses, clerical staff, and health care assistants (12.5%, 7.6%, 6.4%, respectively; p = .005). After adjusting for gender, age, occupation, type of contract, and work schedule, only type of contract was significantly associated with bullying in the workplace; the risk of bullying was twice as high among government employees compared to workers with indefinite duration employment contracts ( p = .038). This study identified a high prevalence of bullying among health professionals; hence a program to prevent and control this phenomenon was implemented in this institution.

a b s t r a c tObjectives: To identify patterns of variation in breast cancer mortality in Europe (1980e2010), using a model-based approach. Methods: Mortality data were obtained from the World Health Organization database and mixed models were used to describe the time trends in the age-standardized mortality rates (ASMR). Model-based clustering was used to identify clusters of countries with homogeneous variation in ASMR. Results: Three patterns were identified. Patterns 1 and 2 are characterized by stable or slightly increasing trends in ASMR in the first half of the period analysed, and a clear decline is observed thereafter; in pattern 1 the median of the ASMR is higher, and the highest rates were achieved sooner. Pattern 3 is characterised by a rapid increase in mortality until 1999, declining slowly thereafter. Conclusion: This study provides a general model for the description and interpretation of the variation in breast cancer mortality in Europe, based in three main patterns.Ó 2013 Elsevier Ltd. All rights reserved. IntroductionBreast cancer is the leading cause of oncological death among women, in both economically developed and developing settings. 1 In Europe, in the last decades the mortality decreased in most countries, 2 along with rising incidence rates. 3 An increasing incidence may be explained by trends towards a more frequent exposure to factors that contribute to a higher risk of breast cancer (e.g.: delayed childbearing, lower parity, use of postmenopausal hormone therapy, obesity, physical inactivity), 4,5 while the widespread use of mammographic screening further contributes to higher incidence rates. 5,6 The decline in mortality rates has been attributed both to an increasing frequency of early diagnosis through mammography screening and access to more efficient treatments, including adjuvant chemotherapy or tamoxifen, besides improved radiotherapy and surgery. 7e11 The identification of clusters of countries with similar trends in breast cancer mortality may contribute to understand the impact, at a population level, of early detection and improved disease management. Previous attempts to describe breast cancer mortality patterns relied on criteria related to geographical, 12 social, economic or cultural 13e15 characteristics. Model-based clustering may allow a more meaningful grouping of the different settings with no a priori constraints, according to the magnitude of the mortality rates at onset of the observation period, as well as its trends. Therefore, we aimed to identify patterns of variation in breast cancer mortality, using a model-based approach. Prospects. 17 We computed age-standardized mortality rates (ASMR) for all ages, by the direct method, using the world standard population 18 as reference. Methods BreastMixed models 19 were used to describe the time trends in the ASMR, including random terms by country, for the intercept and for slope, quadratic and cubic terms. Iceland presented values three times the interquartile range above or below the median for at least one...

ObjectivesTo assess the prevalence of SARS-CoV-2-specific IgM and IgG antibodies among workers of the three public higher education institutions of Porto, Portugal, up to July 2020.MethodsA rapid point-of-care test for specific IgM and IgG antibodies of SARS-CoV-2 was offered to all workers (SD Biosensor STANDARD Q COVID-19 IgM/IgG Duo and STANDARD Q COVID-19 IgM/IgG Combo). Testing was performed and a questionnaire was completed by 4592 workers on a voluntary basis from 21 May to 31 July 2020. We computed the apparent IgM, IgG, and combined IgM or IgG prevalence, along with the true prevalence and 95% credible intervals (95% CrI) using Bayesian inference.ResultsWe found an apparent prevalence of 3.1% for IgM, 1.0% for IgG and 3.9% for either. The estimated true prevalence was 2.0% (95% CrI 0.1% to 4.3%) for IgM, 0.6% (95% CrI 0.0% to 1.3%) for IgG, and 2.5% (95% CrI 0.1% to 5.3%) for IgM or IgG. A SARS-CoV-2 molecular diagnosis was reported by 21 (0.5%) workers; and of these, 90.5% had a reactive IgG result. Seroprevalence was higher among those reporting contacts with confirmed cases, having been quarantined, having a previous molecular negative test or having had symptoms.ConclusionsThe seroprevalence among workers from the three public higher education institutions of Porto after the first wave of the SARS-CoV-2 infection was similar to national estimates for the same age working population. However, the estimated true seroprevalence was approximately five times higher than the reported SARS-CoV-2 infection based on a molecular test.