Strengthening collaboration within Dutch municipalities for a healthier living environment: experiences and possible improvements according to civil servants.

Background: Health is partly determined by the physical environment in which people live. It is therefore crucial to consider health when designing the physical living space. This requires collaboration between the social and physical domains within municipalities. Collaboration is not self-evident, however, and it is difficult to achieve due to barriers relating to culture, language and work processes. Additionally, improvements in collaboration are desperately needed to address complex health issues, and working according to the new Environment and Planning Act in the Netherlands requires more collaboration. One relevant question concerns how civil servants describe the current collaboration between the social and physical domain and the concrete improvements they propose to improve such collaboration to build a healthier living environment. Methods: In this qualitative study, the Collaborative Governance framework was used to present data from semi-structured interviews with 21 civil servants in five Dutch municipalities. Respondents were asked to reflect on their current experiences with collaboration and suggest concrete opportunities for improving collaboration. Results: The results indicate that enhancing collaboration between the social and physical domains can be achieved by proceeding from the inhabitants' perspective, as well as by encouraging aldermen and managerial personnel to take a more active and committed role in collaboration. This involves formulating and communicating a joint vision, in addition to guiding and facilitating collaboration through integrated assignments, forming multidisciplinary teams and appointing boundary-spanners. Civil servants see a clear role for themselves in the collaborative process. They recognize their own contributions to and obligations in enhancing collaboration by actively seeking contact, absorbing each other's perspectives and pursuing common ground, starting today. Conclusion: There are many concrete opportunities to improve collaboration between the social and physical domains. This could be initiated immediately if civil servants, managers and aldermen approach collaboration as an essential part of their jobs and acknowledge the interdependency that exits.

Physical inactivity and its associated factors among pre-retirement government healthcare workers in Kuala Lumpur, Malaysia.

INTRODUCTION: The rising worldwide concern of Non-Communicable Diseases (NCD) is alarming as it is associated with 80% of annual global mortality. NCD threat is rising due to, among others, the increasing ageing population, thus putting the efforts to promote health ageing at the forefront of many countries' health agenda. Physical activity has been recognised as one of the significant factors in the pursuit of healthy ageing. Nevertheless, approximately one third of individuals in Malaysia are physically inactive. The aim of this study is to determine the prevalence of physical inactivity and its associated factors among pre-retirement government healthcare workers. METHODS: This cross-sectional study was conducted from May to June 2023 among pre-retirement government healthcare workers in Kuala Lumpur, Malaysia. The sample size required was 233 and proportionate random sampling was used to recruit potential respondents who answered self-administered online questionnaires. Global Physical Activity Questionnaire (GPAQ) was used to measure the level of physical activity and data analysis was performed using SPSS version 29. RESULTS: A total of 214 complete responses were received from the 233 questionnaires distributed, giving a response rate of 91.8%. The prevalence of physical inactivity among pre-retirement healthcare workers was 39.7% as compare only 29.9% in general population. Significant predictors for physical inactivity included higher education levels (SPM, STPM, or certificate holders) (AOR = 13.4, 95% CI: 2.47-72.65), non-Malay ethinicity (AOR = 4.7, 95% CI: 1.23-18.38), personal barriers (AOR = 1.6, 95% CI:1.35-1.79), social barriers (AOR = 1.21, 95% CI: 1.06-1.39), and physical environment barriers (AOR = 1.468, 95% CI: 1.221-1.765). CONCLUSION: This study shows a worrying prevalence of physical inactivity among pre-retirement healthcare workers that is even higher than the general population in Malaysia. The findings highlight the importance of focusing the preventive strategies among non-Malay workers and those with lower education levels. It is also vital to address all the physical, social, and environmental barriers towards physical inactivity. By prioritising these factors, employers and stakeholders will be able to establish better workplace health promotion and address the issue of physical inactivity more efficiently.

State Laws Governing the Hiring of Public Health Government Employees, 2023.

OBJECTIVE: Governmental public health agencies have experienced longstanding challenges in recruiting individuals at the state and local level. Understanding civil service laws as they relate to the hiring processes is an important component of recruitment and increasing public health workforce capacity. This study presents state hiring laws and regulations governing the public health government workforce. METHODS: Legal mapping techniques were employed to collect and code data on current hiring laws governing governmental public health employees across all 50 states. The review of laws included constitutions, statutes and regulations, and searches of administrative code. RESULTS: In 12 states, the laws do not specify civil service exam criteria or they have no mention of civil service exams in the law. Almost a third of states have laws that establish civil service exam requirements without specifying conditions for when exams must be required, or which positions allow which types of exam/criteria. Similarly, almost all of the states that have civil service exams denoted in their laws have unspecified language about whether there are exam fees. Requirements for the maintenance/use of state hiring lists are in place in 36 states and 26 states have a non-public health agency managing this process. Nearly all states (n = 48, 96%) require hiring preferences for certain types of individuals, most commonly veterans (n = 48, 96%) and family members of veterans (n = 30, 60%). No state laws provide hiring preferences for individuals from public health fellowships or special training programs. CONCLUSION: Key findings suggest that the laws governing the merit system and civil service vary and often lack clarity, which may be difficult for public health agencies and for potential employees to understand, navigate, and successfully recruit key employees. The recruitment and hiring of new governmental public health staff are complicated by the management of hiring by other state agencies and the vague civil service exam requirements and process. Developing preferences for hiring individuals who have additional practical training in public health (eg, public health fellowships and AmeriCorps) should be considered.

Percepção de servidores públicos acerca da transição para a aposentadoria / Public servants' perception of the transition to retirement / Percepción de los servidores públicos sobre la transición a la jubilación

Objetivo: apreender as percepções acerca da transição para a aposentadoria em servidores públicos de uma universidade. Método: estudo qualitativo, incluindo servidores aposentados, à luz da Teoria das Transições de Meleis, sob o conceito condicionantes da transição: fatores que facilitam ou inibem esse processo. Utilizaram-se questões abertas para a coleta de dados, submetidas àanálise de conteúdo. Resultados: participaram 32 aposentados, sendo a maioria do sexo feminino e aposentados de seis meses a cinco anos. Duas categorias emergiram: "Ressignificando o tempo livre" na qual os participantes relataram adoção de novos hábitos, a intensificação do convívio familiar e o desligamento gradual do trabalho; e "Desilusões no caminho"que apresenta os fatores que dificultam o processo: o excesso de tempo livre, a diminuição na renda e o isolamento social. Conclusão: compreender tais fatores possibilita o planejamento de intervenções em saúde nas instituições que facilitem a transição.

Objective: to apprehend the perceptions about the transition to retirement in civil servants of a university. Method: qualitative study, including retired civil servants, in the light of Meleis' Theory of Transitions, under the concept of transition constraints: factors that facilitate or inhibit this process. Open questions were used for data collection and submitted to content analysis. Results: 32 retirees participated, most of them female and retired from six months to five years. Two categories emerged: "Re-signifying free time" in which the participants reported adopting new habits, the intensification of family life and the gradual withdrawal from work; and "Disappointments along the way", which presents the factors that hinder the process: excessive free time, reduced income and social isolation. Conclusion: understanding these factors makes it possible to plan health interventions in institutions that facilitate the transition.

Objetivo: aprehender las percepciones sobre la transición a la jubilación en servidores públicos de una universidad. Método: estudio cualitativo, incluyendo funcionarios jubilados, a la luz de la Teoría de las Transiciones de Meleis, bajo el concepto de restricciones de transición: factores que facilitan o inhiben este proceso. Se utilizaron preguntas abiertas para la recolección de datos, sometidas al análisis de contenido. Resultados: participaron 32 jubilados, la mayoría mujeres y jubilados de seis meses a cinco años. Emergieron dos categorías: "Resignificar el tiempo libre", en la que los participantes relataron la adopciónde nuevos hábitos, la intensificación de la vida familiar y el retiro paulatino del trabajo; y "Desengaños en el camino", que presenta los factores que dificultan el proceso: exceso de tiempo libre, reducción de ingresos y aislamiento social. Conclusión: la comprensión de estos factores posibilita la planificación de intervenciones de salud en instituciones que faciliten la transición.

Civil service organization as a political determinant of health: Analyzing relationships between merit-based hiring, corruption, and population health.

A growing literature finds that the way governments are organized can impact the societies they serve in important ways. The same is apparent with respect to civil service organizations. Numerous studies show that the recruitment of civil servants based on their credentials rather than on nepotism or patronage reduces corruption in government. Political corruption in turn appears to harm population health. Up to this time, however, civil service organization is not a recognized determinant of health and is little discussed outside of political science disciplines. To provoke a broader conversation on this subject, the following study proposes that meritocratic recruitment of civil servants improves population health. To test this proposition, a series of regression models examines comparative data for 118 countries. Consistent with study hypotheses, meritocratic recruitment of civil servants corresponds longitudinally with both lower rates of corruption and lower rates of infant mortality. Results are similar after robustness checks. Findings with regard to life expectancy are more mixed. However, additional tests suggest meritocratic recruitment contributes to life expectancy over a longer span of time. Findings also offer more support for a direct pathway from meritocratic recruitment to population health rather than via changes in corruption levels per se, although this may depend on a country's level of economic development. Overall, this study offers first evidence that civil service organization, particularly the recruitment of civil servants based on the merits of their applications rather than on whom they happen to know in government, is a positive determinant of health. More research in this area is needed.

The PhenX Toolkit: Recommended Measurement Protocols for Social Determinants of Health Research.

Health disparities are driven by unequal conditions in the environments in which people are born, live, learn, work, play, worship, and age, commonly termed the Social Determinants of Health (SDoH). The availability of recommended measurement protocols for SDoH will enable investigators to consistently collect data for SDoH constructs. The PhenX (consensus measures for Phenotypes and eXposures) Toolkit is a web-based catalog of recommended measurement protocols for use in research studies with human participants. Using standard protocols from the PhenX Toolkit makes it easier to compare and combine studies, potentially increasing the impact of individual studies, and aids in comparability across literature. In 2018, the National Institute on Minority Health and Health Disparities provided support for an initial expert Working Group to identify and recommend established SDoH protocols for inclusion in the PhenX Toolkit. In 2022, a second expert Working Group was convened to build on the work of the first SDoH Working Group and address gaps in the SDoH Toolkit Collections. The SDoH Collections consist of a Core Collection and Individual and Structural Specialty Collections. This article describes a Basic Protocol for using the PhenX Toolkit to select and implement SDoH measurement protocols for use in research studies. © 2024 The Authors. Current Protocols published by Wiley Periodicals LLC. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA. Basic Protocol: Using the PhenX Toolkit to select and implement SDoH protocols.

Teamwork and Collaboration: Bright Spots of Governmental Public Health Employee Reflections on the COVID-19 Response.

The public health emergency response following the outbreak of COVID-19 necessitated greater internal public health agency teamwork and external collaboration. Building on previous research, this article is the third of 3 research briefs that highlight "bright spots" or valuable experiences and opportunities from the COVID-19 response. Using PH WINS 2021 data, we qualitatively examined responses to a question about pandemic workforce experiences. Teamwork and collaboration were emphasized as a critical component of employees' experiences. Across 260 responses, 7 subthemes emerged, generally commemorating the ways that the response effort and employees were supported by teamwork and collaboration. Findings highlight the value of ongoing cross-division teamwork within agencies, the role of leaders in teamwork, and that lessons from teamwork/collaboration experiences can inform organizational system improvements. Maintaining and expanding on improved external collaboration and partnerships should be prioritized for preparing for future emergency events and serving public health communities on a daily basis.

Work and Lifestyle Factors Influencing Job Satisfaction of Japanese Civil Servants: A 5-Year Longitudinal Study.

OBJECTIVE: Although work, family, and lifestyle factors were associated with job satisfaction, prospective studies are lacking. This longitudinal study clarified the predisposing factors for job satisfaction. METHODS: Datasets were obtained from the Japanese Civil Servants Study and included 1429 participants. We assessed the relationship between job satisfaction and specific work and lifestyle factors. Logistic regression analyses evaluated the association between deteriorating job satisfaction and poor work and lifestyle factors at baseline and changes in these factors at follow-up. RESULTS: Poor sleep quality and limited job control at baseline were associated with deterioration in job satisfaction. Furthermore, deterioration in job control and work-to-family conflict at follow-up was associated with job dissatisfaction. CONCLUSION: Work and lifestyle characteristics were associated with job dissatisfaction. Employees with limited job control and high work-to-family conflict at baseline were more likely to develop job dissatisfaction.

Translating and validating the sources of pressure scale: Job stressors among Chinese government employees.

In recent years, stress-related suicides have been on the rise among Chinese government employees. Standardized instruments on job stress are abundant, but few of them have been administered and validated among Chinese government employees. Using convenience samples of Chinese government employees, this study aimed to translate and validate the Sources of Pressure Scale (SPS) of the Pressure Management Indicator (PMI), which is a comprehensive instrument on job stress developed by western researchers. Sample 1 participants (n = 278) filled out the PMI questionnaire and the Kessler Psychological Distress scale in person and sample 2 participants (n = 227) completed the same questionnaires online. Exploratory and confirmatory factor analyses were conducted using separate samples. Though the original SPS contained 40 items and eight dimensions, our analyses validated a much shorter version, with four dimensions encompassing 15 items: relationships (5 items), home-work balance (4 items), recognition (3 items), and personal responsibilities (3 items). Also reported in the study is evidence that the shortened version of the the PMI is the Sources of Pressure Scale is a reliable and valid measure of job stressors among Chinese government employees. Government agencies in China can use these findings to develop more relevant organizational-level interventions to reduce job stress and its detrimental consequences.

Contaminação pelo Covid-19 em profissionais de hospital de referência no Pará / Contamination by Covid-19 in professionals of a reference hospital in Para's state / Contaminación por Covid-19 en profesionales de un hospital de referencia del estado de Pará

A pandemia do novo coronavírus colocou em alerta os sistemas de saúde, estabelecendo sentimentos de instabilidade e de medo. O trabalho é e importante pilar para o traçado de políticas públicas. Objetivo: analisar a contaminação pelo COVID-19 em profissionais de hospital de referência no Pará. Metodologia: Trata-se de estudo retrospectivo, quantitativo, observacional, com aplicação de série temporal no período de março de 2020 a março de 2022. Foram incluídos todos os servidores atuantes durante a pandemia, que apresentaram atestados médicos com diagnóstico de COVID, e/ou testagem positiva, ou atestados por suspeita de contaminação. O perfil de servidores foi analisado, explorando as variáveis sexo, idade, convivência ou não com parceiros, grau de escolaridade, cargo e setor; juntamente com a incidência de casos confirmados e incidência total (suspeitos e confirmados). Resultados: O total de afastamentos do trabalho devido ao diagnóstico de COVID-19 foi de 1.420 casos, mais 839 casos suspeitos; sendo que 173 trabalhadores apresentaram reincidência. A incidência foi maior nos meses de maio de 2020, março de 2021 e janeiro de 2022. Houve predominância do sexo feminino e da categoria de enfermagem. Setores administrativos e financeiros apresentaram maior porcentagem de contaminados durante a pandemia (73,40%), proporcionalmente ao quantitativo de servidores atuantes na lotação. Entretanto, foram servidores da assistência direta ao paciente que apresentaram maior porcentagem de reinfecção. Conclusão: Foi possível visualizar três ondas na distribuição temporal dos casos de COVID-19, com destaque para elevação nos primeiros meses de 2022. O declínio no diagnóstico de casos novos no hospital estudado após dois anos de pandemia pode representar esforços individuais e coletivos em resistir às dificuldades da conjuntura. É importante observar o comportamento da pandemia em distintas regiões do Brasil para atualização de estratégias de enfrentamento como um todo.

The new coronavirus pandemic has put health systems on alert, establishing feelings of instability and fear. Working is an important pillar for the design of public policies. Objective: to analyze the contamination by COVID-19 in professionals of a reference hospital in Para's State. Methodology: This is a retrospective, quantitative, observational study, with the application of a time series from March 2020 to March 2022. All civil servants working during the pandemic, who presented medical certificates with a diagnosis of COVID, and/or or positive test, or attestations for suspected contamination. The servants' profile was analyzed, exploring the variables sex, age, living or not with partners, education level, position and sector; along with the incidence of confirmed cases and total incidence (suspected and confirmed). Results: The total number of absences from work due to the diagnosis of COVID-19 was 1,420 cases, plus 839 suspected cases; 173 workers presented recurrence. The incidence was higher in the months of May 2020, March 2021 and January 2022. There was a predominance of females and the nursing category. Administrative and financial sectors had a higher percentage of people infected during the pandemic (73.40%), proportionally to the number of servers working in the capacity. However, it was direct patient care workers who had the highest percentage of reinfection. Conclusion: It was possible to visualize three waves in the temporal distribution of COVID-19 cases, with emphasis on an increase in the first months of 2022. The decline in the diagnosis of new cases in the hospital studied after two years of the pandemic may represent individual and collective efforts to resist to the difficulties of the situation. It is important to observe the behavior of the pandemic in different regions of Brazil to update coping strategies in a general scenery.

La nueva pandemia de coronavirus ha puesto en alerta a los sistemas de salud, estableciendo sentimientos de inestabilidad y miedo. El trabajo es un pilar importante para el diseño de políticas públicas. Objetivo: analizar la contaminación por COVID-19 en profesionales de un hospital de referencia en el Estado de Pará. Metodología: Se trata de un estudio retrospectivo, cuantitativo, observacional, con la aplicación de una serie de tiempo de marzo de 2020 a marzo de 2022. Todos los funcionarios que trabajaron durante la pandemia, que presentaron certificados médicos con diagnóstico de COVID, y/o o test positivo, o atestados por sospecha de contaminación. Se analizó el perfil de los funcionarios, explorando las variables sexo, edad, convivencia o no con la pareja, nivel de escolaridad, cargo y sector; junto con la incidencia de casos confirmados y la incidencia total (sospechosos y confirmados). Resultados: El número total de bajas laborales por diagnóstico de COVID-19 fue de 1.420 casos, más 839 casos sospechosos; 173 trabajadores presentaron recurrencia. La incidencia fue mayor en los meses de mayo de 2020, marzo de 2021 y enero de 2022. Hubo predominio del sexo femenino y de la categoría de enfermería. Los sectores administrativo y financiero presentaron mayor porcentaje de infectados durante la pandemia (73,40%), proporcionalmente al número de servidores que trabajaban en esa función. Sin embargo, fueron los trabajadores de atención directa al paciente los que presentaron el mayor porcentaje de reinfección. Conclusiones: Fue posible visualizar tres olas en la distribución temporal de los casos de COVID-19, destacándose un aumento en los primeros meses de 2022. La disminución en el diagnóstico de nuevos casos en el hospital estudiado después de dos años de pandemia puede representar esfuerzos individuales y colectivos para resistir a las dificultades de la situación. Es importante observar el comportamiento de la pandemia en diferentes regiones de Brasil para actualizar las estrategias de afrontamiento en un escenario general.

Lineamientos para trámites de licencia por misión oficial o becas en el extranjero para servidores públicos del Ministerio de Salud / Guidelines for official mission leave procedures or scholarships abroad for public servants of the Ministry of Health

Los presentes lineamientos técnicos, responden a la necesidad de mejorar el control institucional del trámite de licencia por misión oficial o becas en el extranjero para el personal del Ministerio de Salud. Lo que permitirá que se justifique adecuadamente el tiempo de licencia con goce de sueldo al que tienen derecho los empleados de este Ministerio

The present technical guidelines respond to the need to improve the institutional control of the procedure of leave by official mission or scholarships abroad for the staff of the Ministry of Health. This will allow adequate justification of the paid leave to which employees of this Ministry are entitled

"Exceptionally challenging time for all of us": Qualitative study of the COVID-19 experiences of partners of diplomatic personnel.

BACKGROUND: Although the romantic partners of diplomatic personnel frequently accompany their spouses to overseas postings and face the challenges of having to adjust to new cultures and separation from friends and family, they have rarely been the focus of academic research. This study explores the lived experiences of the partners/spouses of diplomatic personnel from the United Kingdom's Foreign, Commonwealth and Development Office (FCDO) during the COVID-19 pandemic. METHODS: Partners of FCDO staff took part in semi-structured interviews about how COVID-19 had affected their lives and their perceptions of the organisation's response to the pandemic. Thematic analysis was used to analyse the data. RESULTS: Eleven partners of FCDO staff took part, who between them had lived in 14 different countries during the pandemic. The analysis identified six key themes: deployment-specific challenges such as travel restrictions, quarantine and evacuation; children; impacts of the pandemic including financial and psychological; perceptions of the organisational response to COVID-19; support and help-seeking; and suggestions for the future. Overall participants reported experiencing a number of challenges, many of which left them feeling powerless and not in control of their own lives. Participants frequently described a lack of clarity around policies and support. Social support appeared to be valuable, but many participants wanted more support from the organisation and from informal networks. CONCLUSIONS: Diplomatic (and similar) organisations could enhance the wellbeing of the partners of their staff through improved communication and support. Keeping families informed about restrictions, requirements, policies and available help during a crisis, and reaching out to them to offer advice and support, would likely be beneficial. It is important that lessons are learned from the COVID-19 crisis in order for organisations to be able to support their employees and families if another prolonged crisis were to occur.

Saúde Integral: Tai Chi Chuan

O Saúde Integral mostra na reportagem uma tradição milenar oriental que surgiu nas lutas e combates do passado, mas que hoje é usada como um complemento a saúde. É o Tai Chi Chuan, com todos os seus movimentos calmos e bem relaxante. As aulas de Tai Chi Chuan acontecem junto aos corredores do Hospital do Servidor Público Municipal, na zona sul da capital. O estilo ensinado aqui é o da família Yang. O Hospital do Servidor Público está localizado na rua Castro Alves, número 60.

Isolation of Mouse Neutrophils.

Neutrophils represent the first line of defense against bacterial and fungal pathogens. Indeed, patients with inherited or acquired qualitative and quantitative neutrophil defects are at high risk for developing bacterial and fungal infections and suffering adverse outcomes from these infections. Therefore, research aiming at defining the molecular factors that modulate neutrophil effector function under homeostatic conditions and during infection is essential for devising strategies to augment neutrophil function and improve the outcomes of infected individuals. This article describes reproducible density-gradient-centrifugation-based as well as positive and negative immunomagnetic selection protocols that can be applied in any laboratory to harvest large numbers of highly enriched and highly viable neutrophils from the bone marrow of mice. In another protocol, we also present a method that combines gentle enzymatic tissue digestion with a positive immunomagnetic selection technique or fluorescence-activated cell sorting (FACS) to harvest highly pure and highly viable preparations of neutrophils directly from mouse tissues such as the kidney, the liver, or the spleen. Mouse neutrophils isolated by these protocols can be used to examine several aspects of cellular function ex vivo, including pathogen binding, phagocytosis, and killing, neutrophil chemotaxis, oxidative burst, degranulation, and cytokine production, and for performing neutrophil adoptive transfer experiments. © 2023 Wiley Periodicals LLC. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA. Basic Protocol 1: Isolation of Neutrophils from Mouse Bone Marrow Using Positive Immunomagnetic Separation Alternate Protocol 1: Purification of Neutrophils from Bone Marrow Using Negative Immunomagnetic Separation Alternate Protocol 2: Purification of Neutrophils from Bone Marrow Using Histopaque-Based Density Gradient Centrifugation Basic Protocol 2: Isolation of Neutrophils from Mouse Tissues Using Positive Immunomagnetic Separation Alternate Protocol 3: Isolation of Neutrophils from Mouse Tissues Using FACS.

Naming and shaming as a strategy for enforcing the Paris Agreement: The role of political institutions and public concern.

Enforcement is a challenge for effective international cooperation. In human rights and environmental law, along with many other domains of international cooperation, "naming and shaming" is often used as an enforcement mechanism in the absence of stronger alternatives. Naming and shaming hinges on the ability to identify countries whose efforts are inadequate and effectively shame them toward better behavior. Research on this approach has struggled to identify factors that explain when it influences state behavior in ways that lead to more cooperation. Via survey of a large (N = 910) novel sample of experienced diplomats involved in the design of the Paris Agreement, we find support for the proposition that naming and shaming is most accepted and effective in influencing the behavior of countries that have high-quality political institutions, strong internal concern about climate change, and ambitious and credible international climate commitments. Naming and shaming appears less effective in other countries, so further enforcement mechanisms will be needed for truly global cooperation. We also find that the climate diplomacy experts favor a process of naming and shaming that relies on official intergovernmental actors, in contrast with studies suggesting that NGOs, media, and other private actors are more effective at naming and shaming. We suggest that these tensions-the inability for naming and shaming to work effectively within the countries least motivated for climate action and the preference for namers and shamers that seem least likely to be effective-will become central policy debates around making cooperation on climate change more enforceable.

Exposure to ambient air pollutants is associated with an increased incidence of hyperuricemia: A longitudinal cohort study among Chinese government employees.

BACKGROUND: It is widely recognized that ambient air pollution can induce various detrimental health outcomes. However, evidence linking ambient air pollutants and hyperuricemia incidence is scarce. OBJECTIVES: To assess the association between long-term air pollution exposure and the risk of hyperuricemia. METHODS: In this study, a total of 5854 government employees without hyperuricemia were recruited and followed up from January 2018 to June 2021 in Hunan Province, China. Hyperuricemia was defined as serum uric acid (SUA) level of >420 µmol/L for men and >360 µmol/L for women or use of SUA-lowering medication or diagnosed as hyperuricemia during follow-up. Data from local air quality monitoring stations were used to calculate individual exposure levels of PM10, PM2.5, SO2 and NO2 by inverse distance weightingn (IDW) method. Cox proportional hazard model was applied to evaluate the causal relationships between air pollutant exposures and the risk of hyperuricemia occurrence after adjustment for potential confounders and meanwhile, restricted cubic spline was used to explore the dose-response relationships. RESULTS: The results indicated that exposures to PM10 (hazard ratio, HR = 1.042, 95% conficence interal, 95% CI: 1.028, 1.057), PM2.5 (HR = 1.204, 95% CI: 1.141, 1.271) and NO2 (HR = 1.178, 95% CI: 1.125,1.233) were associated with an increased HR of hyperuricemia. In addition, a nonlinear dose-response relationship was found between PM10 exposure level and the HR of hyperuricemia (p for nonlinearity = 0.158) with a potential threshold of 50.11 µg/m3. Subgroup analysis demonstrated that participants usually waking up at night and using natural ventilation were more vulnerable to the exposures of PM10, PM2.5, NO2, and SO2. CONCLUSION: Long-term exposures to ambient PM10, PM2.5 and NO2 are associated with an increased incidence of hyperuricemia among Chinese government employees.

Ganhos e Perdas na Aposentadoria e a Intenção de Empreender de Servidores do Judiciário / Gains and Losses on Retirement and Entrepreneurial Intention on Labor Court Civil Servants / Ganancias y Pérdidas en Jubilación e Intención Empresarial en Servidores del Poder Judicial del Trabajo

Este estudo objetivou identificar possíveis efeitos das atitudes em relação à aposentadoria e intenção de empreender. Participaram da pesquisa 162 servidores públicos do judiciário trabalhista, que responderem a um questionário on-line autoaplicável com escalas sobre intenção de empreender, perdas e ganhos na aposentadoria e potencial empreendedor. Um modelo de regressão múltipla hierárquica stepwise foi proposto para seleção do modelo inicial. Testes de mediação foram utilizados para testar as seguintes hipóteses: H1 - os ganhos percebidos frente a um novo começo na aposentadoria exerceriam influência positiva na intenção empreendedora; H2 - as perdas percebidas quanto aos aspectos tangíveis do trabalho exerceriam influência positiva na intenção empreendedora; H3 - Maiores níveis de oportunidade para empreender predizem maiores níveis de intenção empreendedora; e H4 - a oportunidade para empreender funcionaria como variável mediadora entre os ganhos percebidos de um novo começo e as perdas percebidas dos aspectos tangíveis do trabalho em relação ao desfecho da intenção empreendedora. Os resultados estatísticos foram satisfatórios para a amostra, corroborando as quatro hipóteses mencionadas. As atitudes positivas ou negativas sobre a aposentadoria possuem efeito sobre a intenção de empreender, sendo a oportunidade para empreender um mecanismo importante para este efeito.

This study aimed to identify possible effects of attitudes concerning to retirement and the willing to undertake. There were 162 civil servants of the labor court offices who answered a self-administered online survey with scales about the willing to undertake, losses and gains in retirement, and entrepreneurial potential. A stepwise hierarchical multiple regression model was proposed for the first model selection. Mediation tests were used to validate the following hypotheses: H1 - Perceived gains from a new start in retirement would make a positive influence on entrepreneurial intention; H2 - the perceived losses regarding to the concrete aspects of the work would make a positive influence on the entrepreneurial intention; H3 - Higher levels of opportunity for entrepreneurship predict higher levels of entrepreneurial intention and H4 - the opportunity to undertake would work as a mediating variable between the perceived gains of a new beginning and the perceived losses concerning to the concrete aspects of the work in relation to the entrepreneurial intention outcome. Statistical results were satisfactory for the sample, and therefore it validates the four hypotheses mentioned above. Positive or negative attitudes about retirement influence the intention to entrepreneur. The opportunity for entrepreneurship plays an important role to realize it.

Este estudio tuvo como objetivo identificar los posibles efectos de las actitudes hacia la jubilación y la intención de emprender. En la encuesta participaron un total de 162 funcionarios de la justicia laboral, quienes respondieron un cuestionario autoadministrado en línea con baremos sobre intención de emprender, pérdidas y ganancias en la jubilación y potencial emprendedor. Se propuso un modelo de regresión múltiple jerárquico por pasos para la selección del modelo inicial. Se utilizaron pruebas de mediación para probar las siguientes hipótesis: H1: las ganancias percibidas de un nuevo comienzo en la jubilación ejercerían una influencia positiva en la intención empresarial; H2 - las pérdidas percibidas respecto a los aspectos tangibles del trabajo ejercerían una influencia positiva en la intención emprendedora; H3 - Mayores niveles de oportunidad para emprender predicen mayores niveles de intención emprendedora y H4 - la oportunidad de emprender funcionaría como variable mediadora entre las ganancias percibidas de un nuevo comienzo, las pérdidas percibidas de los aspectos tangibles del trabajo en relación con el resultado de la intención emprendedora. Los resultados estadísticos fueron satisfactorios para la muestra, corroborando las cuatro hipótesis mencionadas. Las actitudes positivas o negativas sobre la jubilación tienen un efecto sobre la intención de emprender, siendo la oportunidad de emprender un mecanismo importante para este efecto.

Stressful Life Events, Unhealthy Eating Behaviors and Obesity among Chinese Government Employees: A Follow-Up Study.

Background: The underlying mechanisms of the relationship between stressful life events and obesity among Chinese workers are unclear. Objective: This study aimed to understand the processes and mechanisms involved in stressful life events, unhealthy eating behavior, and obesity among Chinese workers. Methods: From January 2018 to December 2019, a total of 15,921 government employees were included at baseline and they were followed-up until May 2021. Stressful life events were assessed using the Life Events Scale, and unhealthy eating behavior was assessed using four items. BMI was calculated as weight (kg) divided by height (m2) using physically measured data. Results: Overeating at each mealtime (OR = 2.21, 95%CI: 1.78-2.71) at baseline led to reports of higher risk of obesity at follow up. Eating before going to bed at night sometimes (OR = 1.51, 95%CI: 1.31-1.73) or often (OR = 3.04, 95%CI: 2.28-4.05) at baseline led to reports of higher risk of obesity at follow-up. Eating out sometimes (OR = 1.74, 95%CI: 1.47-2.07) or often (OR = 1.59, 95%CI: 1.07-2.36) at baseline led to reports of higher risk of obesity at follow-up. Stressful life events were not directly associated with obesity, but unhealthy eating behaviors, including overeating at each mealtime (ß = 0.010, 95%CI: 0.007-0.014; ß = 0.002, 95%CI: 0.001-0.004, respectively) and irregular meal timing (ß = -0.011, 95%CI: -0.015--0.008; ß = -0.004, 95%CI: -0.006--0.001, respectively), significantly mediated the associations between stressful life events at baseline and obesity at both baseline and follow-up. Conclusions: Unhealthy eating behaviors mediated the relationship between stressful life events and obesity. Interventions should be provided to workers who have experienced stressful life events and unhealthy eating behaviors.

339ª Reunião do Conselho Nacional de Saúde - 15 feb. 2023

Diplomatic response to global health challenges in recognizing patient needs: A qualitative interview study.

Background: Global health diplomacy is the applied practice of foreign affairs to further national goals that focus on health issues requiring international cooperation and collective action. We aimed to determine how international diplomats and health policy-related professionals in the EU understand the concept of health diplomacy, which impacts both diplomatic relations as well as patients' rights. Methods: In a qualitative interview study, we used a heterogeneous stratified purposeful sampling to reach participants from different countries and different practitioners from the Pyramid of Health Diplomacy: core, multi-stakeholder, and informal. Reflexive thematic analysis was used to identify the main themes. Findings: We contacted 131 practitioners of GHD, of which 37 responded, and nine agreed to be interviewed. From 11 interview questions, four main themes emerged from the analysis of the individual interview. The participants reported limited knowledge about the definition of GHD but also that they engaged in daily activities and decisions of inter-governmental bodies. They were not aware of existing special education and training for health attachés and made suggestions for improving the field and practice of GHD. They were not fully familiar with the European Charter of Patients' Rights. There was a consensus from all participants that patient rights need to improve as a fundamental right. They stressed the fact that the hospital lockdown and the right access to healthcare were impaired during the COVID pandemic. Interpretation: The role of health diplomacy in linking public health and foreign affairs is key to respecting patients' rights. Health over other interests is becoming an increasingly critical element in foreign policy. Establishing a clear career path for health attachés is necessary to foster effective global health agreements and coordination across countries.