[Occupational disease by COVID-19 in healthcare workers]. / Enfermedad de trabajo por COVID-19 en trabajadores de la salud.

Background: 1 out of 5 cases of COVID-19 in Mexico occurred in health workers, and the high risk of contagion in these workers caused absenteeism due to temporary leave from work (TLfW), as well as the need to establish qualification criteria for COVID-19 as an occupational disease (OD). There are no quantitative data about the labor population to whom this benefit has been provided, nor on the economic impact of not being qualified as OD. Objective: To estimate the prevalence of qualification of OD by COVID-19 in health workers from a tertiary care hospital (TCH). Material and methods: Descriptive, cross-sectional, and retrospective study carried out from March 2020 to April 2021, which included health workers from a TCH who had TLfW due to COVID-19 and were working 14 days before it was issued. Variables such as OD, days of TLfW, category, among others, were analyzed, as well as the economic income lost by remaining as a general disease (GD). It was used descriptive statistics. Results: A total of 654 health workers had TLfW due to COVID-19, with a prevalence of OD of 18.5%; 17 days of TLfW were granted on average. Nurses were classified with the high number of OD, and the category with the highest prevalence was cleaning and hygiene assistant (36%). 5310 days of TLfW were subsidized as GD, equivalent to $510,385.60 (Mexican pesos) that were not granted as an economic benefit to the population that did not have an OD qualification due to COVID-19. Conclusions: The prevalence of recognition of COVID-19 as OD was low; most of TLfWs were subsidized as GDs.

Introducción: 1 de cada 5 casos de COVID-19 en México se presentó en trabajadores de la salud (TS) y la alta tasa de contagio provocó ausentismo por incapacidad temporal para el trabajo (ITT), así como la necesidad de establecer criterios para calificar la COVID-19 como enfermedad de trabajo (ET). No hay datos cuantitativos sobre la población laboral a la que se le ha dado esta prestación, ni sobre el impacto económico de que no sea calificada como ET. Objetivo: estimar la prevalencia de calificación de ET por COVID-19 en trabajadores de un hospital de tercer nivel (HTC). Material y métodos: estudio descriptivo, transversal y retrospectivo llevado a cabo de marzo de 2020 a abril de 2021, que incluyó trabajadores de la salud de un HTC que generaron una ITT por COVID-19 y estaban laborando 14 días antes de su expedición. Se analizaron las variables ET, días de ITT, categoría e ingreso económico perdido al permanecer como enfermedad general (EG). Se usó estadística descriptiva. Resultados: 654 trabajadores generaron ITT por COVID-19, con una prevalencia de ET del 18.5%; se otorgaron en promedio 17 días de ITT. A enfermería se le calificó el mayor número de ET y auxiliar de limpieza e higiene tuvo mayor prevalencia de ET (36%). Se generaron 5310 días de ITT subsidiados como EG, equivalentes a $510,385.60 pesos, que no fueron otorgados como prestación económica a la población que no contó con calificación de ET por la COVID-19. Conclusiones: la prevalencia del reconocimiento de la COVID-19 como ET fue baja; más del 80% de las ITT permanecieron y fueron subsidiadas como EG.

Prevalence of Autism Spectrum Disorder in Children in Andalusia (Spain).

Autism Spectrum Disorder (ASD) is socially relevant because of its number and the intensity of the medical and socio-educational response it requires. In Andalusia, one in 70 children will be diagnosed with ASD in 2021. It is much more frequent in boys than in girls, being 5.91 times more likely to present it as a boy than as a girl. The age of diagnosis is increasingly younger, standing at 4.4 years. In more than half of primary schools and more than 75% of secondary schools there are an average of three students with ASD per school. It is necessary to develop a network of preferential care centers for students with ASD to generalize specialized care in ordinary modalities.

Human behavior in the time of COVID-19: Learning from big data.

Since the World Health Organization (WHO) characterized COVID-19 as a pandemic in March 2020, there have been over 600 million confirmed cases of COVID-19 and more than six million deaths as of October 2022. The relationship between the COVID-19 pandemic and human behavior is complicated. On one hand, human behavior is found to shape the spread of the disease. On the other hand, the pandemic has impacted and even changed human behavior in almost every aspect. To provide a holistic understanding of the complex interplay between human behavior and the COVID-19 pandemic, researchers have been employing big data techniques such as natural language processing, computer vision, audio signal processing, frequent pattern mining, and machine learning. In this study, we present an overview of the existing studies on using big data techniques to study human behavior in the time of the COVID-19 pandemic. In particular, we categorize these studies into three groups-using big data to measure, model, and leverage human behavior, respectively. The related tasks, data, and methods are summarized accordingly. To provide more insights into how to fight the COVID-19 pandemic and future global catastrophes, we further discuss challenges and potential opportunities.

A 12-month projection to September 2022 of the COVID-19 epidemic in the UK using a dynamic causal model.

Objectives: Predicting the future UK COVID-19 epidemic allows other countries to compare their epidemic with one unfolding without public health measures except a vaccine program. Methods: A Dynamic Causal Model was used to estimate key model parameters of the UK epidemic, such as vaccine effectiveness and increased transmissibility of Alpha and Delta variants, the effectiveness of the vaccine program roll-out and changes in contact rates. The model predicts the future trends in infections, long-COVID, hospital admissions and deaths. Results: Two-dose vaccination given to 66% of the UK population prevents transmission following infection by 44%, serious illness by 86% and death by 93%. Despite this, with no other public health measures used, cases will increase from 37 million to 61 million, hospital admissions from 536,000 to 684,000 and deaths from 136,000 to 142,000 over 12 months. A retrospective analysis (conducted after the original submission of this report) allowed a comparison of these predictions of morbidity and mortality with actual outcomes. Conclusion: Vaccination alone will not control the epidemic. Relaxation of mitigating public health measures carries several risks, which include overwhelming the health services, the creation of vaccine resistant variants and the economic cost of huge numbers of acute and chronic cases.

Mental Health in Elite Student Athletes: Exploring the Link Between Training Volume and Mental Health Problems in Norwegian College and University Students.

OBJECTIVES: To examine mental health problems among elite athletes in a student population, compared to the general student population, and to explore the association between weekly hours of training across mental health indicators. METHODS: Data are from a national study from 2018 of all college and university students in Norway. Participants indicated if they considered themselves to be an elite athlete, and how many hours per week they trained. Mental health problems were assessed using several well-validated questionnaires. RESULTS: Among 50,054 students, 1.3% identified themselves as elite athletes. Both male and female elite athletes had generally better mental health across most health outcomes, reporting fewer mental health problems, less loneliness, higher satisfaction with life, more positive affect, and fewer alcohol problems. Elite athletes in team sports had slightly better mental health compared to athletes of individual sports. Increased hours of weekly exercise was associated with better mental health. However, there was generally little to be gained from increasing the amount of training from 7-10 hours/week to 14+ hours per week. Female athletes who trained 14 or more hours per week reported poorer mental health across most outcome measures. CONCLUSION: This study showed that both male and female elite athletes generally had better mental health across a range of health outcomes, when compared to the general student population. The study also found a positive dose-response relationship between weekly hours of training and mental health, but also a worsening of mental health for females at the extreme end of exercise continuum. The self-report nature of this student sample means that care should be taken when generalizing to other studies of elite athletes.

THE IMPACT OF COVID-19 ON THE ORTHOPEDIC CARE SYSTEM IN A PRIVATE HOSPITAL.

OBJECTIVE: To evaluate and compare the patient flow in the emergency department and the number of surgeries performed, as well as to determine the incidence of diseases due to the impact generated by the pandemic in April, May, June, and July 2020. METHODS: This is a retrospective cross-sectional study that analyzed medical records using the TASY Phillips software. The 2019 information was compiled and served as a basis accomplish our comparative analyses. The ICD-10 was used to determine the different conditions considering the highest incidence of them. RESULTS: there was a reduction in attendance of 49.3%; the reduction in the number of surgeries was 34.39%; among the main diagnoses in decreasing order were: Pain in the Lumbar Spine (18.76%), Joint Pain (14.82%), Neck Pain (7.7%), Ankle Sprain (4.2%) and Pain in the Limb (3.54%). CONCLUSION: There was a decrease in the number of visits and the overall incidence of surgeries in our service. Level of Evidence II, Retrospective Study.

OBJETIVO: Avaliar e comparar o fluxo de pacientes no pronto-socorro e o número de cirurgias, bem como determinar a incidência das doenças pelo impacto gerado pela pandemia nos meses de abril, maio, junho e julho de 2020. MÉTODOS: Trata-se de estudo retrospectivo transversal que analisou prontuários médicos por meio do software TASY Phillips. Foram compiladas as informações do ano de 2019, que serviram como base para realizar as análises comparativas. Foi utilizado o CID-10 para determinar as diferentes afecções de maior incidência. RESULTADOS: Houve redução nos atendimentos de 49,3%; a redução do número de cirurgias foi 34,39%; os principais diagnósticos em ordem decrescente foram: dor na coluna lombar (18,76%), dor articular (14,82%), cervicalgia (7,7%), entorse de tornozelo (4,2%) e dor no membro (3,54%). CONCLUSÃO: Houve decréscimo do número de atendimentos e da incidência global de cirurgias em nosso serviço. Nível de Evidência II, Estudo Retrospectivo.

Variability in Global Prevalence of Interstitial Lung Disease.

There are limited epidemiologic studies describing the global burden and geographic heterogeneity of interstitial lung disease (ILD) subtypes. We found that among seventeen methodologically heterogenous studies that examined the incidence, prevalence and relative frequencies of ILDs, the incidence of ILD ranged from 1 to 31.5 per 100,000 person-years and prevalence ranged from 6.3 to 71 per 100,000 people. In North America and Europe, idiopathic pulmonary fibrosis and sarcoidosis were the most prevalent ILDs while the relative frequency of hypersensitivity pneumonitis was higher in Asia, particularly in India (10.7-47.3%) and Pakistan (12.6%). The relative frequency of connective tissue disease ILD demonstrated the greatest geographic variability, ranging from 7.5% of cases in Belgium to 33.3% of cases in Canada and 34.8% of cases in Saudi Arabia. These differences may represent true differences based on underlying characteristics of the source populations or methodological differences in disease classification and patient recruitment (registry vs. population-based cohorts). There are three areas where we feel addition work is needed to better understand the global burden of ILD. First, a standard ontology with diagnostic confidence thresholds for comparative epidemiology studies of ILD is needed. Second, more globally representative data should be published in English language journals as current literature has largely focused on Europe and North America with little data from South America, Africa and Asia. Third, the inclusion of community-based cohorts that leverage the strength of large databases can help better estimate population burden of disease. These large, community-based longitudinal cohorts would also allow for tracking of global trends and be a valuable resource for collective study. We believe the ILD research community should organize to define a shared ontology for disease classification and commit to conducting global claims and electronic health record based epidemiologic studies in a standardized fashion. Aggregating and sharing this type of data would provide a unique opportunity for international collaboration as our understanding of ILD continues to grow and evolve. Better understanding the geographic and temporal patterns of disease prevalence and identifying clusters of ILD subtypes will facilitate improved understanding of emerging risk factors and help identify targets for future intervention.

Nosological profile of dermatological diseases in primary health care and dermatology secondary care in Florianópolis (2016-2017).

BACKGROUND: Dermatology encompasses the management of many disorders of the skin and cutaneous appendages, making the analysis of epidemiological profiles relevant for health planning. OBJECTIVE: The study aims to describe the nosological profile of dermatological diseases in Florianopolis, analyzing the interrelation among the primary health care and dermatology services, from January 2016 to December 2017. METHOD: Descriptive study from records of medical visits from the primary health care and dermatology services, as well as records of reports issued by the teledermatology service. RESULTS: In primary health care, from 55,265 medical visits - 28,546 in 2016 and 26,719 in 2017, there was a higher prevalence of "Atopic dermatitis" (6.38%), "other disorders of skin and subcutaneous tissue" (5.10%), and "Scabies" (4.55%). In dermatology secondary care, from 19,964 visits - 10,068 in 2016 and 9626 in 2017, the most prevalent diagnoses were "Other malignant neoplasms of the skin" (14.75%) and "Skin changes due to chronic exposure to nonionizing radiation" (10.20%). STUDY LIMITATIONS: Some dermatological consultations in primary health care may have been under-registered due to the attribution of non-specific or overly broad diagnoses. CONCLUSION: This study presents different nosological profiles of skin diseases in primary health care and dermatology secondary care, reinforcing the importance of primary health care's role in the management of less complex conditions, referring more complex cases that require more specialized experience to dermatology services..

Prevalence, Characteristics, and Epidemiology of Microbial Hand Contamination Among Minnesota State Fair Attendees (2014).

Background: Many antimicrobial-resistant infections are community-acquired, yet community carriage of microorganisms by healthy individuals is poorly characterized. We assessed microorganism carriage on the hands of Minnesota State Fair attendees and explored associated factors. Methods: Minnesota State Fair attendees (in 2014) from households with ≥2 members (≥1 member being <19 years old [a child]) were eligible to participate. Participants provided biological samples via a hand plating technique and completed a questionnaire on factors potentially related to microorganism carriage. Using presumptive taxonomic identifications and disk-diffusion-determined resistance phenotypes, hand-culture isolates were classified by microbial type; types were grouped into four broad categories based on inferred pathogenicity and consistency with the skin microbiota. Descriptive statistics, X2 tests, and generalized linear mixed-effects models were used to explore associations between survey and culture data. Results: We enrolled 206 participants from 82 households during 2 days; 50% of subjects were children. Overall, 99.5% (205/206) of hand samples yielded microorganisms. Most were non-pathogenic, whether skin microbiota (98.5% of participants) or non-skin microbiota (93.2% of participants). Only 2.4% (5/206) of samples yielded antibiotic-resistant bacteria. Children were more likely than adults to carry potentially pathogenic (OR = 3.63, 95% CI: 1.66-7.93) and presumably non-pathogenic (OR = 6.61, 95% CI: 1.67-26.15) non-skin microorganisms. Conclusions: Large community gatherings can serve as efficient sites for estimating the prevalence of microorganism carriage. A small proportion of participants carried antimicrobial-resistant pathogens on their hands; most carried non-pathogenic microorganisms, and no exposures specific to the state fair were associated with microorganism carriage.

Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain.

Objective: Coronavirus disease 2019 (COVID-19) cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to increase worldwide. Although some data from pediatric series are available, more evidence is required, especially in neonates, a group with specific characteristics that deserve special attention. This study aimed to describe general and clinical characteristics, management, and treatment of postnatal-acquired (community and nosocomial/hospital-acquired) COVID-19 neonatal cases in Spain. Methods: This was a national prospective epidemiological study that included cases from a National Registry supported by the Spanish Society of Neonatology. Neonates with postnatal SARS-CoV-2 infection were included in this study. General data and infection-related information (mode and source of transmission, age at diagnosis, clinical manifestations, need for hospitalization, admission unit, treatment administered, and complementary studies performed, hospital stay associated with the infection) were collected. Results: A total of 40 cases, 26 community-acquired and 14 nosocomial were registered. Ten were preterm newborns (2 community-acquired and 8 nosocomial COVID-19 cases). Mothers (in both groups) and healthcare workers (in nosocomial cases) were the main source of infection. Hospital admission was required in 22 community-acquired cases [18 admitted to the neonatal intermediate care unit (NIMCU) and 4 to the neonatal intensive care unit (NICU)]. Among nosocomial COVID-19 cases (n = 14), previously admitted for other reasons, 4 were admitted to the NIMCU and 10 to the NICU. Ten asymptomatic patients were registered (5 in each group). In the remaining cases, clinical manifestations were generally mild in both groups, including upper respiratory airways infection, febrile syndrome or acute gastroenteritis with good overall health. In both groups, most severe cases occurred in preterm neonates or neonates with concomitant pathologies. Most of the cases did not require respiratory support. Hydroxychloroquine was administered to 4 patients in the community-acquired group and to 2 patients in the nosocomial group. Follow-up after hospital discharge was performed in most patients. Conclusions: This is the largest series of COVID-19 neonatal cases in Spain published to date. Although clinical manifestations were generally mild, prevention, treatment, and management in this group are essential.

Emergency department utilization and monetary charges in adolescents with autism spectrum disorder, intellectual disability, and a population comparison group.

Adolescents with autism spectrum disorder (ASD) and/or intellectual disability (ID) may utilize the emergency department (ED) more frequently than individuals in the general population. This study compared ED utilization and charges during adolescence among four groups of individuals: ASD-only, ASD + ID, ID-only, and a population comparison (PC) group. ED visits occurring during age 12-17 years were examined to identify non, low, and high utilizers. Logistic regression was used to compare groups on the odds of having at least one ED visit during adolescence. Generalized linear models were used to compare groups on number of ED visits and total charges, stratified by low and high ED utilization. Descriptive examination of presenting diagnoses was performed. Individuals with ID, with or without co-occurring ASD, were significantly more likely to have at least one ED visit during adolescence. Among high ED utilizers, the ID-only group had the most frequent ED visits but had significantly lower charges than the ASD-only group. Individuals with ASD-only and ASD + ID differed from the ID-only and PC groups in presenting diagnoses. No differences between groups in number of ED visits or charges were observed among low utilizers. ID, with or without ASD, increased the odds of visiting the ED during adolescence. Adolescents with ID-only had the most frequent ED visits, but individuals with ASD-only had the highest ED charges and tended to be seen for psychiatric concerns. Further research is warranted to better characterize and meet the healthcare needs of individuals with ASD and/or ID during adolescence. Autism Res 2019, 12: 1129-1138. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Frequent emergency department (ED) visits strain medical resources and are costlier than primary and urgent care. Our findings show that adolescents with intellectual disability (ID) may use the ED frequently for nonurgent conditions. Adolescents with autism spectrum disorder, without ID, use the ED less frequently but incur higher charges. Further research is needed to understand how to meet the unique needs of these populations in primary care to prevent overuse of the ED.

Ambulatory Care Sensitive Admissions in Individuals With Autism Spectrum Disorder, Intellectual Disability, and Population Controls.

Ambulatory care sensitive (ACS) admissions are those for which effective primary care can prevent the need for emergency department (ED) visits and inpatient hospitalizations, and are an indicator of primary care access. Individuals with autism spectrum disorder (ASD) and/or intellectual disability (ID) may be at higher risk for ACS admissions than individuals in the general population due to difficulty accessing primary care. The objective of this study was to compare the incidence of ACS admissions among four cohorts of individuals aged 2-24 years: ASD without co-occurring ID (ASD-only), ASD with co-occurring ID (ASD + ID), ID without ASD (ID-only), and population controls (PC). Data from ED visits and inpatient hospitalizations occurring between January 1, 2000 and December 31, 2015 were examined to identify ACS admissions. Generalized linear models were used to examine differences between cohorts on the number of ACS ED visits and inpatient hospitalizations. Results revealed the ASD + ID and ID-only cohorts had significantly higher rates of ACS inpatient hospitalizations than the PC cohort. Additionally, the ID-only cohort had higher rates of ACS ED visits than the PC cohort. The ASD-only and PC cohorts did not differ on incidence of ACS admissions. These findings suggest that presence of an ID with or without co-occurring ASD increased the risk for ACS inpatient hospitalizations, and presence of ID-only increased the risk for ACS ED visits. Future work should examine trajectories of ACS admissions over time and consider inclusion of additional characteristics that may elucidate reasons for differences in ACS admissions among these groups. Autism Res 2019, 12: 295-302 © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Preventable hospitalizations are a common indicator of problems with access to quality primary healthcare. Findings of this study suggest that individuals with intellectual disability, with or without autism spectrum disorder, have higher rates of preventable hospitalizations than the general population. Further research is needed to understand how to improve access to primary care and reduce preventable hospitalizations for this vulnerable population.

Hospitalizations in older adults from the Zona da Mata of Minas Gerais, Brazil: data from the Unified Health System, 2016­2018 / Hospitalizações em idosos da Zona da Mata de Minas Gerais, Brasil: dados do Sistema Único de Saúde, 2016­2018

INTRODUCTION: The growing older population increases proportionately the demand for hospital care due to the increase in health problems. OBJECTIVE: To estimate the prevalence and incidence of hospitalizations, and to investigate associated factors in older adults from the Zona da Mata of Minas Gerais, Brazil, between 2016-2018. Secondly, to provide a more comprehensive epidemiological overview of hospitalizations, the following were estimated: monthly hospitalization rate; hospital mortality rate; frequency of hospitalizations according to diagnosis, hospitalizations for conditions sensitive to primary care and in-hospital death; and hospital costs. METHODS: This is an ecological and descriptive-analytic study. Data were obtained from the Brazilian Hospital Information System (SIH/SUS). RESULTS: The prevalence of hospitalizations was 35.1% (31.2% in women and 39.7% in men). The monthly rate of hospitalizations was higher in older men when compared with older women (Rate-Ratio=1.35 [95% CI=1.27-1.43]) and adult men between 40­59 years (Rate Ratio=2.42 [95% CI=2.26-2.58]). The cumulative incidence of hospitalization was 144/1,000 older persons (125/1,000 women and 169/1,000 men). Factors significantly associated with hospitalizations were: male sex (PR=1.52 [95% CI=1.11-2.08]); hospitalization in surgical bed (PR=1.93 [95% CI=1.05-3.56]); absence of death (PR=1.94 [95% CI=1.03-3.65]); and hospital stay ≥15 days (PR=0.71 [95% CI=0.54 0.95]). The cost of hospitalizations was R$ 220,8 million (mean of R$ 201,700/day). CONCLUSÃO: The findings strengthen the need for preventive healthcare for the older population living in the Zona da Mata of Minas Gerais and alert managers to the substantial socioeconomic impact of hospitalizations.

INTRODUÇÃO: O crescente aumento da população idosa faz aumentar proporcionalmente a demanda por cuidados hospitalares devido ao aumento dos problemas de saúde. OBJETIVO: Estimar a prevalência e incidência de hospitalizações, e investigar fatores associados, em idosos da Zona da Mata Mineira, Brasil, entre 2016-2018. Secundariamente, com intuito de fornecer um panorama epidemiológico mais abrangente acerca das hospitalizações, foram estimadas: taxa mensal de hospitalização; taxa de mortalidade hospitalar; frequência de hospitalizações conforme o diagnóstico, internações por condições sensíveis à atenção primária (ICSAP) e óbito hospitalar; e custos hospitalares. MÉTODO: Trata-se de um estudo ecológico e descritivo-analítico. Os dados foram obtidos do Sistema de Informação Hospitalar brasileiro (SIH/SUS). RESULTADOS: A prevalência de hospitalizações em idosos foi de 35,1% (31,2% em mulheres e 39,7% em homens). A taxa mensal de hospitalização foi maior em homens idosos quando comparados com mulheres idosas (Razão-de-Taxas=1,35 [IC 95%=1,27-1,43]) e homens adultos entre 40­59 anos (Razão-de-Taxas=2,42 [IC 95%=2,26-2,58]). A incidência acumulada de hospitalização foi de 144/1.000 idosos (125/1.000 mulheres e 169/1.000 homens). Os fatores significativamente associados com as hospitalizações foram: sexo masculino (RP=1,52 [IC 95%=1,11­2,08]), internação em leito cirúrgico (RP=1,93 [IC 95%=1,05­3,56]), ausência de óbito (RP=1,94 [IC 95%=1,03-3,65]) e permanência hospitalizado ≥15 dias (RP=0,71 [IC 95%=0,54-0,95]). O custo das hospitalizações foi de R$ 220,8 milhões (média de R$ 201,7 mil/dia). CONCLUSÃO: Os resultados reforçam a necessidade de cuidados preventivos à saúde da população idosa da Zona da Mata Mineira e alertam gestores para o substancial impacto socioeconômico gerado pelas hospitalizações.

Perfil epidemiológico dos acidentes por material biológico em médicos da atenção primária em Minas Gerais, de 2012 a 2021 / Epidemiological profile of accidents involving biological material among primary health care physicians in Minas Gerais, from 2012 to 2021 / Perfil epidemiológico de accidentes por material biológico en médicos de atención primaria en Minas Gerais, de 2012 a 2021

Introdução: Os acidentes ocupacionais com material biológico representam um problema de saúde pública. A exposição ocupacional dos profissionais da saúde configura-se como um risco de transmissão de diversos patógenos. Na literatura, há carência de estudos que analisem o perfil dos acidentes com material biológico nos médicos da atenção primária. Objetivo: Buscou-se compreender o perfil epidemiológico dos acidentes com material biológico em médicos da atenção primária em Minas Gerais. Métodos: Estudo epidemiológico descritivo com análise do perfil dos acidentes com material biológico em médicos da atenção primária em Minas Gerais, utilizando dados secundários. Resultados: No período analisado, foram registrados 111 acidentes com material biológico, dos quais 54% ocorreram somente em 2020 e 2021. A maioria dos casos deu-se em mulheres (59%), e os tipos mais frequentes de exposição foram mucosa (38%) e percutânea (33%). Dos médicos, 23% não possuíam esquema vacinal contra a hepatite B completo. Em média, em 36% dos acidentes os testes sorológicos foram negativos e em 61% não foram realizados ou o campo foi ignorado/deixado em branco. Em apenas 7,2% dos casos a quimioprofilaxia foi indicada, mas ressaltam-se os registros ignorados ou em branco. Mais da metade dos acidentados não emitiu a Comunicação de Acidente de Trabalho (CAT). Conclusões: Os acidentes com material biológico predominam em médicas e nas formas de exposição mucosa e percutânea. Investimentos em medidas de biossegurança e educação permanente são necessários para prevenir casos e estimular sua notificação.

Introduction: Occupational accidents with biological material represent a public health problem. The occupational exposure of health professionals represents a risk of transmission of various pathogens. In the literature, there is a lack of studies that analyze the profile of accidents with biological material among primary health care physicians. Objective: We aimed to understand the epidemiological profile of accidents involving biological material among primary health care physicians in Minas Gerais, Brazil. Methods: Descriptive epidemiological study that analyzed the profile of accidents with biological material among primary health care doctors in Minas Gerais, using secondary data. Results: In the period analyzed, 111 accidents with biological material were recorded, of which 54% occurred only in 2020 and 2021. Most cases occurred in women (59%) and the most frequent types of exposure were mucosal (38%) and percutaneous (33%). About a quarter (23%) of physicians did not have a complete immunization record for hepatitis B. On average, in 36% of accidents serological tests were negative and in 61% they were not performed or the field was ignored/left blank. In only 7.2% of cases, chemoprophylaxis was indicated, but ignored or blank records stood out. More than half of the victims did not fill out a work accident report. Conclusions: Accidents with biological material predominate in female doctors and in forms of mucosal and percutaneous exposure. Investments in biosafety measures and permanent education are necessary to prevent cases and encourage their notification.

Introducción: Los accidentes de trabajo con material biológico representan un problema de salud pública. La exposición ocupacional de los profesionales de la salud representa un riesgo de transmisión de varios patógenos. En la literatura faltan estudios que analicen el perfil de accidentes con material biológico en médicos de atención primaria. Objetivo: Buscamos comprender el perfil epidemiológico de los accidentes con material biológico en médicos de atención primaria en Minas Gerais. Métodos: Estudio epidemiológico descriptivo con análisis del perfil de accidentes con material biológico en médicos de atención primaria en Minas Gerais, utilizando datos secundarios. Resultados: En el período analizado se registraron 111 accidentes con material biológico, de los cuales el 54% ocurrió solo en 2020 y 2021. La mayoría de los casos ocurrieron en mujeres (59%) y los tipos de exposición más frecuentes fueron mucosa (38%) y percutánea (33%). El 23% de los médicos no disponía de un calendario completo de vacunación frente a la hepatitis B. En promedio, en el 36% de los accidentes, las pruebas serológicas fueron negativas y en el 61% no se realizó o se ignoró/dejó el campo en blanco. Solo en el 7,2% de los casos se indicó quimioprofilaxis, pero destacan los registros ignorados o en blanco. Más de la mitad de las víctimas no emitieron el CAT. Conclusiones: Predominan los accidentes con material biológico en médicas y en formas de exposición mucosa y percutánea. Son necesarias inversiones en medidas de bioseguridad y educación permanente para prevenir casos e incentivar su notificación.

Estudo de violência sexual em crianças e adolescentes em Joinville, SC, 2019 / Study of sexual violence in children and adolescents in Joinville, SC,2019

A violência sexual em crianças e adolescentes constitui um problema grave de saúde pública. Objetivo: conhecer as características do agravo violência sexual contra crianças e adolescentes na cidade de Joinville em 2019. Método: estudo observacional, analítico e transversal, com abordagem quantitativa realizado com dados secundários do Serviço de Vigilância Epidemiológica, Instituto Médico Legal e denunciados na Delegacia de Polícia da Criança, Adolescente, Mulher e Idoso das vítimas de violência sexual entre 0 e 18 anos. A variável dependente foi a faixa etária. Utilizou-se na análise o teste de Qui-Quadrado e Exato de Fischer. Resultados: Foram notificados pelas três instituições 606 crianças/adolescentes. A maior prevalência foi no sexo feminino entre 10 e 14 anos. O estupro foi a violência sexual mais acometida. Houve associação entre ruptura himenal relacionada a faixa etária e entre local de ocorrência da violência sexual com a faixa etária, sendo a residência da vítima o local de maios proporção. A maior prevalência de agressores do sexo masculino entre 25 e 59 anos, sendo o pai o principal. Conclusões: Este estudo possibilitou identificar as características das crianças e adolescentes vítimas de abuso sexual que constitui um grave problema de saúde pública. A possível existência de uma subnotificação de crianças que sofreram violência sexual, assim como, a ausência do preenchimento de variáveis na ficha de notificação pode limitar a qualidade das informações para a implementação de programas de prevenção de violência infanto-juvenil.

Sexual violence against children and adolescents is a serious public health problem. Objective: to know the characteristics of sexual violence against children and adolescents in the city of Joinville in 2019. Method: observational, analytical and cross-sectional study, with a quantitative approach, carried out with secondary data from the Epidemiological Surveillance Service, Legal Medical Institute and reported at the Police Station of Police for Children, Adolescents, Women and Elderly victims of sexual violence between 0 and 18 years old. The dependent variable was age. The Chi-Square and Fischer's Exact testwere used in the analysis. Results: 606 children/adolescents were notified by the three institutions. The highest prevalence was in females between 10 and 14 years old. Rape was the most affected sexual violence. There was an association between hymenal rupture related to age group and between place of occurrence of sexual violence and age group, with the victim's residence being the place with the highest proportion. The highest prevalence of male aggressors between 25 and 59 years old, with the father being the main one. Conclusions: This study made it possible to identify the characteristics of children and adolescents victims of sexual abuse, which constitutes a serious public health problem. The possible existence of underreporting of children who havesuffered sexual violence, as well as the absence of filling out variables in the notification form, may limit the quality of information for the implementation of programs to prevent violence against children and adolescents.

Benefícios previdenciários de pescadores artesanais e marisqueiras em comunidade quilombola no Nordeste do Brasil / Social security benefits for small-scale fisherman in a quilombola community in northeastern Brazil

Resumo Introdução: a pesca artesanal e a mariscagem são consideradas atividades especiais, para fins de benefícios, no âmbito do Regime Geral de Previdência Social do Brasil. Objetivo: descrever o acesso aos benefícios previdenciários por uma população quilombola tradicional pesqueira no Nordeste do Brasil, cuja principal atividade ocupacional é a extração e beneficiamento de mariscos. Métodos: estudo transversal, descritivo, em uma comunidade da Ilha da Maré, em Salvador, Bahia, Brasil. Os dados foram coletados por meio de entrevistas, utilizando questionários padronizados. Resultados: participaram 213 pescadores artesanais e marisqueiras, 76,5% do sexo feminino. Dentre os participantes, 62,9% não recebem nenhum tipo de benefício previdenciário. Apesar de se submeter a uma jornada de trabalho exaustiva (90,9%), com exposição a substâncias químicas (83,9%), ruído (69,9%) e radiação solar (88,2%), a maioria não obtém rendimentos que garantam a subsistência familiar (79,6%). Conclusão: há um importante déficit no recebimento de benefícios previdenciários em uma população quilombola tradicional que atende aos critérios de segurados especiais. Sugere-se adequação da legislação, de forma que o acesso aos benefícios se torne mais justo para as comunidades tradicionais.

Abstract Introduction: artisanal fishing and shellfish gathering are considered special activities under the Brazilian general social security system for the purposes of social security benefits. Objective: to describe the access to social security benefits for a traditional fishing quilombola community in northeastern Brazil, whose main occupational activity is shellfish extraction and processing. Methods: a cross-sectional descriptive study conducted in a community from Ilha da Maré, Salvador, Bahia, Brazil. Results: 213 fishermen (76.5% female) participated in the study, of which 62.9% did not receive social benefits. Although most participants undergoing an exhausting working hours (90.9%), with exposure to chemicals (83.9%), noise (69.9%) and solar radiation (88.2%), the majority of them do not earn an income that guarantees their family's subsistence (79.6%). Conclusion: there is an important deficit in social security benefits access for a traditional quilombola population that meets the criteria for special insurance. Legislation must be adapted to ensure fairer access to social benefits for this population.

Sleep characteristics and excessive daytime sleepiness in adolescents and adults: results from the birth cohorts of three Brazilian cities — RPS Consortium / Características do sono e sonolência diurna excessiva em adolescentes e adultos: resultados das coortes de nascimento de três cidades brasileiras - Consórcio RPS

ABSTRACT Objective: To describe the prevalence of insufficient sleep duration, long sleep latency, terminal or maintenance insomnia, subjective sleep quality, and excessive daytime sleepiness among participants of birth cohorts conducted in three Brazilian cities, and to evaluate differences in prevalence rates within cohorts according to sociodemographic characteristics. Methods: Cross-sectional analyses involving adolescents and adults participating in four birth cohorts conducted in Ribeirão Preto (RP78 and RP94), Pelotas (PEL93) and São Luís (SL97/98). Sleep duration, latency, terminal or maintenance insomnia, and subjective sleep quality were obtained through the Pittsburgh Sleep Quality Index; and excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale. Differences in the prevalence of the outcomes were analyzed in each cohort according to sociodemographic characteristics (skin color, marital status, socioeconomic status, study and working at the time of the interview) stratified by sex. Results: Insufficient sleep duration was the most common outcome at the four cohorts, with higher frequency among men. Long latency was more frequently reported by young adult women in RP94 and PEL93 cohorts, and insomnia by women of the four cohorts, when compared to men of the same age. Women generally suffered more from excessive daytime sleepiness and evaluated the quality of their sleep more negatively than men. In addition to sex, being a student and working were associated with the largest number of outcomes in both sexes. Conclusion: Sleep disorders are more prevalent in women, reinforcing the need for greater investment in sleep health in Brazil, without disregarding gender and socioeconomic determinants.

RESUMO Objetivo: Descrever a prevalência de duração do sono, latência, insônia terminal, qualidade subjetiva do sono e sonolência diurna excessiva entre participantes de coortes de nascimentos realizadas em três cidades brasileiras, bem como avaliar as diferenças nas taxas de prevalência das coortes de acordo com características sociodemográficas. Métodos: Análises transversais envolvendo participantes de quatro coortes de nascimento realizadas em Ribeirão Preto (RP78 e RP94), Pelotas (PEL93) e São Luís (SL97). A duração, a latência, a insônia terminal e a qualidade subjetiva do sono foram obtidas por meio do Índice de Qualidade do Sono de Pittsburgh; e a sonolência diurna excessiva foi avaliada pela Escala de Sonolência de Epworth. As diferenças na prevalência dos desfechos foram analisadas em cada coorte segundo características sociodemográficas estratificadas por sexo. Resultados: A duração insuficiente do sono foi o desfecho mais comum nas quatro coortes, com maior frequência entre os homens. Latência longa foi mais frequentemente relatada por mulheres adultas jovens nas coortes RP94 e PEL93, e insônia por mulheres das quatro coortes, quando comparadas a homens da mesma idade. As mulheres geralmente sofriam mais com sonolência diurna excessiva e avaliavam a qualidade do sono de forma mais negativa do que os homens. Além do sexo, ser estudante e trabalhar estiveram associados ao maior número de desfechos em ambos os sexos. Conclusão: Os distúrbios do sono são mais prevalentes em mulheres, reforçando a necessidade de maior investimento na saúde do sono no Brasil, sem desconsiderar gênero e determinantes socioeconômicos.

Caracterização e completitude das fichas de notificação de violência contra a pessoa idosa em Niterói-RJ, 2011-2020 / Caracterización y completitud de las fichas de notificación de violencia contra las personas mayores en Niterói-RJ, 2011-2020 / Characterization and completeness of notification sheet of violence against the older adults in Niterói-RJ, 2011-2020

Objetivo: analisar o perfil da violência contra a pessoa idosa e o grau de completitude das fichas de notificação do evento em Niterói, Rio de Janeiro, Brasil. Métodos: estudo descritivo, utilizando como fonte de dados as fichas de notificação de violência obtidas do Sistema de Informação de Agravos de Notificação, 2011-2020; a análise da completitude realizou-se segundo critérios propostos pelo Ministério da Saúde. Resultados: dos 486 casos registrados, o tipo de violência mais notificada foi a violência física (48,1%), seguida das violências psicológica (22,2%) e autoprovocada (21,4%); os campos com maior grau de incompletitude corresponderam à escolaridade da vítima (32,8%) e à violência de repetição (41,5%). Conclusão: apesar do aumento das notificações no período, predominantemente de violência física, alguns campos importantes das fichas persistem com baixa completitude, o que reforça a importância do treinamento dos profissionais visando melhorar o processo de notificação e a qualidade dos dados.

Objetivo: Analizar el perfil de la violencia contra los ancianos y el grado de integridad de los formularios de notificación de eventos en Niterói, Rio de Janeiro, Brasil. Métodos: estudio descriptivo con fuente de datos las fichas de notificación de violencia obtenidas en Sistema de Información de Agravios de Notificación, 2011-2020; análisis de la exhaustividad se realizó según criterios propuestos por el Ministerio de Sanidad. Resultados: De 486 casos registrados, el tipo de violencia más notificado fue física (48,1%), seguida psicológica (22,2%) y autolesión (21,4%); campos con mayor grado de incompletitud fueron: educación de la víctima (32,8%) y reincidencia en la violencia (41,5%). Conclusiones: A pesar del aumento de notificaciones en el periodo, predominantemente violencia física, persisten algunos campos importantes con baja completitud, lo que refuerza la importancia de la capacitación de los profesionales para mejorar el proceso de notificación y la calidad de los datos.

Objective: to analyze the profile of violence against the elderly and the degree of completeness of event notification forms in Niterói, Rio de Janeiro, Brazil. Methods: this was a descriptive study having as its data source violence notification forms held on the Notifiable Health Conditions Information System for the period 2011-2020; analysis of form completeness was performed according to criteria proposed by the Ministry of Health. Results: of the 486 registered cases, physical violence was the most reported type of violence (48.1%), followed by psychological violence (22.2%) and self-harm (21.4%); the fields with the highest degree of incompleteness were victim's level of schooling (32.8%) and repeat violence (41.5%). Conclusion: despite the increase in notifications in the period, predominantly of physical violence, completeness of some of the form fields continues to be poor, which reinforces the importance of training professionals to improve the reporting process and data quality.

Autoavaliação negativa do estado de saúde entre adultos no Brasil / Negative self-assessment of health status among adults in Brazil / Autoevaluación negativa del estado de salud entre adultos en Brasil

Objetivo: Descrever a autoavaliação negativa do estado de saúde entre adultos no Brasil no período de 2011 a 2020. Método: Estudo ecológico descritivo de série temporal realizado com dados secundários oriundos da Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL). As variáveis consideradas foram: ano, região de residência, capitais, sexo, idade e escolaridade. Resultados: No período ocorreu uma redução das taxas de adultos brasileiros com autoavaliação negativa do estado de saúde. A região Norte apresentou o maior percentual de autoavaliação negativa de saúde (3,9%). A frequência de autoavaliação negativa do estado de saúde foi maior nas mulheres (4,9%), entre as pessoas na faixa etária de 65 anos ou mais e em adultos com menor escolaridade (7,5%). Conclusão: As mulheres, adultos com mais idade e com menor grau de escolaridade tem uma maior autoavaliação negativa de saúde.

Objective: To describe the negative self-assessment of health status among adults in Brazil from 2011 to 2020. Method: Descriptive ecological study of time series conducted with secondary data from the Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey (VIGITEL). The variables considered were: year, region of residence, capital, sex, age, and education. Results: In the period there was a reduction in the rates of Brazilian adults with negative self-assessment of health status. The North region presented the highest percentage of negative self-rated health (3.9%). The frequency of negative self-assessment of health status was higher in women (4.9%), among people aged 65 years or more and in adults with lower education (7.5%). Conclusion: Women, adults with older age and lower level of education have a higher negative self-rated health.

Objetivo: Describir la autoevaluación negativa del estado de salud entre adultos en Brasil de 2011 a 2020. Método: Estudio descriptivo de serie temporal ecológica realizado con datos secundarios de la Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas por Encuesta Telefónica (VIGITEL). Las variables consideradas fueron: año, región de residencia, capitales, sexo, edad y escolaridad. Resultados: Durante el período, hubo una reducción en las tasas de adultos brasileños con estado de salud autopercibido negativo. La región Norte presentó el mayor porcentaje de salud autoevaluada negativa (3,9%). La frecuencia de autoevaluación negativa del estado de salud fue mayor entre las mujeres (4,9%), entre las personas de 65 años o más y entre los adultos con menor escolaridad (7,5%). Conclusión: Las mujeres, los adultos mayores y los adultos con menor nivel educativo tienen una mayor autopercepción negativa de salud.

Notificação de COVID-19 relacionada ao trabalho: estudo descritivo sobre o perfil sociodemográfico e ocupacional, Brasil, 2020 e 2021 / Notification of work-related COVID-19: a descriptive study of sociodemographic and occupational profile, Brazil, 2020 and 2021

Resumo Objetivo: descrever as características dos casos de COVID-19 relacionados ao trabalho notificados no Brasil, em 2020 e 2021. Métodos: estudo descritivo com dados do Sistema de Informação de Agravos de Notificação (Sinan). Foram calculadas as frequências de casos segundo variáveis sociodemográficas, ocupacionais e epidemiológicas. Resultados: nos anos de 2020 e 2021, foram notificados 36.110 e 34.508 casos de COVID-19 relacionados ao trabalho, respectivamente. Considerando os dois anos, houve maior frequência de notificações de casos de indivíduos do sexo feminino (65,1%), de raça/cor da pele preta e parda (42,1%) e na faixa etária de 30 a 39 anos (32,8%). A região Nordeste concentrou 28,4% dos casos notificados. Houve emissão de comunicação de acidente de trabalho (CAT) em 13,5% dos casos notificados, com elevada proporção de informação ausente para essa variável (42,6%). As categorias ocupacionais com mais notificações foram técnicos de nível médio (31,0%) e profissionais de ciências e artes (23,7%). A evolução cura foi a mais frequente nos dois anos analisados (2020: 72,0%; 2021: 68,0%). Conclusão: os resultados apontam para um perfil de casos com predominância de mulheres, trabalhadores(as) de raça/cor da pele preta e parda e com idades entre 30 e 39 anos. Destaca-se, ainda, a baixa completude das notificações.

Abstract Objective: to describe the characteristics of work-related COVID-19 cases reported in Brazil between 2020 and 2021. Methods: descriptive study using secondary data collected from the Brazilian Notifiable Diseases Information System (SINAN). Frequency was calculated according to sociodemographic, occupational and epidemiological variables. Results: in the years 2020 and 2021, a total of 36,110 and 34,508 work-related COVID-19 cases were reported, respectively. Considering both years, there was a higher frequency of notifications for female individuals (65.1%), black and mixed-race (42.1%), from the age group 30 to 39 years (32.8%). The Northeast region accounted for 28.4% of the reported cases. Work Accident Report (CAT) was issued in 13.5% of the reported cases, with a high percentage of missing information for this variable (42.6%). Middle-level technicians (31.0%) and professionals in sciences and the arts (23.7%) accounted for most notifications. Cure was the most prevalent outcome in both years (2020: 72.0%; 2021: 68.0%). Conclusion: the results point to a predominant profile of cases among women, black and mixed-race individuals, and those aged between 30 and 39 years. The low completeness of notifications is noteworthy.