RESUMEN
AIM: To assess the efforts made in Romania towards achieving the Goal 4 from MDGs--Reduce Child Mortality. MATERIALS AND METHODS: A descriptive study about the deaths among Romanian children under five, between 2002 and 2015, from the perspective of the MDGs. To help track progress toward this commitment, following specific targets and indicators were developed: Target 1-Halve the mortality rate in children aged 1-4 years between 2002-2015; Target 2--Reduce infant mortality by 40% between 2002 and 2015; Target 3--Eliminate measles by 2007. The comparison allows establish the status (achieved or not) for each target. RESULTS: From 2002, the under-five mortality rate recorded a continuous descendent trend till now (20.8 to 10.3 under five deaths per 1000 inhabitants in 2013). The infant mortality rates declined from 17.3 to 8.5 deaths per 1,000 live births (2002-2013). Eliminating measles by 2007--was achieved one year later, because of the measles epidemic in 2005 and 2006. High vaccination rates have been maintained, with the proportion of children 1 year old vaccinated against measles reaching and being maintained at between 94-98%. CONCLUSIONS: Substantial progress has been made in Romania, in achieving the Millennium Development Goal no. 4. All the three targets were achieved. However, infant mortality still remains above the average of European Union (4 infant deaths per 1,000 live-births).
Asunto(s)
Mortalidad del Niño/tendencias , Salud Global/tendencias , Promoción de la Salud , Mortalidad Infantil/tendencias , Niño , Preescolar , Femenino , Salud Global/estadística & datos numéricos , Promoción de la Salud/tendencias , Humanos , Lactante , Recién Nacido , Masculino , Sarampión/prevención & control , Vacuna Antisarampión , Rumanía , Naciones Unidas , VacunaciónRESUMEN
AIM: To identify the factors that may conduct to various forms of social exclusion of the population from the primary healthcare and to analyze health disparities as population-specific differences in the access to primary healthcare in rural compared to urban residence areas from Iasi, the second biggest county, situated in the North--East region of Romania. MATERIALS AND METHODS: This research is a type of inquiry-based opinion survey of the access to primary healthcare in rural compared to urban areas of the county of Iasi. Data were collected by face-to-face interviews. There were taken into account the socioeconomic status (education level in the adult population, employment status, family income, household size) and two temporal variables (the interval of time spent to arrive at the primary healthcare office as a marker for the geographical access and the waiting time for a consultation). The study group consisted of two samples, from rural and urban area, each of 150 patients, all ages, randomly selected, who were waiting at the family doctor's practice. RESULTS: The study has identified disparities related to a poor economic status assessed through the employed status ("not working" 15% in urban and of 20% in rural).The income calculated per member of family and divided in terciles has recorded significant differences for "high" (36.7% urban and 14.7% rural) and "low", respectively (14.6% urban and 56.6% rural). High household size with more than five members represented 22.6% of the total subjects in rural and 15.3% in urban areas. The assessment of the education level in the adult population (> 18 years) revealed that in the rural areas more than a half (56%) of the sample is placed in the category primary and secondary incomplete, whereas the value for secondary complete and postsecondary was 37.3%. The proportion of respondents in the urban areas who have post-secondary education is five times higher than those in rural areas (15.4% vs. 2.7%). The reduced geographical access assessed as the interval of time spent to arrive at the primary healthcare office revealed, on average, 25 minutes in urban versus 75 minutes in rural areas. CONCLUSIONS: The research outcomes highlight the fact that the population living in rural communities from the county of Iasi, are disadvantaged in accessing the primary health services, with negative consequences on the health status.
Asunto(s)
Disparidades en Atención de Salud/estadística & datos numéricos , Pobreza , Atención Primaria de Salud/estadística & datos numéricos , Población Rural , Población Urbana , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Países en Desarrollo , Empleo , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Encuestas Epidemiológicas , Humanos , Lactante , Masculino , Persona de Mediana Edad , Pobreza/estadística & datos numéricos , Factores de Riesgo , Rumanía , Población Rural/estadística & datos numéricos , Tiempo de Tratamiento/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Poblaciones VulnerablesRESUMEN
UNLABELLED: A great physical effort associated with work during night shifts can lead to negative effects on the worker's health. THE AIM of our study is to evaluate the risk of associating great physical effort with night shifts in hypertensive patients. MATERIAL AND METHODS: We have studied 2 groups of hypertensive patients, each group being consisted of 20 male patients, age 30 to 50, that have been diagnosed with mild hypertension during the periodical medical exam, group I being consisted of subjects that performed great physical effort, and their work program implied night shifts. Group II consisted of workers that performed work that implied mild effort during day shifts. RESULTS AND DISCUSSIONS: At the end of the 2 year study period, 8 patients from group I (great physical effort associated with night shifts) developed a severe increase in blood pressure (beyond 160/100 mmHg), as well as an increase in basal cardiac frequency, whilst only one patient from group II presented such modifications. CONCLUSIONS: Night shift work associated with great physical effort can lead to a significant rise in blood pressure and heart rate, all the more if the subject suffers from hypertension thus predisposing the patients to coronary events.
Asunto(s)
Presión Sanguínea , Frecuencia Cardíaca , Hipertensión/fisiopatología , Admisión y Programación de Personal , Esfuerzo Físico , Trastornos del Sueño del Ritmo Circadiano , Adulto , Monitoreo Ambulatorio de la Presión Arterial , Humanos , Hipertensión/diagnóstico , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Tolerancia al Trabajo ProgramadoRESUMEN
AIM: To identify the occupational risks in an ambulance service and to assess their impact on the health of employees. MATERIAL AND METHODS: Two marched groups (number, sex, age, length of exposure) from two different work sectors were selected. A 60 item questionnaire was used. The 60 items were grouped into four categories related to work organization, work environment, neuropsychosensorial risk factors and health system and occupational safety-related risk factors and hazards. The data were statistically processed, significant correlations between the risk factors and the associated symptoms being found. RESULTS AND DISCUSSION: Compared to the control group, significantly higher values (p<0.001) for work complexity, work environment factors, and organizational risk factors (walking on uneven ground, carrying weight, vicious postures) were found in ambulance service staff; cervical and lumbar spine problems were the most common complaints of ambulance service staff. CONCLUSION: The specific risk factors for ambulance service employees directly related to musculoskeletal disorders have been established.
Asunto(s)
Ambulancias , Enfermedades Musculoesqueléticas/etiología , Enfermeras y Enfermeros/estadística & datos numéricos , Enfermedades Profesionales/etiología , Exposición Profesional/efectos adversos , Médicos/estadística & datos numéricos , Adulto , Estudios de Casos y Controles , Servicios Médicos de Urgencia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Musculoesqueléticas/psicología , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/psicología , Prevalencia , Factores de Riesgo , Rumanía/epidemiología , Encuestas y Cuestionarios , Lugar de Trabajo/psicologíaRESUMEN
AIM: To identify the key favorable issues, showing a high degree of job satisfaction, and also the adverse issues that may affect the work performance among medical assistants. MATERIAL AND METHODS: This research is a type of inquiry-based opinion survey carried out by administering a self-managed, anonymous questionnaire, consisting of five sections with 25 items. The study group included 175 medical assistants from all specialties, working in public hospitals in the city of Iasi, who answered the questionnaires. A number of 167 subjects have responded, the return rate being of 95.4%. The respondents were asked to indicate the amount of agreement or disagreement on a typical five-level Likert scale. RESULTS: The study has identified some positive aspects: positive perception of the medical assistant profession (76.6%); concern about personal growth and career development (86.3%); good rel ationships established with other colleagues (71.2%), and some negative aspects: inappropriate work conditions and equipments (70%); the income compared to the volume of work was perceived by majority as an important source of dissatisfaction (80.8%); willingness to work abroad (53.9%). CONCLUSIONS: The findings of the present research focused on the variables of job satisfaction in the medical assistant profession and should be a real concern for managers, because the job dissatisfaction may affect the employee's productivity.
Asunto(s)
Satisfacción en el Trabajo , Enfermeras y Enfermeros/psicología , Reorganización del Personal , Salarios y Beneficios , Carga de Trabajo/psicología , Adulto , Femenino , Hospitales Públicos/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Motivación , Enfermeras y Enfermeros/estadística & datos numéricos , Personal de Enfermería en Hospital/psicología , Reorganización del Personal/estadística & datos numéricos , Rumanía/epidemiología , Salarios y Beneficios/estadística & datos numéricos , Muestreo , Encuestas y Cuestionarios , Carga de Trabajo/estadística & datos numéricos , Lugar de Trabajo/psicologíaRESUMEN
UNLABELLED: The objective of this paper is to study the association occupation-cardiovascular diseases in a clinic of occupational diseases from Rehabilitation University Hospital, Iasi, Romania. MATERIAL AND METHODS: The survey represents a descriptive analysis of 2003-2007 data regarding the 1771 first admitted and new diagnosed patients. The association between occupation and cardiovascular diseases was assessed using odds ratio (point estimate and 95% confidence interval). RESULTS: A special attention must be paid for smoking reduction among miners (specific prevalence 67.86 per 100 patients) and for overweight in administrative staff (54.32 cases with body mass index >30 kg/m2 per 100 inpatients). The most significant and strong association between occupational status--cardiovascular diseases has been recorded in administrative staff (ischaemic heart--odds ratio = 12.47; hypertensive heart disease--odds ratio =2.49) and in civil engineering (ischaemic heart disease- odds ratio = 3.12; hypertensive heart disease--odds ratio = 1.81). CONCLUSIONS: Activities in cardiovascular disease prevention should focus on those occupational sectors where cardiovascular risks are most prevalent. Early diagnosis of cardiovascular diseases in connection with risk factors may prevent a premature death, affecting workforce, with medical and socio-economical consequences. Cooperation between general practitioner-occupational diseases specialist-cardiologist may improve the efficiency of prevention programs.
Asunto(s)
Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Pacientes Internos/estadística & datos numéricos , Enfermedades Profesionales/complicaciones , Enfermedades Profesionales/prevención & control , Adulto , Anciano , Índice de Masa Corporal , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Intervalos de Confianza , Diagnóstico Precoz , Femenino , Encuestas Epidemiológicas , Hospitales Universitarios , Humanos , Hipertensión/etiología , Hipertensión/prevención & control , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/etiología , Isquemia Miocárdica/prevención & control , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/epidemiología , Oportunidad Relativa , Sobrepeso , Centros de Rehabilitación , Factores de Riesgo , Rumanía/epidemiología , Fumar/efectos adversos , Lugar de Trabajo/estadística & datos numéricosRESUMEN
UNLABELLED: The objective of this paper is to study the hospitalized morbidity for cardiovascular diseases in connection with risk factors in a clinic of occupational diseases from Rehabilitation University Hospital, Iasi, Romania. MATERIAL AND METHODS: The survey represents a descriptive analysis of 2003-2007 data regarding the 1771 first admitted and new diagnosed inpatients. The association between risk factors and cardiovascular diseases was assessed using odds ratio (point estimate and 95% confidence interval). RESULTS: Blood hypertension has been diagnosed in 9.20 cases per 100 inpatients and ischemic heart disease in 1.98 cases per 100 inpatients. The prevalence increased with age for both diseases. One in five cases was smoker and had vascular family records. In blood hypertension the odds ratio revealed an increased risk with the exposure for following factors: male gender, smoker status, vascular family records, obesity assessed through body mass index > 30 kg/m2, age > 45 years in male, age > 55 years in female (p < 0.05). The ischemic heart disease was significant associated only with family records and age > 55 years in female. Most of these cases diagnosed in the occupational diseases clinic represent active workforce (47.96 +/- 8.82 years). CONCLUSION: Early diagnosis of cardiovascular diseases in connection with risk factors may prevent a premature death, affecting workforce, with medical and socio-economical consequences. Cooperation between general practitioner-occupational diseases specialist-cardiologist may improve the efficiency of prevention programs.
Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Pacientes Internos/estadística & datos numéricos , Enfermedades Profesionales/epidemiología , Adulto , Distribución por Edad , Índice de Masa Corporal , Enfermedades Cardiovasculares/diagnóstico , Diagnóstico Precoz , Femenino , Encuestas Epidemiológicas , Humanos , Hipertensión/epidemiología , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/epidemiología , Obesidad/complicaciones , Enfermedades Profesionales/diagnóstico , Oportunidad Relativa , Prevalencia , Factores de Riesgo , Rumanía/epidemiología , Distribución por Sexo , Fumar/efectos adversosRESUMEN
The development of the European schedule of the occupational diseases has the aim to harmonize the data from all Member States. For this purpose European Agency for Safety and Health at work recommends for all the Member States to progressively make their statistics concerning occupational diseases, compatible with European schedule, in order to evaluate the incidence of the recognised occupational diseases and to define quantified criteria for the recognising each occupational disease. The presented data allude to the incidence of the recognised occupational diseases for the first time in 2001, supposed reference year, and to the deaths due to occupational diseases. The used indicators were the number and incidence rate of occupational diseases by sex, age, economic activity, occupation and causative agents, workplaces, exposed professions.
Asunto(s)
Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Salud Laboral , Adolescente , Adulto , Anciano , Asbestosis/epidemiología , Asma/epidemiología , Dermatitis Profesional/epidemiología , Unión Europea , Femenino , Agencias Gubernamentales , Pérdida Auditiva/epidemiología , Humanos , Incidencia , Masculino , Mesotelioma/epidemiología , Persona de Mediana Edad , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Profesionales/etiología , Enfermedades Profesionales/mortalidad , Enfermedades Profesionales/prevención & control , Exposición Profesional/legislación & jurisprudencia , Salud Laboral/legislación & jurisprudencia , Neoplasias Pleurales/epidemiología , Formulación de Políticas , Enfermedad de Raynaud/epidemiología , Rumanía/epidemiologíaRESUMEN
The stress is defined as a self perceived negative or unpleasant impact. Distress is reserved for the experience of specific symptoms such as anxiety or depression. The term stressor covers some environmental circumstances directly or indirectly affecting the individual. As Selye has suggested, we must remember that stress is the great equalizer of biological activities. If we use the same parts of our bodies or minds over and over again, nature has only stress with which to face us out of the routine. As a consequence, unhealthy levels of stress lead to a variety of disorders and illness.
Asunto(s)
Estado de Salud , Trastornos Psicofisiológicos/psicología , Estrés Psicológico/complicaciones , Ansiedad/psicología , Depresión/psicología , Humanos , Acontecimientos que Cambian la Vida , Calidad de Vida , Trastornos por Estrés Postraumático/psicologíaRESUMEN
The objective of this article is to present a series of 12 cases with the chronic lead poisoning produced after a short but intensive professional exposure (in average 12-14 hours per day, 41.6 days) at mineral dust and oxides containing lead (technical revision of a oven and of a furnace network by mechanical and welding operation). After the first case with saturnine colic, all the workers of the same team (n=12) were hospitalised (average time was of 14 days) with clinical examination and by specific toxicological indicators. Particularly, for clinical picture were uncharacteristic and oligosymptomatic complaints. Occupational exposure was augmented by the level of Pb-blood (46.8-286 mg/100 ml are ranges), Pb-urine (221-637 mg/l are ranges), d-aminolevulinic urinary acid (22.9-99.1 mg/l are ranges) and increased urinary coproporphyrins (+ +, + + +) exceeding biological limits and high urinary discharge of lead induced by CaNa2-EDTA treatment. The biological effects of lead intoxication consist in the occurrence of stippled basophilic erythrocytes (2 cases with 46,000/1 mil erythrocytes), the anemia (only 4 cases with haematocrit L 40%) and the liver cytolytic syndrome (the increase of GPT, GOT and of g-GT). These changes and the polyneuropathic syndrome (the decrease of motor and sensitive speed velocity) were judged by toxic combination between ethanol and lead.