The Chinese version of the Computer Vision Syndrome Questionnaire: translation and cross-cultural adaptation.

BACKGROUND: The Spanish version of the Computer Vision Syndrome Questionnaire (CVS-Q©) is a validated instrument, with good psychometric properties, to measure Computer Vision Syndrome (CVS) in workers using Video Display Terminals (VDTs). To date, there are no known valid instruments in Chinese for the assessment of CVS despite the high exposure to VDTs at work that this population presents. For this, the purpose of this study is to translate and cross-culturally adapt the CVS-Q© into Chinese. METHODS: A study with five consecutive stages: direct translation, synthesis of translations, back translation, consolidation by a committee of experts, and pre-test. During the pre-test, a cross-sectional pilot study was conducted on VDT users (n = 44) who completed the Chinese version of the questionnaire plus an ad hoc post-test to assess the comprehensibility of the scale and to verify aspects of its applicability and feasibility. Data concerning sociodemographic information, general and ocular health, use of optical correction and varying exposure to VDTs was also collected. RESULTS: The entire sample considered the Chinese version of the CVS-Q© simple, clear, and easy to understand and 95.5% also found it easy to complete. 88.7% considered that the scale did not need any improvement. The final version of the Chinese scale to measure CVS was obtained (the CVS-Q CN©). The mean age of participants was 31.3 ± 9.8 years, 47.6% were women, and 57.1% used VDTs to work for more than 8 h/day. CONCLUSIONS: The CVS-Q CN© can be considered an easy tool to assess CVS in workers exposed to digital devices in China. This version would facilitate research, its use in clinical practice, and the prevention of occupational hazards in the workplace.

Randomised controlled trial of an accommodative support lens designed for computer users.

PURPOSE: Accommodative support (AS) lenses are a low add progressive addition spectacle lens designed to ease symptoms in computer vision syndrome (CVS). The study aims to investigate if (1) AS lenses improve CVS symptoms; (2) binocular/accommodative functions predict a benefit from AS lenses and (3) wearing AS lenses for six months impacts on binocular/accommodative functions. METHODS: Pre-presbyopic adults with symptoms of CVS (Computer Vision Syndrome Questionnaire, CVS-Q© , score ≥ 6) were randomly allocated to wear AS lenses or control single vision (SV) lenses. The CVS-Q© and a battery of optometric tests were applied at baseline and after three and six months. Participants and researchers were masked to participant group. After six months, the SV group were unmasked and changed to AS lenses and one week later asked to choose which they preferred. RESULTS: The change in CVS-Q© scores from baseline to six months did not differ significantly in the two groups. At the end of the one week period, when the control group wore the AS lenses, control group participants were significantly more likely to prefer AS lenses to SV lenses. No optometric functions correlated with the benefit from AS lenses. AS lenses did not have any adverse effects on binocular or accommodative function. CONCLUSIONS: In pre-presbyopic adults, there was no greater improvement in CVS-Q© scores in the group wearing AS lenses than in the control group. No adverse effects on optometric function (including accommodation) are associated with wearing AS lenses.

Translation, cross-cultural adaptation and validation of the Computer Vision Syndrome Questionnaire into Persian (CVS-Q FA©).

PURPOSE: To translate, cross-culturally adapt and validate the Computer Vision Syndrome Questionnaire (CVS-Q©) into Persian. METHODS: This study was carried out in 2 phases: (1) the CVS-Q© was translated and cross-culturally adapted into Persian and (2) the validity and reliability of CVS-Q FA© were assessed in a cross-sectional validation study. An expert committee composed of 15 optometrists evaluated content validity (item-level (I-CVI) and scale-level (S-CVI) content validity index were calculated). A pretest was performed (n = 20 participants) to verify the comprehensibility of the questionnaire. A total of 102 computer users completed the final questionnaire. Criterion validity and diagnostic performance of the CVS-Q FA© were assessed by calculating sensitivity, specificity and receiver characteristic operator curve. Cronbach's alpha was calculated for the assessment of internal consistency and 46 participants refilled the questionnaire for the second time and the interclass correlation coefficient (ICC) and Cohen's kappa (κ) were evaluated for test-retest reliability. RESULTS: The translation and cross-cultural adaptation process was performed successfully according to accepted scientific recommendations without any major difficulties. The I-CVI was above 0.80 for all items (symptoms) except item 15 (feeling that sight is worsening) and the S-CVI was 0.92. The CVS-Q FA© showed good sensitivity (81.1%) and acceptable specificity (69.2%). Also, it achieved good internal consistency (Cronbach's alpha = 0.80) and test-retest reliability (ICC = 0.81 and κ = 0.65). CONCLUSION: The CVS-Q FA© was successfully translated, cross-culturally adapted, and validated into Persian. This study provides a valid and reliable tool for the assessment of computer vision syndrome among the Iranian working population.

Labour trafficking: Challenges and opportunities from an occupational health perspective.

In this essay for the collection on Human Trafficking, Exploitation, and Health, Elena Ronda-Perez and colleague discuss ways occupational health services can detect and address labour trafficking.

Comparison of menstrual disorders in hospital nursing staff according to shift work pattern.

AIM AND OBJECTIVE: To assess the association between work in a rotating shift schedule and menstruation characteristics among nurse staff in a prospective study. BACKGROUND: Rotating shifts have been linked to alterations in the reproductive cycle. In the case of menstrual alterations, the conclusions are not clear. DESIGN: Prospective epidemiological study with follow-up over four months. METHOD: All the female nurse staff (<40 years) in a hospital were interviewed, collecting sociodemographic and employment information. They were given a menstrual diary to keep a record of their shifts and characteristics of their menstruation (duration, amount of blood, dysmenorrhoea). They had two types of shifts: (1) Rotating shift schedule (two mornings, two afternoons, one night and two days off) including morning shifts (8:00-15:00), afternoon/evening shifts (15:00-22:00) and night shifts (22:00-8:00), and (2) Day shift schedule including morning shifts (8:00-15:00) and/or afternoon/evening shifts (15:00-22:00). The crude and adjusted odds ratios with 95% confidence interval were calculated using logistic generalised estimating equations (GEE) taking into account the correlations of multiple cycles per worker. RESULTS: One hundred and thirteen workers on the rotating shift and 75 on the day shift participated, and information from 730 menstrual cycles were obtained. There were no differences in prolonged duration, dysmenorrhoea, prolonged duration dysmenorrhoea and excessive bleeding among nurses on rotating shift compared to those on the day shift. For prolonged duration of menstruation, workers with more than five years on the rotating shift showed a slightly lower (nonsignificant) risk compared with those with <5 years. CONCLUSIONS: Nurse staff on the rotating shift did not show increased risk of having menstrual disorders comparing with day staff. RELEVANCE TO CLINICAL PRACTICE: Shifts with short rotation cycles and a progressive sequence do not appear to cause menstrual disorders in nurse staff who work rotating shifts.

Is health a right for all? An umbrella review of the barriers to health care access faced by migrants.

OBJECTIVE: To synthesise the scientific evidence concerning barriers to health care access faced by migrants. We sought to critically analyse this evidence with a view to guiding policies. DESIGN: A systematic review methodology was used to identify systematic and scoping reviews which quantitatively or qualitatively analysed data from primary studies. The main variables analysed were structural and contextual barriers (health system organisation) as well as individual (patients and providers). The quality of evidence from the systematic reviews was critically appraised. From 2674 reviews, 79 were retained for further scrutiny, and finally 9 met the inclusion criteria. RESULTS: The structural barriers identified were the lack of health insurance and the high cost of drugs (non-universal health system) and organisational aspects of health system (social insurance system and national health system). The individual barriers were linguistic and cultural. None of the reviews provided a quality appraisal of the studies. CONCLUSIONS: Barriers to health care for migrants range from entitlement in non-universal health systems to accessibility in universal ones, and determinants of access to the respective health services should be analysed within the corresponding national context. Generate social and institutional changes that eliminate barriers to access to health services is essential to ensure health for all.

[Fibromyalgia patients' perceptions of the impact of the disease in the workplace]. / Percepciones de pacientes con fibromialgia sobre el impacto de la enfermedad en el ámbito laboral.

OBJECTIVE: To explore the perceptions of patients with fibromyalgia (FM) on the problems they experience in the workplace, to discuss how they face and adapt to the limitations imposed by the symptoms of this disease. DESIGN: An exploratory qualitative study conducted in 2009. LOCATION: Associations of patients of FM from Valencia (Spain). PARTICIPANTS: Sixteen patients (13 women and 3 men) diagnosed with FM by a rheumatologist, of different ages and occupations, selected from key informants and the snowball technique. METHOD: Pragmatic sample. Semi-structured interviews until saturation of information when no new information emerged. Qualitative content analysis using the software Atlas.ti-5, to generate and assign codes, forming categories and identifying a latent theme. RESULTS: We identified four categories: difficulties in meeting the work demands, need for social support in the workplace, strategies adopted to continue working, and resistance to leave the employment. A theme which crosscut these categories emerged: FM patients motivation to continue in the labour market. CONCLUSIONS: Addressing the specific needs of patients it is essential in order to helping them to stay in the labour market, according to their capabilities. Awareness programs about the consequences of FM in the workplace are needed to achieve the collaboration of managers, entrepreneurs, occupational health professionals and primary care physicians and nurses.

Effectiveness of mRNA booster doses in preventing infections and hospitalizations due to SARS-CoV-2 and its dominant variant over time in Valencian healthcare workers, Spain.

OBJECTIVE: This study aimed to evaluate the effectiveness of SARS-CoV-2 mRNA vaccines in preventing infection and hospitalization among healthcare workers (HCWs) in the Valencian Community (Spain), considering vaccination timing, dose number, and predominant variant. METHODS: A test-negative case-control design estimated vaccine effectiveness against symptomatic disease and hospitalization due to SARS-CoV-2. HCWs who underwent PCR or antigen testing for SARS-CoV-2 from January 2021 to March 2022 were included. Cases had a positive diagnostic test, while controls had negative tests. Adjusted vaccine effectiveness (aVE) was calculated using the formula: aVE = (1 - Odds ratio) × 100. RESULTS: During the Delta variant's predominance, aVE against infection within 12-120 days post-second dose was 64.8 % (BNT162b2) and 59.4 % (mRNA-1273), declining to 21.2 % and 42.2 %, respectively, after 120 days. For the Omicron variant, aVE within 12-120 days post-second dose was 61.1 % (BNT162b2) and 85.1 % (mRNA-1273), decreasing to 36.7 % and 24.9 %, respectively, after 120 days. After a booster dose of mRNA-1273, aVE was 64.0 % (BNT162b2 recipients) and 65.9 % (initial mRNA-1273 recipients). Regardless of variant, aVE for hospitalization prevention after 2 doses was 87.0 % (BNT162b2) and 89.0 % (mRNA-1273). CONCLUSION: The administration of two doses of Moderna-mRNA-1273 against SARS-CoV-2 in HCWs proved to be highly effective in preventing infections and hospitalizations in the first 120 days after the second dose during the predominance of the Omicron variant. The decline in VE after 120 days since the administration of the second dose was significantly restored by the booster dose administration. This increase in VE was greater for the Pfizer vaccine. COVID-19 hospitalization prevention remained stable with both mRNA vaccines throughout the study period.

Gender inequalities in occupational health related to the unequal distribution of working and employment conditions: a systematic review.

INTRODUCTION: Gender inequalities exist in work life, but little is known about their presence in relation to factors examined in occupation health settings. The aim of this study was to identify and summarize the working and employment conditions described as determinants of gender inequalities in occupational health in studies related to occupational health published between 1999 and 2010. METHODS: A systematic literature review was undertaken of studies available in MEDLINE, EMBASE, Sociological Abstracts, LILACS, EconLit and CINAHL between 1999 and 2010. Epidemiologic studies were selected by applying a set of inclusion criteria to the title, abstract, and complete text. The quality of the studies was also assessed. Selected studies were qualitatively analysed, resulting in a compilation of all differences between women and men in the prevalence of exposure to working and employment conditions and work-related health problems as outcomes. RESULTS: Most of the 30 studies included were conducted in Europe (n=19) and had a cross-sectional design (n=24). The most common topic analysed was related to the exposure to work-related psychosocial hazards (n=8). Employed women had more job insecurity, lower control, worse contractual working conditions and poorer self-perceived physical and mental health than men did. Conversely, employed men had a higher degree of physically demanding work, lower support, higher levels of effort-reward imbalance, higher job status, were more exposed to noise and worked longer hours than women did. CONCLUSIONS: This systematic review has identified a set of working and employment conditions as determinants of gender inequalities in occupational health from the occupational health literature. These results may be useful to policy makers seeking to reduce gender inequalities in occupational health, and to researchers wishing to analyse these determinants in greater depth.

Patients' and professionals' views on managing fibromyalgia.

BACKGROUND: Managing fibromyalgia is a challenge for both health care systems and the professionals caring for these patients, due, in part, to the fact that the etiology of this disease is unknown, its symptoms are not specific and there is no standardized treatment. OBJECTIVE: The present study examines three aspects of fibromyalgia management, namely diagnostic approach, therapeutic management and the health professional-patient relationship, to explore specific areas of the health care process that professionals and patients may consider unsatisfactory. METHODS: A qualitative study involving semistructured interviews with 12 fibromyalgia patients and nine health professionals was performed. RESULTS: The most commonly recurring theme was the dissatisfaction of both patients and professionals with the management process as a whole. Both groups expressed dissatisfaction with the delay in reaching a diagnosis and obtaining effective treatment. Patients reported the need for greater moral support from professionals, whereas the latter often felt frustrated and of little help to patients. Patients and professionals agreed on one point: the uncertainty surrounding the management of fibromyalgia and, especially, its etiology. CONCLUSION: The present study contributes to a better understanding regarding why current management of fibromyalgia is neither effective nor satisfactory. It also provides insight into how health professionals can support fibromyalgia patients to achieve beneficial results. Health care services should offer greater support for these patients in the form of specific resources such as fibromyalgia clinics and health professionals with increased awareness of the disease.

Welfare state regimes and gender inequalities in the exposure to work-related psychosocial hazards.

BACKGROUND: Gender inequalities in the exposure to work-related psychosocial hazards are well established. However, little is known about how welfare state regimes influence these inequalities. OBJECTIVES: To examine the relationship between welfare state regimes and gender inequalities in the exposure to work-related psychosocial hazards in Europe, considering occupational social class. METHODS: We used a sample of 27, 465 workers from 28 European countries. Dependent variables were high strain, iso-strain, and effort-reward imbalance, and the independent was gender. We calculated the prevalence and prevalence ratio separately for each welfare state regime and occupational social class, using multivariate logistic regression models. RESULTS: More female than male managers/professionals were exposed to: high strain, iso-strain, and effort-reward imbalance in Scandinavian [adjusted prevalence ratio (aPR) = 2·26; 95% confidence interval (95% CI): 1·87-2·75; 2·12: 1·72-2·61; 1·41: 1·15-1·74; respectively] and Continental regimes (1·43: 1·23-1·54; 1·51: 1·23-1·84; 1·40: 1·17-1·67); and to high strain and iso-strain in Anglo-Saxon (1·92: 1·40-2·63; 1·85: 1·30-2·64; respectively), Southern (1·43: 1·14-1·79; 1·60: 1·18-2·18), and Eastern regimes (1·56: 1·35-1·81; 1·53: 1·28-1·83). CONCLUSION: Gender inequalities in the exposure to work-related psychosocial hazards were not lower in those welfare state regimes with higher levels of universal social protection policies.

Juggling during Lockdown: Balancing Telework and Family Life in Pandemic Times and Its Perceived Consequences for the Health and Wellbeing of Working Women.

The COVID-19 pandemic disrupted work-family balance due to lockdown measures. The aim of this study was to explore the experiences of working mothers in Spain and the consequences of trying to balance work and family for their health and wellbeing. We conducted a qualitative study based on 18 semi-structured interviews with mothers of children under 10. Five themes were identified: (1) Telework-characteristics and challenges of a new labor scenario; (2) Survival and chaos-inability to work, look after children, and manage a household at the same time; (3) Is co-responsibility a matter of luck?-challenges when sharing housework during lockdown; (4) Breakdown of the care and social support system; and (5) decline in health of women trying to balance work and family life. Mothers who had to balance telework against family life suffered physical, mental, and social effects, such as anxiety, stress, sleep deprivation, and relationship problems. This study suggests that, in situations of crisis, gender inequality increases in the household, and women tend to shift back to traditional gendered roles. Governments and employers should be made aware of this, and public policies should be implemented to facilitate work-family reconciliation and co-responsibility within couples.

Cross-cultural validation into Portuguese of a questionnaire to assess computer vision syndrome in workers exposed to digital devices.

PURPOSE: As digital devices are increasingly used at work, valid and reliable tools are needed to assess their effect on visual health. This study aimed to translate, cross-culturally adapt, and validate the Computer Vision Syndrome Questionnaire (CVS-Q©) into Portuguese. METHODS: A 5-phase process was followed: direct translation, synthesis of translation, back-translation, consolidation by an expert committee, and pretest. To run the pretest, a cross-sectional pilot study was conducted with 26 participants who completed the prefinal Portuguese version of the CVS-Q© and were asked about difficulties, comprehensibility, and suggestions to improve the questionnaire. To evaluate the reliability and validity of the Portuguese version of the CVS-Q©, a cross-sectional validation study was performed in a different sample (280 workers). RESULTS: In the pretest, 96.2% had no difficulty in completing it, and 84.0% valued it as clear and understandable. CVS-Q© in Portuguese (Questionário da Síndrome Visual do Computador, CVS-Q PT©) was then obtained. Validation revealed the scale's good internal consistency (Cronbach's alpha=0.793), good temporal stability (intraclass correlation coefficient=0.847; 95% CI 0.764-0.902, kappa=0.839), adequate sensitivity and specificity (78.5% and 70.7%, respectively), good discriminant capacity (area under the curve=0.832; 95% CI 0.784-0.879), and adequate convergent validity with the ocular surface disease index (Spearman correlation coefficient=0.728, p<0.001). The factor analysis provided a single factor accounting for 37.7% of the explained common variance. A worker who scored ≥7 points would have computer vision syndrome. CONCLUSIONS: CVS-Q PT© can be considered an intuitive and easy-to-understand tool with good psychometric properties to measure computer vision syndrome in Portuguese workers exposed to digital devices. This questionnaire will assist in making decisions on preventive measures, interventions, and treatment and comparing exposed populations in different Portuguese-speaking countries.

Oral health-related quality of life in a group of patients with rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) and periodontitis (PD) are chronic diseases that are associated with connective tissue and bone destruction, which affects the quality of life of the people suffering from these conditions. The identification of social conditions and the determinants of RA and PD would permit the elaboration of policies and strategies based on social reality. OBJECTIVES: The aim of the present study was to identify the relationship between oral health-related quality of life (OHRQoL) and the indicators of general health and oral health in patients with RA. MATERIAL AND METHODS: A cross-sectional study involving 59 patients with RA was conducted between 2019 and 2020. Demographic, general health, periodontal, and oral health parameters were collected. In addition, the Oral Health Impact Profile-14 (OHIP-14) questionnaire was administered to each patient. A description of the OHIP-14 dimensions according to different variables was performed. The relationship between OHRQoL and general/oral health indicators was analyzed with logistic and linear regression analyses. RESULTS: The highest OHIP-14 scores were found in people that were 60 years of age and over, single, had low educational achievements, a low socioeconomic status, were unemployed, and had no health affiliation. In the adjusted model, the prevalence of the impact on OHRQoL was 1.34 (1.10-5.29) times greater in those with erosive RA than in those without, and 2.22 (1.16-29.50) times greater in those who self-reported morning stiffness. Regarding the stage of PD, those with stage IV had a prevalence of the impact on the OHRQoL of 70%, an average extent of 3.4 ±4.5 and a severity score of 11.5 ±22.0, with statistically significant differences. CONCLUSIONS: The dimensions with the greatest impact on the OHRQoL of patients were physical pain, discomfort and psychological disability. The type of RA and the severity of PD are indicators of worse scores on the OHRQoL scale.

Estimation of Additional Costs in Patients with Ventilator-Associated Pneumonia.

Healthcare-associated infections (HAIs) present a global public health challenge, contributing to high morbidity and mortality and substantial economic burdens. Ventilator-associated pneumonia (VAP) ranks as the second most prevalent HAI in intensive care units (ICUs), emphasizing the need for economic analyses in this context. This retrospective cohort study, conducted at the General Hospital of Alicante from 2012 to 2019, aimed to assess additional costs related to VAP by comparing the extended length of stay for infected and non-infected ICU patients undergoing mechanical ventilation (MV) for more than 48 h. Employing propensity score association, 434 VAP patients were compared to an equal number without VAP. The findings indicate a significantly longer mechanical ventilation period for VAP patients (17.40 vs. 8.93 days, p < 0.001), resulting in an extra 13.56 days of stay and an additional cost of EUR 20,965.28 per VAP episode. The study estimated a total cost of EUR 12,348,965.28 for VAP during the study period, underscoring the economic impact of VAP. These findings underscore the urgent need for rigorous infection surveillance, prevention, and control measures to enhance healthcare quality and reduce overall expenditures.

A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services' accessibility in economic migrants.

BACKGROUND: Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997-2011). METHODS: A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen's conceptual framework of access and use of health services and by incorporating other emergent categories. RESULTS: We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. CONCLUSIONS: Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.

Differences in working conditions and employment arrangements among migrant and non-migrant workers in Europe.

OBJECTIVE: To determine migrant workers' exposure to select occupational risks and compare it with that of non-migrant workers in Europe. DESIGN: Based on the European Working Conditions Survey (EWCS-2005, n=29,654 workers, 31 countries) we examined differential prevalence amongst migrant and non-migrant workers' primary paid jobs in terms of employment arrangements (working >10 hours/day, working >5 days/week, on Sundays, without a contract, changes in the work schedule and not free to decide when to take holidays or days off) and working conditions (exposure to hazards including chemical, physical agents, physical load and psychological conditions). For the purpose of this study, a migrant is defined as a person without nationality of the country of residence (n=926). Adjusted prevalence ratios (aPRs) for age, economic sector and education were calculated. RESULTS: Differences in employment arrangements and working conditions were noted by migration status, gender and occupational status. Among non-manual workers, migrant males are more exposed than non-migrant males to negative psychosocial conditions--working at a very high speed (aPR 1.23; 95% CI 1.07-1.42) and shift work (aPR 1.66; 95% CI 1.27-2.17)--and adverse employment arrangements: working on Sundays (aPR 1.91; 95% CI 1.42-2.55), variable starting/finishing times (aPR 1.17; 95% CI 1.04-1.32) and changes in work schedule (aPR 1.56; 95% CI 1.30-1.88). Compared with non-migrant males, male migrant manual workers are the group with a greater number of disparities in terms of exposure to negative working conditions. Female migrant non-manual workers are more exposed to psychosocial conditions - working at very high speed (aPR 1.26; 95% CI 1.10-1.44) and shift work (aPR 1.61; 95% CI 1.29-2.01) while female manual migrant workers were more likely to report standing or walking (aPR 2.43; 95% CI 1.98-2.97), not having a contract (aPR 2.94; 95% CI 2.07-4.10) and not being free to decide days off and holidays (aPR 1.25; 95% CI 1.07-1.48) than non-migrants. CONCLUSION: Migrant workers across Europe are more likely to be exposed to certain working and employment arrangements that may place them at higher risk of future health problems.

A Scoping Review about Migrants' Oral Health in South-South Contexts.

OBJECTIVE: To gather the available scientific evidence about the oral health of migrants in south-south contexts. METHODS: A scoping review methodology was applied through a comprehensive search in databases of scientific and grey literature: PubMed/Medline, Scopus, LILACS, EMBASE, Google Scholar and the International Centre for Migration, Health and Development. A descriptive analysis of the characteristics of the selected studies was conducted. RESULTS: The search yielded 23 papers. Seventeen studies (17/23, 73.9%) were conducted on the Asian continent and 91.3% (21/23) were cross-sectional. Studies were focused on oral health problems such as dental caries and periodontal disease with diverse findings when comparing immigrants with natives. Some studies found poor oral health indexes in migrants. Migrants face barriers to dental health services. Other oral health variables addressed in the studies were oral health-related quality of life, beliefs, knowledge and practices in oral health. Determining factors related to oral health were evidenced, such as migration status, sociodemographic, cultural, psychological, living, economic and material conditions, social support, oral health practices and previous oral and general health status. Studies reported conceptual and methodological gaps and limitations that must be considered when interpreting the results. CONCLUSION: According to the scientific evidence, immigrant populations in south-south migratory contexts show poor oral health indicators, and this translates into social vulnerability in this group. Further research is needed to increase the scientific body about the social and contextual determinants in oral health and understanding of the social construction of this phenomenon.

[Health risk behaviors by occupation in working population in Spain]. / Conductas de riesgo para la salud según la ocupación en población empleada en España.

OBJECTIVE: This study aims to analyze the variations in the prevalence of different health risk behaviors according to occupation in working population in Spain. METHOD: Cross-sectional study with data from the Spanish National Health Survey of 2017. The analysis includes adults between 18 and 65 years with employment at the time of the survey. Health risk behaviors are obesity, physical inactivity in free time, tobacco consumption and excessive alcohol consumption. The primary explanatory variable is the occupation, using the National Classification of Occupations of 2011. Sociodemographic characteristics are gender, age, country of birth and educational level. The prevalences (P) of risk behaviors have been calculated, as well as the odd and adjusted odds ratios (aOR). RESULTS: The highest figures of obesity are observed in operators of installations and machinery and assemblers (P: 20.0%; ORa: 1.26; A95%CI: 1.04-1.52). The higher level of physical inactivity during free time appears in elementary occupations (P: 83.4%; ORa: 1.70; A95%CI: 1.45-1.99). Tobacco consumption is higher in operators of installations and machinery and assemblies (P: 37.4%; ORa: 1.22; A95%CI: 1.05-1.43). Excessive alcohol consumption appears to a greater extent on skilled workers in the agricultural sector, livestock, forestry and fisheries (P: 3.9%; ORa: 1.51; A95%CI: 0.83-2.75). CONCLUSIONS: The results indicate a greater relationship between risk behaviors for health and manual or lower-skilled occupations.

A qualitative study of employment, working and health conditions among Venezuelan migrants in Colombia.

This study aims to explore the perceptions of the Venezuelan immigrant population in Medellín, Colombia, regarding their employment, working and health conditions (physical, mental and psychosocial). A qualitative study was conducted (focused ethnography perspective). Semi-structured interviews were carried out with 31 Venezuelans and 12 key informants from different social organisations that work with the immigrant population. A narrative content analysis was carried out (Atlas.Ti 8.0 software). The migratory process for Venezuelans is caused for political, economical and social aspects in Venezuela and Colombia is offered as the first destination for labour establishing. Access to the labour market is limited to certain occupations, in many cases in the informal economy. Participants referring low salaries, working long hours and reduced social benefits. Occupational risks are evidenced by low experience in the labour market. Some health problems are perceived, and a good part of the interviewed population referred to signs and symptoms related to mental health problems. Barriers to access health and social protection services were found. Finally, future expectations depend on their adaptation to Colombia, the improvement of social conditions in Venezuela or having chances of improving their social and living conditions in another country. A high labour and social vulnerability were found in Venezuelan participants that impact on physical and mental health. Political and strategies from a public health perspective are required and the implementation of systems for monitoring and evaluating the labour and health situation in the working immigrant population.