Use of Global Risk Score for Cardiovascular Evaluation of Rural Workers in Southern Brazil.

The objectives of the present study were to classify the cardiovascular evaluation of rural workers through the Global Risk Score and analyze the intensity of the relationship between the classification and the variables of the score. A descriptive study was developed with 38 rural workers from the extreme southern Brazil. Data collection was performed through an interview and verification of anthropometric measurements and arterial blood pressure. Data were analyzed descriptively and inferentially using the Spearman correlation test. The overall 10-year cardiovascular risk classification using the Framingham global score showed a predominance of low risk (n = 22; 57.9%); however, 11 rural workers (28.9%) had a high cardiovascular risk. Spearman's correlation analysis showed significance between the Global Risk Score and gender (rho = 0.623, p ≤ 0.001), age (rho = 0.783, p ≤ 0.001), systolic blood pressure (rho = 0.545, p ≤ 0.001), and smoking (rho = 0.483, p = 0.002). These results show that rural workers need attention with regard to components that may put them at risk for cardiovascular disease. This study may help in the early diagnosis and more effective actions on the risk factors for cardiovascular disease.

Respiratory alterations in workers: study of single ports. / Alterações respiratórias em trabalhadores: estudo de portuários avulsos.

OBJECTIVE: To identify alterations in the respiratory system in port workers through radiographic and pulmonary function tests; to identify the use of personal protective equipment during port activities; and to relate age, working time, exposure to substances such as fertilizers and the use of personal protective equipment during port activities, to changes in the respiratory system in port workers. METHOD: Descriptive and exploratory study, in south Brazilian maritime port, from July of 2014 to January of 2015. A retrospective quantitative analysis of the results of chest x-ray and spirometry of 695 port workers' chart and prospective analysis of 66 workers were performed. RESULTS: Most of the workers did not present radiographs 98.7% and 11.4% presented ventilatory alterations. A positive correlation was identified for the variables age, working time and spirometry results. CONCLUSION: There was a change in the respiratory function of single port workers, which may be related to the exposure to fertilizers.

Rural workload and factors associated with the use of medication by elderly people.

OBJECTIVE: Identify the prevalence and factors associated with the use of medication by elderly rural workers and verify the association between the use of medication and rural workload. METHOD: Cross-sectional, exploratory study, conducted among elderly rural workers from the state of Rio Grande do Sul. The data was collected through interviews, using a structured questionnaire. RESULTS: Ninety-five elderly people participated in the study. Prevalence of medication use was 32% higher among women than men, and the type of medication most used by women was for the nervous and musculoskeletal systems. One additional degree in the frustration level with farm work resulted in a 1% increase in the probability of elderly people using medication. CONCLUSION: It is necessary to consider strategies that seek to reduce the physical and mental demand of rural work, through investments in public policies that enable elderly people to reduce rural labor for subsistence purposes and, consequently, their workload.

Scientific evidence of dockworker illness to nursing clinical reasoning.

OBJECTIVE: To identify scientific evidence of occupational illness of dockworkers published in the literature. METHOD: systematic review of the literature, developed according to the Cochrane method. The databases searched were: Cochrane, LILACS, MEDLINE/PubMed, CINAHL and SciELO. Studies from 1988 to 2014 were selected. The data were analyzed according to the level of evidence and Strengthening the Reporting of Observational Studies in Epidemiology. RESULTS: We included 14 studies, in which 11 (78.6%) were from international journals. The year of 2012 showed greater number of studies. All studies were classified as: Level of Evidence 4, highlighting lung cancer, musculoskeletal and ischemic diseases, causal link in chemical risks. CONCLUSION: The development of preventive measures should especially include chemical exposure of workers applying the clinical reasoning of nurses' environmental knowledge to care for illnesses. OBJETIVO: Identificar evidências científicas de adoecimento ocupacional do trabalhador portuário publicadas na literatura. MÉTODO: Revisão sistemática da literatura, construída conforme o método Cochrane. As bases de dados pesquisadas foram Cochrane, LILACS, MEDLINE/PubMed, CINAHL e SciELO. Foram selecionados artigos publicados de 1988 a 2014. Os dados foram analisados conforme o Nível de Evidência e Strengthening the Reporting of Observational Studies in Epidemiology. RESULTADOS: Foram selecionadas 14 publicações, das quais 11 (78,6%) de revistas internacionais. O ano de 2012 reuniu maior número de publicações no período de estudo. Todas as publicações pertenciam ao Nível de Evidência 4, destacando o câncer pulmonar, doenças osteomusculares e isquêmicas, com nexo causal nos riscos químicos. CONCLUSÃO: A elaboração de medidas preventivas deve prever especialmente a exposição química do trabalhador, aplicando ao raciocínio clínico do enfermeiro um conhecimento ambiental para a assistência aos adoecimentos.

Mental Health of Elementary Schoolteachers in Southern Brazil: Working Conditions and Health Consequences.

The mental health of educators is a growing problem in many countries. This study sought to identify self-reported stressful working conditions of elementary schoolteachers and the biopsychosocial consequences of those working conditions and then identify working conditions that promote well-being for teachers in the workplace. Exploratory study was done with 37 teachers. Data collection was performed using a structured interview with a questionnaire. Results show that stressful working conditions are related to inadequate salary, an excessive number of activities, and having to take work home. Biopsychosocial consequences include anxiety, stress, and sleep disorders. There was a statistically significant association between inadequate salary and anxiety (p = 0.01) and between an excessive number of activities and stress (p = 0.01). Teachers reported that a good relationship among colleagues is a working condition that promotes well-being in the workplace. The identification of stressful working conditions for teachers, the biopsychosocial consequences, and working conditions that promote well-being in the workplace are relevant to determining actions that improve the work environment and, consequently, the health of teachers.

[Skin cancer in rural workers: nursing knowledge and intervention]. / Câncer de pele em trabalhadores rurais: conhecimento e intervenção de enfermagem.

OBJECTIVE: To identify the exposure of rural workers to the sun's ultraviolet radiation and pesticides; to identify previous cases of skin cancer; and to implement clinical and communicative nursing actions among rural workers with a previous diagnosis of skin cancer. METHOD: Observational-exploratory study conducted with rural workers exposed to ultraviolet radiation and pesticides in a rural area in the extreme south of Brazil. A clinical judgment and risk communication model properly adapted was used to develop interventions among workers with a previous history of skin cancer. RESULTS: A total of 123 (97.7%) workers were identified under conditions of exposure to the sun's ultraviolet radiation and pesticides; seven (5.4%) were identified with a previous diagnosis of skin cancer; four (57.1%) of these presented potential skin cancer lesions. CONCLUSION: This study's results enabled clarifying the combination of clinical knowledge and risk communication regarding skin cancer to rural workers.

The Working Environment in Primary Healthcare Outpatient Facilities: Assessment of Physical Factors and Health Professionals' Perceptions of Working Environment Conditions.

The objectives of this study were to assess the adequacy of physical parameters/factors (temperature, relative humidity, noise, and illuminance levels) of the work environment in PHC facilities, to evaluate the association between the adequacy of these measured physical parameters and the physical characteristics of the PHC facilities and their surroundings and to assess the association between health professionals' perceptions about exposure to physical risks in the PHC work environment and the adequacy of physical parameters measured in the same facilities. The study monitored 23 PHC facilities in southern Brazil and interviewed 210 health professionals. Data analysis involved Pearson's chi-square, Fisher's exact test, Spearman's correlation, and multivariate linear regression analysis was used to control for confounding factors. The significance level was set at 5% (p ≤ 0.05). The combination of temperature and relative humidity presented thermal comfort levels outside the adopted criteria for adequacy in consultation (outdoor relative humidity, p = 0.013) and procedure rooms (front door open, p = 0.034). Inadequate sound comfort (noise) levels in the morning shift were found in the vaccination (front door open, p = 0.021) and consultation rooms (movement of people, p = 0.016). In PHC facilities where reception rooms had insufficient lighting, internal curtains were opened less frequently (p = 0.047). The analysis of health professionals' perceptions of physical factors demonstrated that physicians more frequently perceive the physical risk of temperature and humidity (p = 0.044). The higher the number of nurses (p = 0.004) and oral health technicians in the PHC facilities (p = 0.031), the greater the general percentage of adequacy of monitored physical parameters. It was also confirmed that the higher the perception of moderate or severe physical risk among health professionals, the lower the general percentage of the adequacy of the physical parameters of the work environment of the PHC facilities evaluated (rs = -0.450, p = 0.031). This study's evidence contributes to a better understanding of physical conditions and future occupational interventions to ensure the comfort, safety, and well-being of PHC workers.

Risk Perception and Fatigue in Port Workers: A Pilot Study.

INTRODUCTION AND OBJECTIVES: The aims of this study were to assess fatigue in port workers; analyze the association between fatigue and levels of trust in organizations, as well as the association between authorities and risk perception; and examine the official documents governing the studied port, along with the current health and communication status of the port workers. MATERIALS AND METHODS: This was a descriptive and cross-sectional pilot study, which presented quantitative and qualitative data, and it was carried out among port workers in the city of Pelotas, Rio Grande do Sul, Brazil. Thirty-nine port workers responded to quantitative questionnaires, which collected their socio-demographic data, as well as a risk perception questionnaire, the Chalder Fatigue Scale, and the Checklist of Individual Strength. Five documents from the port regiment were studied and qualitatively analyzed. The health communications consisted of presenting infographics with research data and providing information for reducing fatigue. RESULTS: Fifteen workers (38.5%) were considered fatigued. There was a reduction in fatigue associated with trust in the unions and the labor management body, and there was an agreement that the precarious environment was completely unacceptable. The qualitative data in the documents indicated that it was possible to identify the infrastructure of the port environment, the legislation, the strategies to be adopted in cases of natural disasters, emergency plans, plans for the protection and promotion of workers' health, individual and collective protection plans, the division of the sectors and those responsible for them, and documents detailing the hierarchy within the ports. The qualitative analysis culminated in graphic representations (infographics) created to communicate the research results to port workers, specifically in relation to fatigue, and we presented the ways to prevent fatigue at work. Discussion/Limitations: Studying the risk perceptions and fatigue levels of port workers through research with the active participation of these workers presented their lived experiences, which promoted discussion and perhaps more effective proposals to change their work conditions.

[Clinical practice as an arborescent and rhizomorphic practice in surgical nursing work]. / A clínica como prática arborífica e rizomórfica do trabalho em enfermagem cirúrgica.

A qualitative and exploratory case study was conducted in a surgery unit of a university hospital. The study aimed to analyze the nurses' work from the perspective of health care production and clinical practice. The subjects of the study were six nurses. Non-participant observations, documentary research and in-depth interviews were carried out, followed by discursive textual analysis. Nursing work is organized according to two interconnected and interdependent perspectives: a clinical model, which forms the central structure of its practice, and a structure formed by multiple and heterogeneous elements. in this way, the clinical model of health care is organized as a centered structure that enables the fulfillment of biological needs and acts as a basis for connecting disparate knowledge and practices that expand practice through interconnections with the work environment.

Hospital sustainability indicators and reduction of socio-environmental impacts: a scoping review.

OBJECTIVE: To synthesize knowledge about hospital sustainability indicators and evidence of reduced socio-environmental impact. METHOD: Literature scoping review using Pubmed, Science Direct, Scielo and Lilacs databases. Studies in a time frame of 10 years, addressing hospital sustainability indicators and evidence of reduced socio-environmental impact published in any language were included. RESULTS: A total of 28 articles were included, most were applied research, published in 2012, in English. Studies showed ways to save water and energy, as well as ways to monitor and mitigate the impact of activities related to effluents, waste and emissions. All studies had nursing work directly or indirectly involved in hospital sustainability. CONCLUSION: The possibilities of generating less impact on the environment and increasing the economy/efficiency of a hospital are countless. The particularities of each hospital must be taken into account and workers, especially nurses, should be involved.

Musculoskeletal Pain in the Neck and Lower Back Regions among PHC Workers: Association between Workload, Mental Disorders, and Strategies to Manage Pain.

Scientific evidence indicates that workers in the health sector are commonly exposed to work-related musculoskeletal pain. OBJECTIVES: We aimed to identify the relationship between the presence and intensity of musculoskeletal pain in the neck and lumbar regions reported by Primary Health Care (PHC) workers with workloads and occupational risks, analyze musculoskeletal pain in the presence and absence of self-reported mental disorders based on a medical diagnosis, and identify workers' strategies to manage pain. METHOD: This cross-sectional study addressed 338 health professionals working in PHC outpatient services in the extreme South of Brazil. One questionnaire addressed sociodemographic questions concerning occupation, occupational risks, and mental disorders. The Nordic Musculoskeletal Questionnaire was used to assess self-reported musculoskeletal pain. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) measured the workload. A descriptive and inferential analysis was performed using SPSS version 21.0. RESULTS: Most (55.3%) participants reported neck and (64.5%) lower back pain in the previous 12 months, and 22.5% and 30.5% reported intense neck and lower back pain, respectively, in the previous 12 months. The results showed different independent associations with increased musculoskeletal pain among health workers. Dentists presented the highest prevalence of neck pain, while female workers presented the highest prevalence of lower back pain. Furthermore, the perception of ergonomic risk and virtually all self-reported mental disorders (except panic syndrome for neck pain) were associated with pain in the neck and lower back regions and a higher frustration level (mental demand). Additionally, professionals with graduate degrees, nurses, and professionals working the longest in PHC services reported seeking complementary therapies more frequently, while physicians and those with self-reported mental disorders self-medicated more frequently.

Risk communication as a tool for training apprentice welders: a study about risk perception and occupational accidents.

The present study has aimed to identify the perceptions of apprentice welders about physical, chemical, biological, and physiological risk factors to which they are exposed; identify types of occupational accidents involving apprentice welders; and report the development of a socioenvironmental education intervention as a tool for risk communication for apprentice welders. A quantitative study was performed with 161 apprentice welders in Southern Brazil in 2011. Data collection was performed via structured interviews with the apprentice welders about risk perception, occupational accidents, and time experienced in welding. The data were analyzed using SPSS 19.0. The participants identified the following risk types: physical (96.9%), chemical (95%), physiological (86.3%), and biological (51.5%). In this sample, 39.7% of apprentice welders reported occupational accidents and 27.3% reported burning. The inferential analysis showed that the frequency of risk perception factors increases with the length of experience, and apprentice welders who have experienced accidents during welding activity perceive a higher amount of risk factors than those who have never experienced them. It is concluded that apprentice welders perceive risks and that they tend to relate risks with the occurrence of occupational accidents as an indicator of the dangerous nature of their activity.

[Family labor: desired distribution of housework and childcare between spouses]. / Trabalho familiar: distribuição desejada do trabalho doméstico e cuidados dos filhos entre cônjuges.

This study investigates the desired distribution of family labor between spouses who have jobs and children of 6 years or less. This is a quantitative study developed with the participation of 92 couples living in the city of Rio Grande, state of Rio Grande do Sul Brazil. The desired distribution of housework and children care is predominantly an equal one, though the woman was seen as more responsible for the care of children. Management/repairing were subitems of the housework analysis, and were considered to be activities that should be mostly done by men. Knowing the changes of contemporary families will allow nursing to be less exclusionary and more flexible in its family nursing actions.

Occupational Well-Being of Multidisciplinary PHC Teams: Barriers/Facilitators and Negotiations to Improve Working Conditions.

Well-being at work is one of the factors determining healthy work conditions and is perceived by workers as a positive psychological state. In this study, the concept of well-being at work was used together with occupational functionality (i.e., current health state, current work environment, and barriers/facilitators to implementing well-being at work), occupational risk perception, and proactivity/negotiations held by workers to improve working conditions. In this context, the objectives were to identify the socio-demographic and occupational characteristics independently associated with levels of well-being at work of the multidisciplinary PHC health team; detect barriers or facilitators resulting from the attitudes of colleagues, community members, and managers that influence the well-being at work of the multidisciplinary health team; and identify with whom and what reasons led health workers to become proactive and negotiate improved working conditions. This cross-sectional study addressed 338 health workers from the multidisciplinary teams of PHC outpatient services in the extreme south of Brazil. Multivariate linear regression models were adopted to analyze data. The results show various independent associations with levels of well-being at work. Nursing workers (technicians and nurses) more frequently expressed job commitment and job satisfaction. Difficulties in solving problems and performing work routines, and co-workers' attitudes directly influence the well-being of the PHC team members. Risk perception (physical and chemical) also influences well-being. Negotiations in which PHC managers engaged to improve working conditions appeared as a significant predictor of job commitment, job satisfaction, and job involvement. The results reveal that well-being at work is an important indicator of the potential of workers' proactivity in negotiating improved working conditions.

Domains of Physical and Mental Workload in Health Work and Unpaid Domestic Work by Gender Division: A Study with Primary Health Care Workers in Brazil.

Various studies indicate that workload metrics can be used to assess inequities in the division of labor according to gender and in the mental health of health care professionals. In most studies, the workload is portrayed in a way that does not integrate the different fields of work, that is, work in health services and unpaid domestic work. The objective was to determine the effects of the workload domains of health work and unpaid domestic work according to the gender division of health professionals working in primary health care (PHC), and to analyze the workload as an inducer of anxiety disorders and episodes of depression. This cross-sectional study consisted of 342 health care professionals recruited for interview at primary health care units in the extreme south of Rio Grande do Sul, Brazil. Sociodemographic and occupational variables, workload in PHC and unpaid domestic work, and dichotomies of anxiety disorders and episodes of depression were considered. Poisson and multivariate linear regression models were used for data analysis. Cohen's standardized effect size was used to assess the magnitude of the difference between women and men in terms of workload. The female professionals presented higher scores in terms of PHC work and unpaid domestic work and higher proportions of episodes of depression and anxiety disorders compared to males. The male professionals showed that anxiety disorders presented a medium standardized effect size on domestic workload and the level of frustration with family involvement was higher in those with episodes of depression. The results illustrate that the workload metric is an important indicator of female vulnerability to working conditions in PHC and in the family environment.

[Factors associated with delay in children development, Rio Grande, Rio Grande do Sul, Brazil]. / Fatores associados ao atraso no desenvolvimento em crianças, Rio Grande, Rio Grande do Sul, Brasil.

This analytical study aims to evaluate the factors associated to developmental delay in 8-12 months aged children, indicated as at risk at birth in Rio Grande, Rio Grande do Sul Brazil. The instruments used were the Denver Development Screening Test II, anthropometric evaluation and questionnaires. Two hundred and twenty children (both at risk and out of risk) participated. It was found a prevalence of o20.5% of potential delay in psychomotor development. Children who presented a risk of a suspicious DDST II were part of lower income families; their mothers had not been to more than six prenatal visits; and had inappropriate weight-age indicator The data suggest the need of a rethinking of policies on child health, given that other criteria could be included in the risk conditions to the child at birth.

[Communication process: a group activities tool in the family health strategy]. / Processo comunicacional: instrumento das atividades em grupo na estratégia Saúde da Família.

The objective of the present study was to analyze the communication process tools triggered in group activities in the Family Health strategy. Data collection was performed using semi-structured interviews recorded with 51 nurses and through non-participating, non-systematic public observation in natural situations of 19 group activities analyzed according to content qualitative approach. Based on the reports of the professionals, two categories emerged: dialogue-action and dialogue-interaction, which evinced that the communication process is an instrumental means of group activities in the Family Health strategy. The former by the predominant use of verbal language as a means for developing operational procedures specific to each professional in relation to monitoring the health of the client, and the latter as an instrument in which, according to the nurses, there is a simultaneous use of verbal and nonverbal communication.

Communication in health and inter-professional collaboration in the care for children with chronic conditions.

OBJECTIVE: to understand how health communication in the care of children with chronic conditions interferes with inter-professional collaboration. METHOD: a multicentric qualitative research. Data collection, carried out through interviews and observation, occurred from October 2017 to February 2018. For data organization, the NVivo software, version 12, was used. These data were analyzed from a dialectical perspective. RESULTS: a total of 79 professionals were interviewed, including physicians and nurses in the Family Health Strategy. Essential markers for inter-professionality stand out, such as multi-institutional communication; the historical and political context of the municipalities; the bond between staff and families with children with chronic conditions; and active and purposeful communication. CONCLUSION: inter-professional collaboration is strengthened when the therapeutic plan of the child with a chronic condition is coordinated by the Family Health Strategy, plus the intention of communicating with the secondary sector. It is considered that the research included important issues, contributing to planning the work process in the Family Health Strategy.

Workplace violence: legislation, public policies and possibility of advances for health workers.

OBJECTIVES: to discuss specific laws and public policies for workplace violence in the health sector, highlighting possibilities for the collective confrontation of this phenomenon in Brazil. METHODS: this is a reflective and argumentative study that refers to some previous experiences regarding the implementation of legal aspects to curb workplace violence directed at health professionals. RESULTS: there are experiences regarding the existence of legislation or public policies to specifically contain workplace violence in the health sector, but these are still restricted to some places or countries. The literature provides resources for developing specific strategies for managing this phenomenon, highlighting prevention programs and conducts for case management. FINAL CONSIDERATIONS: implementation of legal aspects or public policies at the municipal, regional, state and/or national level is a strategy with potential to confront workplace violence in health services in a collective and sustainable way.

Obtaining tissues and organs: empowering actions of nurses in the light of ecosystem thinking.

OBJECTIVES: to analyze, in the light of ecosystem thinking, the actions of nurses that stimulate the potential to increase the rates of organ and tissue donation. METHODS: descriptive, exploratory, mixed method study, of the embedded type, with simultaneous realization and emphasis on the quantitative approach, including 125 nurses from the Intra-hospital Commission for Donation of Organs and Tissues for Transplants in the Southern Region of Brazil. Data were collected using an online survey questionnaire. Quantitative data were analyzed using the Statistical Package for the Social Sciences software; and qualitative, Bardin content analysis. RESULTS: the identified actions refer to the reception of the family, exclusive dedication and remunerated valorization of the nurses of the commission, media and dissemination campaigns for society in general and educational actions for the training of professionals. CONCLUSIONS: the results of the actions encourage the possibility of increasing the rates of organ and tissue donation for transplantation.