Behind the Headset: Predictive Accuracy of Patient-Reported Outcome Measures for Voice Symptoms in Call Centers

Objective: This study examines factors predicting self-reported voice symptoms in call center workers. Methods: Multivariate analysis and predictive modeling assess personal, work-related, acoustic, and behavioral factors. Generalized Linear Models (GLMs) and Receiver Operating Characteristic (ROC) curves are employed. Results: Age and sleep patterns impacted voice quality and effort, while workplace factors influenced symptom perception. Unhealthy vocal behaviors related to tense voice and increased effort, while hydration was protective. Voice acoustics showed diagnostic potential, supported by ROC data. These findings emphasize voice symptom complexity in call center professionals, necessitating comprehensive assessment. Limitations: This study recognizes its limitations, including a moderate-sized convenience sample and reliance on PROM metrics. Future research should incorporate more objective measures in addition to self-reports and acoustic analysis. Value: This research provides novel insights into the interplay of personal, occupational, and voice-related factors in developing voice symptoms among call center workers. Predictive modeling enhances risk assessment and understanding of individual susceptibility to voice disorders. Conclusion: Results show associations between various factors and self-reported voice symptoms. Protective factors include sleeping more than six hours and consistent hydration, whereas risk factors include working conditions, such as location and behaviors like smoking. Diagnostic models indicate good accuracy for some voice symptom PROMs, emphasizing the need for comprehensive models considering work factors, vocal behaviors, and acoustic parameters to understand voice issues complexity.

Objetivo: Este estudio examina los factores que predicen los síntomas de voz en los trabajadores de call centers. Métodos: Se utilizan análisis multivariados y modelos predictivos para evaluar factores personales, laborales, acústicos y de comportamiento. Se emplean Modelos Lineales Generalizados (GLM) y curvas ROC. Resultados: La edad y los patrones de sueño afectaron la calidad vocal y el esfuerzo, mientras que los factores laborales influyeron en la percepción de síntomas. Los comportamientos vocales no saludables se relacionaron con voz tensa y mayor esfuerzo, mientras que la hidratación fue protectora. Los parámetros acústicos de voz mostraron potencial diagnóstico respaldado por datos de ROC. Los hallazgos subrayan complejidad de síntomas vocales en profesionales de centros de llamadas, requiriendo una evaluación integral. Limitaciones: Este estudio reconoce sus limitaciones, que incluyen una muestra de conveniencia de tamaño moderado y la dependencia de medidas PROMs. Futuras investigaciones deberían incorporar medidas objetivas, además de los autorreportes y análisis acústico. Importancia: Esta investigación aporta nuevos conocimientos sobre factores personales, laborales y síntomas de voz en trabajadores de call centers. El modelado predictivo mejora la evaluación de riesgos y la comprensión de la susceptibilidad individual a trastornos de la voz. Conclusión: Los resultados muestran asociaciones entre diversos factores y los síntomas vocales reportados. Los factores de protección incluyen dormir más de seis horas y una hidratación constante; los factores de riesgo incluyen las condiciones de trabajo, como la ubicación y comportamientos como fumar. Los modelos de diagnóstico indican una buena precisión para algunas PROMs de síntomas de la voz, lo que subraya la necesidad de modelos integrales que tengan en cuenta los factores laborales, los comportamientos vocales y los parámetros acústicos para comprender la complejidad de los problemas de la voz.

Uso de agrotóxicos em canaviais de Pernambuco e danos à saúde do trabalhador / Use of pesticides in Pernambuco sugarcane fields and damage to workers' health

RESUMO O presente estudo teve por objetivo analisar a exposição aos agrotóxicos e os danos à saúde dos trabalhadores das plantações de cana-de-açúcar em Pernambuco. Trata-se de pesquisa participante desenvolvida em territórios rurais de cinco municípios com forte expressão em área plantada de cana-de-açúcar. Os dados primários foram produzidos em oficinas com trabalhadores rurais para construção de diagnóstico rural participativo, analisados mediante condensação de significados e interpretados à luz do referencial teórico da epidemiologia crítico latino-americana. Os resultados estão apresentados em três seções: i) Fluxograma do trabalho nas plantações de cana-de-açúcar; ii) Exposição aos agrotóxicos utilizados nas lavouras; iii) Danos à saúde do trabalhador. Conclui-se que a exposição permanente aos agrotóxicos envolve o trabalho nas plantações de cana-de-açúcar e emerge de um construto histórico e socioambiental, em que se encontram subsumidos os modos de vida dos territórios sob o domínio do agronegócio canavieiro. Recomendam-se políticas públicas de fomento à agricultura familiar com diversificação, escoamento e distribuição da produção agroecológica, além do fortalecimento da Atenção Primária à Saúde e de ações integradas de vigilância epidemiológica, sanitária, ambiental e do trabalhador.

ABSTRACT This study aims to analyze exposure to pesticides and harm to the health of workers on sugarcane plantations in Pernambuco. This participatory research was conducted in rural territories of five municipalities with a strong presence in sugarcane-planted areas. The primary data were produced in workshops with rural workers to construct a participatory rural diagnosis, analyzed through condensation of meanings, and interpreted in light of the theoretical framework of Latin American critical epidemiology. The results are presented in three sections: i) Flowchart of work on sugarcane plantations; ii) Exposure to pesticides used on crops; iii) Harm to worker's health. We conclude that permanent exposure to pesticides involves working on sugarcane plantations and emerges from a historical and socio-environmental construct in which the ways of life of the territories under the control of sugarcane agribusiness are subsumed. Public policies are recommended to promote family farming with diversification, flow, distribution of agroecological production, and strengthening primary health care and integrated epidemiological, health, environmental, and worker surveillance actions.

Prevalência e fatores de riscos relacionados a comportamentos suicidas em profissionais do sexo / Prevalencia y factores de riesgo relacionados con la conducta suicidal en trabajadores sexuales / Prevalence and risk factors related to suicidal behavior in sex workers

Introdução: O trabalho sexual consentido é, historicamente, permeado por estigmas, proporcionando a marginalização social de profissionais do sexo e sua maior exposição a fatores de riscos que tendenciam a condutas suicidas. Objetivo: Identificar a prevalência e dos fatores de riscos relacionados a comportamentos suicidas em profissionais do sexo, tendo em vista a vulnerabilidade social desse grupo. Metodologia: Este estudo é uma revisão integrativa de literatura, determinada a partir da seguinte questão de pesquisa: "Qual a prevalência e os fatores de riscos relacionados a comportamentos suicidas entre profissionais do sexo?". Em seguida, aplicou os subsequentes Descritores em Ciências da Saúde: "Suicide" e "Sex workers", que foram combinados com o operador booleano "AND", nas plataformas National Library of Medicine, Science Direct, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Literatura Latino-americana e do Caribe, Scientific Eletronic Library Online, BioMed Central, Business Source Completee WorldWideScience. Foram selecionados 19 artigos relacionados ao objeto de estudo. Resultados: A prevalência de suicídio em profissionais do sexo foi classificada em três subcategorias: tentativas de suicídio, com predominância de 31,57% (n=6), ideação suicida com 15,78% (n=3) e o risco de suicídio com 5,26% (n=1). Os riscos de comportamentos suicidas foram associados a diversos fatores, sobretudo a violência (47,36%; n=9), depressão (26,31%; n=5) e a pobreza (15,78%; n=3). Conclusões: Há uma alta prevalência de comportamentos suicidas em profissionais do sexo que está associada a diversos fatores de riscos, verificando a carência de abordagens comunitárias direcionadas à vulnerabilidade social desse grupo (AU).

Introduction: Consensual sex work has historically been permeated by stigma, leading to the social marginalization of sex workers and their increased exposure to risk factors that tend to correlate with suicidal behaviors. Objective:To explore the prevalence and risk factors related to suicidal behavior in sex workers, considering the social vulnerability of this group. Methodology: This study is an integrative literature review, guided by the research question: "What is the prevalence and risk factors related to suicidal behaviors among sex workers?" The following Health Science Descriptors were applied: "Suicide" and "Sex workers," combined with the boolean operator "AND," on platforms such as the National Library of Medicine, Science Direct, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Literatura Latino-americana e do Caribe, Scientific Eletronic Library Online, BioMed Central, Business Source Complete, and WorldWideScience. Nineteen articles related to the study's objectivewere selected. Results:The prevalence of suicide among sex workers were classified into three subcategories: suicide attempts, with a predominance of 31.57% (n=6), suicidal ideation with 15.78% (n=3) and the risk of suicide with a prevalence of 5.26% (n=1). The risks of suicidal behavior were associated with several factors, especially violence (47,36%; n=9), depression (26.31%; n=5) and poverty (15.78% /n=3). Conclusions: There is a high prevalence of suicidal behaviors among sex workers, associated with various risk factors, highlighting the need for community-based approaches addressing the social vulnerability of this group (AU).

Introducción: El trabajo sexual consensuado ha estado históricamente impregnado de estigmas, llevando a la marginación social de los profesionales del sexo y a una mayor exposición a factores de riesgo que tienden a asociarse con conductas suicidas. Objetivo: Identificar la prevalencia y los factores de riesgo relacionados con comportamientos suicidas en profesionales del sexo, considerando la vulnerabilidad social de este grupo. Metodología: Este estudio es una revisión integradora de la literatura, derivada de la siguiente pregunta de investigación: "¿Cuál es laprevalencia y los factores de riesgo relacionados con comportamientos suicidas entre los profesionales del sexo?". Posteriormente, se aplicaron los siguientes Descriptores en Ciencias de la Salud: "Suicide" y "Sex workers", combinados con el operador booleano "AND", en plataformas como la Biblioteca Nacional de Medicina, Science Direct, Portal de Periódicos de la Coordinación de Perfeccionamiento de Personal de Nivel Superior, Literatura Latinoamericana y del Caribe, Scientific Electronic Library Online, BioMed Central, Business Source Complete y WorldWideScience. Se seleccionaron 19 artículos relacionados con el objeto de estudio. Resultados: La prevalencia de suicidio en profesionales del sexo se clasificó en tres subcategorías: intentos de suicidio, con una predominancia del 31,57% (n=6), ideación suicida con el 15,78% (n=3) y el riesgo de suicidio con el 5,26% (n=1). Los riesgos de comportamientos suicidas se asociaron con varios factores, especialmente la violencia (47,36%; n=9), la depresión (26,31%; n=5) y la pobreza (15,78%; n=3). Conclusiones: Existe una alta prevalencia de comportamientos suicidas en profesionales del sexo asociada con diversos factores de riesgo, destacando la necesidad de enfoques comunitarios dirigidos a la vulnerabilidad social de este grupo (AU).

Efecto de un programa de autocuidado en hábitos de vida saludable con relación a la obesidad en personal de salud de una institución de tercer nivel / Efeito de um programa de autocuidado nos hábitos de vida saudáveis em relação à obesidade em profissionais de saúde de uma instituição terciária / Effect of a self-care program on healthy lifestyle habits in relation to obesity in health personnel of a tertiary institution

Introducción. A nivel mundial, la obesidad es considerada como un problema de salud pública debido a que afecta a la población de todas las edades, incluso al mismo personal que trabaja en instituciones de salud, situación que repercute en su ámbito personal, familiar, pero sobre todo laboral, causando en el trabajador dificultad para realizar algunos procedimientos, ausentismo laboral, discapacidad parcial o total y/o necesidad de cuidado, entre otros.  Objetivo.  Evaluar el efecto de una intervención de autocuidado en hábitos de vida saludable con relación a la obesidad en personal de salud de una institución de tercer nivel.  Metodología. Estudio cuasi experimental, muestra 30 trabajadores con sobrepeso o algún grado de obesidad de una institución de salud de tercer nivel. Se impartieron 10 temas con relación a la obesidad, para cambiar hábitos deficientes por hábitos saludables, además de 10 sesiones de actividad física.    Resultados. Al final de la intervención, dos personas bajaron el nivel de su índice de masa corporal, una persona con obesidad grado III y una de grado II bajaron a peso normal. En cuanto a las medidas antropométricas posterior a la intervención, hubo reducción en cada uno de los parámetros, referente a la evaluación del cuestionario hábitos de vida saludable, relacionados con la obesidad posterior a la intervención, se encontraron cambios positivos en cada una de las dimensiones. Sin embargo, tanto en la reducción de IMC, así como en las dimensiones del cuestionario, la diferencia encontrada, no fue estadísticamente significativa.  Conclusiones. Los resultados sugieren que una intervención educativa en hábitos de vida saludable vinculados con la obesidad en personal de salud, son eficaces para contribuir al autocuidado de los trabajadores en el ámbito laboral

Introduction. Worldwide, obesity is considered a public health problem because it affects the population of all ages, including the same personnel who work in health institutions, a situation that has repercussions in their personal and family environment, but above all at work, causing the worker difficulty in performing some procedures, absenteeism, partial or total disability and/or need for care, among others. Objective. To evaluate the effect of a self-care intervention on healthy life habits in relation to obesity in health personnel of a third level institution. Methodology. Quasi-experimental study, sample of 30 workers with overweight or some degree of obesity in a tertiary health institution. Ten topics related to obesity were taught in order to change deficient habits for healthy habits, in addition to 10 sessions of physical activity. Results. At the end of the intervention, two people lowered their body mass index level, one person with grade III obesity and one with grade II obesity lowered to normal weight. Regarding the anthropometric measures after the intervention, there was a reduction in each one of the parameters, regarding the evaluation of the healthy life habits questionnaire, related to obesity after the intervention, positive changes were found in each one of the dimensions. However, both in the reduction of BMI and in the dimensions of the questionnaire, the difference found was not statistically significant. Conclusions. The results suggest that an educational intervention on healthy lifestyle habits related to obesity in health personnel is effective in contributing to the self-care of workers in the workplace

Introdução. A nível mundial, a obesidade é considerada um problema de saúde pública porque afecta a população de todas as idades, incluindo o próprio pessoal que trabalha nas instituições de saúde, situação que tem repercussões no seu ambiente pessoal e familiar, mas sobretudo no trabalho, causando ao trabalhador dificuldade na realização de alguns procedimentos, absentismo, incapacidade parcial ou total e/ou necessidade de cuidados, entre outros. Objectivos. Avaliar o efeito de uma intervenção de autocuidado sobre hábitos de vida saudáveis em relação à obesidade em profissionais de saúde de uma instituição de cuidados terciários. Metodologia. Estudo quase-experimental, amostra de 30 trabalhadores com excesso de peso ou algum grau de obesidade numa instituição de saúde terciária. Foram ensinados dez temas relacionados com a obesidade, com o objetivo de mudar hábitos deficientes por hábitos saudáveis, além de 10 sessões de atividade física. Resultados. No final da intervenção, duas pessoas baixaram o índice de massa corporal, uma pessoa com obesidade de grau III e uma com obesidade de grau II passaram para o peso normal. Relativamente às medidas antropométricas após a intervenção, verificou-se uma redução em cada um dos parâmetros, e relativamente à avaliação do questionário de hábitos de vida saudáveis relacionados com a obesidade após a intervenção, verificaram-se alterações positivas em cada uma das dimensões. No entanto, tanto na redução do IMC como nas dimensões do questionário, a diferença encontrada não foi estatisticamente significativa. Conclusões. Os resultados sugerem que uma intervenção educativa sobre hábitos de vida saudáveis ligados à obesidade no pessoal de saúde é eficaz para contribuir para o autocuidado dos trabalhadores no local de trabalho

Evaluation by community health agents of the attributes of Primary Health Care for fighting leprosy: a cross-sectional study

OBJECTIVE: To evaluate whether the attributes of Primary Healthcare are present in leprosy control actions in Londrina from Community Health Workers' (CHW) perspectives. METHOD: Observational and evaluative study. Data collection occurred between January and March 2020 in Londrina, Paraná, using the questionnaire "Primary Care Assessment Tool (PCATool) - Hansen's disease - CHW version" and a population-based census of 246 CHWs from 52 Primary Healthcare Units. The analyses used a cutoff point (≥ 6.6), central tendency, and dispersion measures. One-way ANOVA and Tukey's post hoc tests were used to analyze differences. Results: The general performance towards the primary healthcare attributes were evaluated as strong (mean = 6.95 / SD = 1.08) and the essential score (mean = 7.39 / SD = 1.0). On the other hand, the derived score was evaluated as poor (mean = 6.07 / sd = 1.06). Concerning the Access attribute, the rural zone had a lower score than the urban (mean = 4.47 / SD = 1.63). Conclusion: The study highlights issues that can be improved, such as first contact access, catalog of services offered to leprosy patients, information provided to the community, professional training, and differences in PHC performance between urban and rural regions.

On the right to occupational disease diagnosis / 中国职业医学

The right of occupational disease diagnosis is a worker's right to occupational health protection, and a procedural right to protect substantive rights. Its contents include the submission of occupational disease diagnosis, the application for occupational disease diagnosis and appraisal, as well as the cooperative obligation of the parties. The right of occupational disease diagnosis and appraisal is the embodiment and extension of the right of occupational disease diagnosis. For workers, the right of occupational disease diagnosis is private, and waiving the diagnosis of occupational diseases is a personal right. For employers, there is no legal right to request initial occupational disease diagnosis, but there is a right to apply for occupational disease diagnosis appraisal and to request re-diagnosis of occupational diseases. The cooperative obligation in occupational disease diagnosis is to guarantee the initiation and smooth progression of the right to occupational disease diagnosis. After workers request occupational disease diagnosis, if they unreasonably refuse to cooperate in health examinations or medical examinations during the diagnosis process, it can be considered as waiving the right to occupational disease diagnosis. If the employers apply for appraisal of occupational disease diagnosis without paying the appraisal fee, it can be handled as waiving their rights or withdrawing their appraisal applications. When workers apply for occupational disease diagnosis or appraisal of occupational disease diagnosis, but the employer refuses to pay the corresponding fee, it does not affect the progress of occupational disease diagnosis and appraisal work. In this case, the employer should bear the corresponding administrative responsibilities according to law.

Analysis of the NLRP3 gene polymorphism and loci interaction in susceptibility to coal workers' pneumoconiosis in the Xinjiang Region / 中国职业医学

ObjectiveTo investigate the correlation of polymorphism and loci interaction of nucleic acid binding oligomeric domain-like receptor heat protein domain associated protein 3 (NLRP3) gene and susceptibility to coal workers' pneumoconiosis (CWP) in Xinjiang Region. Methods A total of 109 CWP were selected as the case group, and 69 coal miners with similar age, years of dust exposure and work types were selected as the control group by convenient sampling method. Blood samples of individuals in workers in these two groups were collected, and the genotypes of single nucleotide polymorphism loci, rs1539019, rs4612666, rs4925650 and rs7525979, in the NLRP3 gene were detected using an improved multiplex ligation detection reaction. The optimal genetic model was selected based on the Akaike information criterion. Results The results of unconditional logistic regression analysis showed that individuals with the C allele of rs1539019 or rs4612666 had a higher risk of CWP than those with the A or T allele (all P<0.05), and individuals with the AA genotype of rs1539019 or the TT genotype of rs4612666 had a lower risk of CWP than those with the CC genotype (all P<0.05), after adjusting for age, years of work, alcohol, and smoking. The optimal genetic models for rs1539019 and rs4612666 were the recessive model and the additive model, respectively, and these differences were associated with the susceptibility to CWP at the Bonferroni-corrected level (all P<0.05). No correlation was found between rs4925650 and rs7525979 and the susceptibility to CWP (all P>0.05). In the smoking population, the rs1539019 co-dominant model, recessive model, and additive model were associated with a decreased risk of CWP (all P<0.05). The rs4612666 co-dominant model, dominant model and additive model were associated with an increased risk of CWP (all P<0.05), with the optimal genetic models being the recessive model and the additive model among smokers. The rs1539019 and rs4612666 were not found to be associated with the increased risk of CWP in non-smokers (all P>0.05). The rs4612666 dominant model and additive model were associated with an increased risk of CWP (all P<0.05), and the rs4925650 recessive model and over-dominant model were associated with a decreased and increased risk of developing CWP (all P<0.05), with the optimal genetic models being the dominant model and the over-dominant model in drinkers. The rs1539019 co-dominant model, dominant model, recessive model, and additive model were associated with a decreased risk of developing CWP (all P<0.05), and the rs4612666 co-dominant model, recessive model, and additive model were associated with an increased risk of developing CWP (all P<0.05), with the optimal genetic models being the additive model and the recessive model in non-drinkers. The result of haplotype analysis showed that the ACAC and ACGC haplotypes were associated with a reduced risk of CWP (all P<0.05). Conclusion The rs1539019 and rs4612666 loci of the NLRP3 gene are associated with susceptibility to CWP. This study provides clues for further research on the risk of CWP in coal workers.

Interaction of occupational and non-occupational noise exposure leads to high frequency hearing loss / 中国职业医学

ObjectiveTo explore the impact of the interaction between occupational and non-occupational noise exposure on the risk of high-frequency hearing loss (HFHL) in noise-exposed workers. Methods A total of 602 male workers with normal hearing, engaged in an automobile manufacturing company between 2016 and 2018, were selected as the study subjects using the retrospective cohort study method. Pure-tone audiometry and questionnaire surveys were conducted on the workers. The Kaplan-Meier survival analysis and multivariate Cox proportional hazards regression model were used to analyze the interaction between occupational and non-occupational noise exposure and the risk of HFHL in these workers. Results The prevalence of HFHL of the workers was 34.1% in 2020, without any cases of speech frequency hearing loss. Kaplan-Meier survival analysis result showed that the risk of HFHL increased in workers with excessive national occupational noise exposure intensity, self-reported noisy living environments, and both excessive national occupational noise exposure intensity and self-reported noisy living environments (all P<0.01). The results of the Cox proportional hazards model showed that the combined effect of excessive national occupational noise exposure intensity and self-reported noisy living environments [relative risk (RR)=2.40, P<0.01] was higher than the individual effects of excessive national occupational noise exposure intensity (RR=2.09, P<0.01) and self-reported noisy living environments (RR=2.39, P<0.01). There was an antagonistic effect between excessive national occupational noise exposure intensity and self-reported noisy living environments (interaction index <1.00). Conclusion Both occupational and non-occupational noise exposure can increase the risk of HFHL in noise-exposed workers, and there is an interaction between them.

Pengetahuan, Sikap dan Amalan Ergonomi Dalam Mencegah Gnagguan Otot Semasa Kerja Dalam Kalangan Pekerja Pejabat di Malaysia (Ergonomics Knowledge, Attitudes and Practices in Preventing Muscle Injury During Work Among Office Workers in Malaysia) / Jurnal Sains Kesihatan Malaysia

@#This study aims to determine the knowledge, attitudes and ergonomic practices (KAP) of office workers in Malaysia in preventing work-related musculoskeletal disorders. An online crosssectional survey of 266 office workers in Malaysia was conducted. All participants were asked to complete a five-part questionnaire to extract information on sociodemographic data, prevalence of work-related muscle disorders (WMSD), level of knowledge, attitudes, and ergonomic practices. The prevalence of WMSD was measured using the Cornell MS Discomfort Questionnaire (CMDQ) with high reliability and validity, with a Cronbach's Alpha value exceeding 0.95, and an intraclass correlation coefficient (ICC)= 0.69-0.95. Ergonomic knowledge was measured using the Ergonomic Knowledge Questionnaire with high validity (0.98) and fair reliability (r= 0.75). The attitude questionnaire was measured using a Likert scale consisting of yes, no, and maybe. Ergonomic practices are obtained by using the Rapid Office Strain Assessment (ROSA). ROSA is a questionnaire with high inter-observer and intraobserver reliability (ICC 0.88 and 0.91). Participants answered a picture-based questionnaire consisting of 3 parts: (1) chair, (2) monitor and telephone, (3) mouse. Most office workers experienced WMSD (99.3%) with moderate discomfort (66.5%). The common complaints being upper back (83%), right upper arm (78.9%) and neck (78.6%). A total of 73.7% of office workers have poor and little knowledge about ergonomics. The majority of office workers (97%) have a positive attitude towards ergonomics. 75.2% of office workers in Malaysia have good ergonomic practices. Most office workers in Malaysia have poor ergonomic knowledge, positive attitudes and good ergonomic practices.

Perspectives of persons in charge regarding support for the health and daily lives of female technical intern trainees who migrate to Japan: a qualitative study / Journal of Rural Medicine

Objectives: Migrant technical intern trainees who migrate to Japan have become essential to the Japanese labour force, especially in rural areas. Persons in charge of supervising organisations and training coordinators both support the trainees’ health and daily lives during their stay in Japan. This support is significant for trainees as it helps them access and interact with Japanese society. This study explored the perspectives of persons in charge of female technical trainees regarding support for the latter’s health and daily lives.Materials and Methods: Semi-structured interviews were conducted with 14 persons in charge of female technical trainees, followed by a thematic analysis of the interview data to extract key themes.Results: Four primary themes emerged: fostered beliefs and roles, cultural considerations and health support, language considerations, and concerns about female trainees in relationships. These considerations and support developed solely through experience of persons in charge of female trainees. Additionally, those in charge expressed concerns about trainees being involved in a relationship. However, no specific measures, such as providing female trainees with information, have been taken.Conclusion: Persons in charge of female technical intern trainees need to be provided opportunities to learn about cultural considerations and providing health support for their trainees. Furthermore, the cooperation of health professionals with supervising organisations and training facilities is essential to promote the healthy lives of technical intern trainees. These insights can contribute to the development of an integrated community-based approach to support the health and daily lives of female trainees.

Trends in the prevalence of common chronic diseases among workers of automotive industry in 2019 - 2021 / 公共卫生与预防医学

Objective To analyze the prevalence, annual trends, and co-morbidity trends of common chronic diseases among workers in a large automotive industry from 2019 to 2021, and to provide a scientific basis for the health management of workers in the automotive industry. Methods The health examination data of workers in a large automotive industry from 2019-2021 were analyzed. Trends in the prevalence of chronic diseases and co-morbidities were analyzed using Join Point software and trend χ2 test. Results The prevalence of metabolic syndrome, hyperuricemia, and fatty liver in the 2019 – 2021 health checkups of workers in this enterprise increased at an average rate of 9.27%, 11.35%, and 3.99% per year, respectively. The prevalence of metabolic syndrome, hyperuricemia, and fatty liver in male workers showed an increasing trend at an average rate of 7.05%, 9.25%, and 2.91% per year, respectively. The prevalence of metabolic syndrome in female workers showed an increasing trend at an average rate of 20.76% per year. The prevalence of metabolic syndrome, hyperuricemia and fatty liver was on the rise in the age groups ≤ 29 years old and 40 – 49 years old. The proportion of metabolic syndrome and its co-morbidity with one or two common chronic diseases showed an increasing trend. Conclusion The prevalence and co-morbidity of common chronic diseases in this enterprise are generally on the rise. The enterprise should focus on health education and preventive care for chronic diseases among workers aged ≤ 29 and 40 – 49 years old and male workers and control the annual increasing trend of metabolic syndrome among female workers and workers in the age group ≤ 29 years.

Development of a mobile personnel radiation protection equipment / 中国辐射卫生

Objective To design a mobile personnel radiation protection equipment for operation in environments with high radiation such as spent fuel reprocessing plants, to achieve simultaneous protection against γ radiation, neutron radiation, and radioactive aerosol, to reduce the internal and external exposure dose of radioactive workers, and to meet the requirement of operation for two hours. Methods The core parts of the mobile personnel radiation protection equipment included a shielding chamber and a respiratory maintenance system. An automated chassis was used for the movement and lifting of the shielding chamber. MCNP software was used to simulate and calculate the protective effects of shielding chamber made of different materials and material thicknesses. Experimental verification of the shielding chamber design was conducted. Mathematical models were established to describe the variations in the content of various gases in the chamber with personnel operation time. A respiratory maintenance system, a harmful gas absorption device, and an automated mobile chassis were designed. Results The shielding chamber made of polyethylene with a thickness of 80 mm achieved an 80% neutron shielding rate. The respiratory maintenance system could support workers for 2 hours of operation inside the equipment. The mobile chassis allowed operation of the equipment with one person. Conclusion This mobile personnel radiation protection equipment can solve the problem in simultaneous protection against γ radiation, neutron radiation, and radioactive aerosol. The equipment can provide radiation protection for radioactive workers, reduce exposure dose, and reduce personnel burden. This system provides technical means for the operation and maintenance of equipment in high-radiation sites such as spent fuel reprocessing plants.

Analysis of correlation between job embedding and turnover intention of hospital nurses / 现代医院

Objective To understand the status quo of job embeddedness and turnover intention of hospital nurses,and to explore their correlation.Methods Using convenient sampling method,we selected 538 nursing workers from 8 tertiary hospi-tals in Guangzhou,and conducted an electronic questionnaire survey with job embeddedness Scale and Turnover Intention Scale.Results The total average score of job embeddedness was(3.41±1.26),and the total average score of turnover intention was(2.66±0.94).There was a negative correlation between job embeddedness and turnover intention(r =-0.060,P＞0.05).Conclusion The scores of job embeddedness and turnover intention of hospital nurses are at the middle level,and job embed-dedness is negatively correlated with the total average score of turnover intention.It is suggested that the management mode of hospital nurses should be standardized,the legitimate rights and interests of nurses should be guaranteed,the construction of pro-fessional certification system should be promoted,the nurses'positive job embeddedness should be promoted,the hospital nurs-ing staff should be stabilized,and the satisfaction of nursing service should be improved.

Study on the Problems and Countermeasures in Reforming the Outpatient Co-payment Protection Mechanism of Basic Medical Insurance for Urban Workers Policy / 中国卫生经济

The process of establishing and improving the Employee Health Insurance Outpatient Co-payment Protection Mecha-nism is one of the major livelihood projects to deepen the reform of China's medical insurance system.The implementation of the mu-tual-aid mechanism for covering outpatient bills in each coordinating region is accompanied by the risks of squeezing outpatient medi-cal resources,the prevalence of fraud and deception,the increase of the government s economic burden and the lack of public ac-ceptance.In this regard,suggestions are made to improve the policy:open source and cut costs to make up for the shortage of funds,linkage of three medical institutions to build a medical security pattem,coordinated supervision to maintain the stability of medical insurance funds,and optimized policies to promote the reform of medical insurance payment methods.

Research on the Operation Efficiency of Basic Medical Insurance for Urban Workers and Its Influencing Factors in China from 2020 to 2021 / 中国卫生经济

Objective:Efficiency is a key factor in the sustainable operation of the medical insurance system.By measuring the current efficiency of the urban employee basic medical insurance system in 31 provinces in China from 2020 to 2021,it discovers possible problems,and provides reference suggestions for improving the efficiency of the system.Methods:Using the super efficiency SBM model based on unexpected output and the Malmquist index to measure the static and dynamic efficiency of employee medical in-surance in 31 provinces in China,and using Tobit regression analysis to analyze its influencing factors.Results:The overall compre-hensive efficiency of the national employee medical insurance operation is 0.826 in 2020 and 0.827 in 2021 respectively.The efficien-cy of employee medical insurance operation in the eastern region is significantly higher than that in the central and westem regions.Over 60％of provinces have inefficient operation of employee medical insurance.The overall total factor productivity of employee medical insurance operation is showing a downward trend,and the decline in technological progress is the main limiting factor.The level of economic development has a significant promotion effect on the efficiency of employee medical insurance operation,and the degree of population aging has a significant inhibitory effect on it.Conclusion:The efficiency of employee medical insurance opera-tion in China still needs to be improved,and there is a significant efficiency gap among different regions.Therefore,investment and attention should be increased in the central and western regions to bridge regional gaps and promote the equity development of medi-cal insurance.Therefore,the reform efforts should be continuously intensified to achieve technological progress.In addition,attention should also be paid to the driving role of economic development in the efficiency of employee medical insurance operation and the for-mulation of positive policies on population aging.

Efetividade da aromaterapia na dependência de nicotina em trabalhadores da saúde / Effectiveness of aromatherapy in nicotine dependence in healthcare workers

INTRODUÇÃO: O tabagismo é considerado uma doença crônica de dependência da nicotina e um fator de risco para doenças graves como câncer e doenças cardiovasculares, além de ser uma das principais causas de mortes evitáveis no mundo. Os programas de controle do uso do tabaco atingiram um bom resultado nas últimas décadas, com a redução do número de fumantes. Contudo, verifica-se que o tratamento medicamentoso e comportamental não apresenta 100% de eficácia, com recaídas e efeitos colaterais para o fumante. Novos desafios foram impostos após a pandemia da COVID-19, principalmente no setor da saúde, no qual a preocupação com os impactos na saúde dos trabalhadores e das trabalhadoras ficou em evidência. Nesse cenário, foi verificada a importância de cuidar dos que mais se expuseram aos efeitos nocivos desse período, voltando o olhar não somente para transtornos a nível psíquico dessa parcela populacional, mas também para a promoção da qualidade de vida do trabalhador, principalmente do trabalhador que apresenta um comportamento de risco em saúde, como por exemplo, o trabalhador tabagista. A aromaterapia, uma Prática Integrativa e Complementar em Saúde apoiada em evidências de efetividade clínica nas mais diversas condições clínicas, foi proposta como intervenção neste grupo. OBJETIVO: Avaliar a efetividade da aromaterapia na dependência de nicotina em trabalhadores tabagistas. MÉTODO: Estudo piloto, clínico, randomizado, duplo-cego que utilizou dois óleos essenciais, piper nigrum e angelica archangelica, por meio de inalação, em dois grupos de trabalhadores da saúde, para avaliar o efeito desses óleos nos níveis de dependência do tabagismo. Os desfechos avaliados foram o nível de dependência de nicotina (desfecho primário), mensurado por meio do Teste de Fagerstrom, e a medida da carga tabágica (desfecho secundário) do participante. A pesquisa foi desenvolvida em um período de 30 dias nas dependências de um hospital universitário da cidade de Belo Horizonte/MG com uma população de 29 trabalhadores tabagistas. A análise dos dados foi realizada por meio do programa SPSS versão 21.0 e as mudanças nos níveis de dependência da nicotina e de carga tabágica no estudo foram avaliadas utilizando o teste de Wilcoxon emparelhado. As associações entre as variáveis categorizadas foram feitas por meio do teste qui-quadrado de Pearson. A efetividade dos óleos essenciais entre os grupos foi realizada pelo Teste de Mann-Whitney. Para todos os testes, foi fixado o nível de significância de 5%. RESULTADOS: Os grupos aleatorizados foram semelhantes entre si na maioria das variáveis analisadas (p>0,05). Houve diminuição tanto da carga tabágica quanto no teste de dependência à nicotina após a intervenção com os óleos essenciais em ambos os grupos (p<0,05), com o grupo Angélica iniciando a pesquisa com um grau moderado de dependência no Teste de Fagerstrom e carga tabágica moderada, e ao final demonstrando uma baixa dependência e carga tabágica baixa. Da mesma maneira, o grupo Pimenta-preta exibiu uma baixa dependência de nicotina e carga tabágica baixa no teste inicial e após a intervenção, uma baixíssima dependência. Dois participantes do sexo masculino, cada um de um grupo avaliado, alcançou a abstinência. Não houve diferença significativa (p>0,05) no tamanho do efeito em relação ao tipo de óleo essencial utilizado. CONCLUSÃO: Os óleos essenciais utilizados na pesquisa foram efetivos na redução da dependência da nicotina e na diminuição da carga tabágica dos sujeitos avaliados. Não houve diferença significativa entre o efeito dos OE do grupo controle em relação ao grupo experimental.

INTRODUCTION: Smoking is considered a chronic nicotine addiction disease and a risk factor for serious illnesses such as cancer and cardiovascular disease, as well as being one of the main causes of preventable deaths worldwide. Tobacco control programs have achieved good results in recent decades, with a reduction in the number of smokers. However, drug and behavioral treatment is not 100% effective, with relapses and side effects for smokers. New challenges have been imposed following the COVID-19 pandemic, especially in the health sector, where concerns about the impact on workers' health have been highlighted. In this scenario, the importance of caring for those who have been most exposed to the harmful effects of this period has been verified, looking not only at the psychological disorders of this population, but also at promoting the quality of life of the worker, especially the worker who presents a health risk behavior, such as the smoking worker. Aromatherapy, an Integrative and Complementary Health Practice supported by evidence of clinical effectiveness in a wide range of clinical conditions, was proposed as an intervention for this group. OBJECTIVE: To evaluate the effectiveness of aromatherapy on nicotine dependence in workers who smoke. METHOD: A pilot, clinical, randomized, double-blind study using two essential oils, piper nigrum and angelica archangelica, by inhalation, in two groups of health workers, to evaluate the effect of these oils on levels of smoking dependence. The outcomes assessed were the level of nicotine dependence (primary outcome), measured using the Fagerstrom Test, and the measure of the participant's smoking load (secondary outcome). The study was carried out over a period of 30 days on the premises of a university hospital in the city of Belo Horizonte/MG with a population of 29 workers who were smokers. Data analysis was carried out using the SPSS program version 21.0 and changes in levels of nicotine dependence and smoking load in the study were assessed using the paired Wilcoxon test. Associations between the categorized variables were made using Pearson's chi-square test. The effectiveness of the essential oils between the groups was assessed using the Mann-Whitney test. A significance level of 5% was set for all tests. RESULTS: The randomized groups were similar in most of the variables analyzed (p>0.05). There was a decrease in both smoking load and nicotine dependence after the intervention with essential oils in both groups (p<0.05), with the Angelica group starting the study with a moderate degree of dependence in the Fagerstrom test and moderate smoking load, and at the end showing low dependence and low smoking load. Similarly, the Black Pepper group exhibited a low nicotine dependence and low smoking load in the initial test and after the intervention, a very low dependence. Two male participants, each from an evaluated group, achieved abstinence. There was no significant difference (p>0.05) in effect size in relation to the type of essential oil used. CONCLUSION: The essential oils used in the study were effective in reducing nicotine dependence and the smoking burden of the subjects evaluated. There was no significant difference between the effect of EOs in the control group and the experimental group.

Willingness of WHO staff to work in health emergencies in the African Region: opportunity for phased deployment of staff and ensure continuity of health services

A human resource base that ensures appropriate deployment of staff to emergencies, addressing different shock events in emergencies, without disrupting continuity of service is germane to a successful response. Consequently, the WHO Health Emergencies programme in the African Region, in collaboration with Africa Centre for Disease Control (ACDC) launched the African Volunteer Health Corps (AVoHC) and Strengthening and Utilization of Response Group for Emergencies (SURGE), an initiative aimed at ensuring a pool of timely responders. We explored the willingness of WHO staff to work in emergencies. A call for expression of interest to be part of the Elite Emergency Experts (Triple E) was published on 5th July 2022 via email and was open for 5 weeks. The responses were analyzed using simple descriptive statistics and presented with graphic illustrations. A total of 1253 WHO staff, from all the six WHO regions, cutting across all cadre, applied to the call. The applicants had various trainings and experiences in emergency and have responded to mostly disease outbreaks. Two-third of the applicants were males. This paper did not explore reasons for the willingness to work in emergencies. However, contrary to fears expressed in literature that health workers would not want to work in emergencies with potential for infections, the applicants have worked mostly in infectious emergencies. Literature identified some themes on factors that could impact on willingness of health workers to work in emergencies. These include concerns for the safety of the responders and impact of partners, child and elderly care, as well as other family obligations, which emergency planners must consider in planning emergency response.

Psychological distress among South African healthcare workers during the COVID-19 pandemic

Background: The COVID-19 pandemic has placed immense pressure on healthcare workers (HCWs). Objectives: This study sought to find the prevalence and factors associated with psychological distress among HCWs in South Africa during the beginning phases of COVID-19 and make relevant recommendations. Method: The survey was administered online through a data-free platform. Data were benchmarked to the national population of over 500 000 healthcare professionals in South Africa. Multiple logistic regressions were used to determine association between psychological distress and potential explanatory variables. Results: A total of 7607 healthcare professionals participated in the study (1760 nurses, 2843 medical practitioners and 3004 other healthcare professionals). Half of the nurses, 41% of medical practitioners and 47% of other healthcare professionals were classified as psychologically distressed. Those who were of older age, provided with well-being support services and having a positive outlook on the healthcare system were significantly less likely to be distressed. Being female medical practitioners and female other healthcare professions, requesting routine counselling, being concerned about not having enough leave and that their life insurance policy did not cover COVID-19 were more likely to be distressed. Conclusion: Psychological well-being of HCWs in South Africa is at risk. We recommend that psychological distress of HCWs be routinely assessed and that routine counselling, well-being support services, appropriate hazardous leave and insurance be provided to all HCWs. Contribution: This study adds to the literature on the psychological distress faced by HCWs in South Africa during COVID-19.

Fast-track interventions for HIV and AIDS epidemic control among key populations: A rapid review

Background: Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. Aim: This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. Methods: An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2­3 h long and conducted in English, and data saturation was attained by the fifth FGDs. Results: An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. Conclusion: The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence. Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy.

Characterization of genital chlamydia amongst female sex workers in Nairobi, Kenya

Introduction: genital chlamydia, which is caused by diverse Chlamydia trachomatis genotypes, is largely asymptomatic. We aimed to identify C. trachomatis genotypes causing genital chlamydia among female sex workers attending a sex workers outreach program clinic in Nairobi, Kenya. Methods: this cross-sectional study was conducted between 18 April 2017 and 19 March 2021. Genitourinary complaints from eligible female sex workers were documented using a structured questionnaire. Endocervical swabs were collected for laboratory analysis. C. trachomatis plasmid DNA was extracted, PCR-amplified, and sequenced. Consensus sequences were generated and aligned with reference sequences to determine the C.trachomatis genotypes. Bivariate analysis was used to determine the association between genitourinary complaints and genital chlamydia. Results: endocervical swabs were collected from a total of 348 participants. Of these, 46 (13.2%) were positive for C. trachomatis. Most (297, 85.3%) of the participants presented with pelvic discharge with or without other symptoms. Fifteen (15, 4.3%) had abdominal pain and 3 (0.9%) had an itchy vulva. There was no statistically significant relationship between clinical presentation and genital chlamydia. Twenty-three samples were successfully sequenced. Each sequence was at least 90% identical to each of the 13 references C. trachomatis genotypes A, B, C, D, E, F, G, Ia, J, L1, L2, L2b and L3. Conclusion: we found no significant association between individual genitourinary complaints and genital chlamydia infection. The C. trachomatis genotypes circulating amongst female sex workers in Nairobi could be related to genotypes A, B, C, D, E, F, G, Ia, J, L1, L2, L2b, and L3.