Triagem otoneurológica em trabalhadores expostos à altura / Otoneurological screening in workers exposed to height / Triaje otoneurológica en trabajadores expuestos a la altura

O trabalho em altura está entre as principais causas de acidentes ocupacionais no Brasil e é o fator que apresenta o maior risco de morte no ambiente laboral. Objetivo: Avaliar a presença de sinais e sintomas otoneurológicos em trabalhadores expostos à altura, no Distrito Federal. Método: Trata-se de um estudo observacional, transversal, de triagem otoneurológica, com 46 trabalhadores da construção civil, expostos à altura, localizados no Distrito Federal. Resultados: 52,2% dos participantes apresentaram alterações significativas no teste de Fukuda e correlação estatisticamente relevante (valor-p< 0.05) entre a média da idade e as queixas de tontura e desequilíbrio. Conclusão: A triagem mostrou-se uma ferramenta prática rápida, de baixo custo e eficaz para avaliar as queixas, sinais, sintomas e alterações otoneurológicas que podem comprometer a segurança do trabalhador quanto ao risco de queda.

Working at height is among the leading causes of occupational accidents in Brazil and is the factor that presents the greatest risk of death in the workplace. Objective: To evaluate the presence of otoneurological signs and symptoms in workers exposed to heights in the Federal District. Method: This is an observational, cross-sectional study of otoneurological screening, with 46 construction workers exposed to heights, located in the Federal District. Results: 52.2% of the participants had significant alterations in the Fukuda test and a statistically relevant correlation (p-value < 0.05) between the mean age and complaints of dizziness and unbalance. Conclusion: The screening proved to be a quick, low-cost and effective practical tool to assess complaints, signs, symptoms, and otoneurological changes that may jeopardize the safety of the worker as to the risk of falling.

El trabajo en altura está entre las principales causas de accidentes laborales en Brasil y es el factor que presenta mayor riesgo de muerte en el lugar de trabajo. Objetivo: Evaluar la presencia de signos y síntomas otoneurológicos en trabajadores expuestos a la altura, en el Distrito Federal. Método: Se trata de un estudio observacional, transversal, de triaje otoneurológico, con 46 trabajadores de la construcción, expuestos a la altura, ubicados en el Distrito Federal. Resultados: el 52,2% de los participantes mostró cambios significativos en el test de Fukuda y una correlación estadísticamente relevante (valor p < 0,05) entre la edad promedio y las quejas de mareos y desequilibrio. Conclusión: El screening demostró ser una herramienta práctica rápida, de bajo costo y efectiva para evaluar quejas, signos, síntomas y cambios otoneurológicos que podrían comprometer la seguridad del trabajador frente al riesgo de caída.

Compliance with the five moments for hand hygiene of healthcare workers in a pediatric hospital. A prospective observational study

Introduction: Healthcare-associated infections (HAIs), also known as nosocomial infections or hospital-acquired infections, begin within 48 hours of hospitalization, within 30 days after hospital discharge, or 90 days after undergoing surgical procedures. Objective: The study aimed to describe the compliance with the five moments for hand hygiene (HH) of the healthcare workers (HCWs) in a hospital. Methods: A prospective observational study was conducted from June 1 to 30,2020 in a pediatric hospital. HCWs compliance with the five moments of HH was registered by direct observation blindly to the participants, using the fact sheet for HH of the WHO. In the rows, the five moments of contact with the patients were recorded: before touching a patient, before clean aseptic procedure, after body fluid exposure risk, after touching a patient and after touching patient surroundings. The actions performed, also was registered: hand washing, alcohol hand friction, omission, or use of gloves. Data were analyzed in SPSS V 21. The protocol was approved by the institutional review board. Results: During the study period, 2.595 observations to 104 HCWs were made. They were pediatric residents 38.5 %, nurses 32.7 % and pediatricians 28.8 %. A global compliance with the five moments of HH of the participants were 64.5% (1673/2595). Before touching a patient, the adherence was 86,9%. The nurses adhered in 69%, pediatrician in 68.6 % and the pediatric residents in 57.2%. Discussion: The global percentage of compliance with the five moments of HH of the medical and nursing staff of the pediatric hospital was 64.5%. Nurses had the highest percentage of adherence. Handwashing compliance was higher before contact with the patients.

Introducción: Las infecciones asociadas a la atención médica (IAAS), también conocidas como infecciones nosocomiales o infecciones adquiridas en el hospital, comienzan dentro de las 48 horas posteriores a la hospitalización, dentro de los 30 días posteriores al alta hospitalaria o 90 días después de someterse a procedimientos quirúrgicos. Objetivo: El estudio tuvo como objetivo describir el cumplimiento con los cinco momentos para la higiene de manos (HH) de los trabajadores de la salud (TDS) en un hospital. Metodología: Se realizó un estudio observacional prospectivo del 1 al 30 de junio de 2020 en un hospital pediátrico. La adherencia de los TDS con los cinco momentos de HH fue registrada por observación directa de manera ciega a los participantes, utilizando la hoja informativa para HH de la OMS. En las filas se registraron los cinco momentos de contacto con los pacientes: antes de tocar a un paciente, antes de un procedimiento aséptico limpio, después de exponerse a fluidos corporales, después de tocar a un paciente y después de tocar el entorno del paciente. También se registraron las acciones realizadas: lavado de manos, fricción con alcohol en gel, omisión o uso de guantes. Los datos fueron analizados en SPSS V 21. El protocolo fue aprobado por el comité de ética institucional. Resultados: Durante el período de estudio, se realizaron 2,595 observaciones a 104 TDS. Eran residentes pediátricos en un 38.5%, enfermeras en un 32.7% y pediatras en un 28.8%. La adherencia global a los cinco momentos de HH de los participantes fue del 64.5% (1673/2595). Antes de tocar a un paciente, la adherencia fue del 86.9%. Las enfermeras se adhirieron en un 69%, los pediatras en un 68.6% y los residentes pediátricos en un 57.2%. Discusión: El porcentaje global de cumplimiento con los cinco momentos de HH del personal médico y de enfermería del hospital pediátrico fue del 64.5%. Las enfermeras tuvieron el mayor porcentaje de adherencia. El cumplimiento del lavado de manos fue mayor antes del contacto con los pacientes.

Análisis del síndrome post-COVID-19 en personal de salud: comparación sobre condiciones de género y trabajo / Analysis of long COVID in health personnel: comparing gender and work factors

Resumen Introducción : El objetivo del estudio fue describir la prevalencia del reporte de síndrome post-COVID-19 y sus características según género, profesión y otros de terminantes sociales, en personal de salud. Métodos : Se realizó un estudio de corte transver sal en profesionales de salud con antecedentes de COVID-19 en América Latina, y para este análisis se seleccionaron las 2030 respuestas de Argentina. Se recolectaron datos sociodemográficos, información sobre el curso inicial de la enfermedad COVID-19, y persistencia de 21 síntomas más allá del primer mes, su gravedad, evolución clínica y requerimiento de ser vicios de salud. Resultados : Se identificó que la prevalencia re portada de síndrome post-COVID-19 fue mayor en mujeres para cada uno de los grupos de síntomas explorados. La gravedad del cuadro inicial, el género femenino, la profesión de enfermería, el multiempleo y trabajar en áreas de emergencia fueron variables independientes. Discusión : La mayor sobrecarga del personal de sa lud durante la pandemia -altamente feminizado- y las determinaciones de género asociadas podrían explicar parcialmente estos hallazgos.

Abstract Introduction : This study aimed to describe the re ported prevalence of post-COVID-19 syndrome and its characteristics by gender, profession, and other deter minants among health care workers. Methods : A cross-sectional study was conducted among health workers with a history of COVID-19 in Latin America, and the 2030 responses from Argentina were selected for this analysis. Sociodemographic infor mation, as well as data on initial course of COVID-19, and the persistence of 21 symptoms beyond the first month, their severity, clinical evolution, and health care demands were collected. Results : The reported prevalence of post-COVID-19 syndrome was higher in women for each of the symptom clusters studied. Severity of the initial symptoms, female gender, nursing profession, multi-employment, and work ing in emergency areas were all independent variables. Discussion : The greater strain of health care workers during the pandemic -highly feminized- and the as sociated gender conditions may partially explain these findings.

Experiencia de trabajo de cuidados de trabajadores de la salud en Chile durante la pandemia COVID-19 y su impacto en la salud mental: estudio cualitativo a partir de la iniciativa internacional HEROES / The caregiving work experience of healthcare workers in Chile during the COVID-19 pandemic and its impact on mental health: A qualitative study based on the international initiative HEROES

Introducción La pandemia por COVID-19 ha impactado la salud mental de los trabajadores de salud. La perspectiva de cuidados se ha identificado como necesaria de estudiar, para entender causas atribuibles asociadas a hallazgos específicos en materia de salud mental y proponer cursos de acción para abordarla. Métodos Estudio de carácter transversal con enfoque analítico temático, derivado de la iniciativa internacional (HEROES) Fue realizado entre trabajadores de salud en Chile, durante el segundo semestre de 2022 y el primero de 2023, a través entrevistas semiestructuradas y codificación inductiva. Resultados Síntesis narrativa de 35 entrevistas, en cuatro temas: cuidados en el trabajo: presencia de cambios de funciones, preocupación por contagio, "mística" colectiva, estigma por condición de trabajador de la salud, conflictos con pacientes; cuidados en el hogar: diversas formas de arreglos de tareas domésticas, relevancia de la convivencia con otros, interrelación con dinámicas laborales, "doble carga" entre mujeres; relación con la propia salud mental: reconocimiento de afectación en salud mental, estrés asociado a cambio e incertidumbre, percepción de sobrecarga laboral, sentimientos de culpa o responsabilidad por contagio a familiares; y creencias y valores sobre la pandemia y sus efectos: aceptación de afectación psíquica de trabajadores de la salud, cultura organizacional como elemento relevante en postergación de propia salud mental, incredulidad inicial ante efectos de la pandemia, similitudes con periodos de conmoción social previos, igualdad entre personas respecto a vulnerabilidad frente a enfermedad. Conclusiones Cinco elementos surgen como potenciales áreas de intervención: perspectiva de género, exposición previa a experiencias de crisis, espacios de autocuidado, apoyo de pares y respuesta institucional. La perspectiva de cuidados es útil para estudiar la relación entre algunos factores estresantes y la salud mental de los trabajadores de salud en el contexto de pandemia.

Introduction The COVID-19 pandemic has impacted the mental health of healthcare workers. Studying the care perspective is essential to understanding the causes of specific mental health findings and proposing strategies to address them. Methods Cross-sectional study with a thematic analytical approach, derived from the international initiative "The Health Care Workers Study" (HEROES), conducted among healthcare workers in Chile during the second semester of 2022 and the first of 2023 through semi-structured interviews and inductive coding. Results A narrative synthesis of 35 interviews in four themes: care at work: the presence of changes in work tasks, concern about becoming infected, collective "mystique", stigma due to being a healthcare worker, conflicts with patients; care at home: multiple ways of arranging household tasks, the relevance of living with others, interrelation with work dynamics, "double burden" among women; relationship with one's own mental health: recognition of mental health impact, the stress associated with change and uncertainty, perception of work overload, feelings of guilt or responsibility for infecting family members; and beliefs and values about the pandemic and its effects: acceptance of psychological impact on healthcare workers, organizational culture as a relevant element in postponing one's own mental health, initial disbelief in the effects of the pandemic, similarities with previous periods of social upheaval, and equality among people in terms of vulnerability to the disease. Conclusions Five elements emerge as potential areas for intervention: gender perspective, previous exposure to crisis experiences, self-care spaces, peer support, and institutional response. The care perspective helps study the relationship between some stressors and healthcare workers' mental health in the context of a pandemic.

Assessment of nutritional status and health challenges among female garment workers: a cross-sectional study

Background: The economic status of women is now accepted as an indicator of a society’s development in Bangladesh. Women workers like the majority in the informal sector have been exposed to rigorous work, discipline, fixed working hours, specific production norms etc. The aim of the study was to perform cross-sectional study was conducted to assess nutritional status of female garment workers in Chattogram, Bangladesh. Methods: The study was conducted with the help of a semi-structured questionnaire to collect data from the respondents by face-to-face interview. Informed written consent was obtained from the respondents. A checklist containing height and weight (measured using measuring tape and digital weight machine respectively) of the respondents included in the questionnaire. Results: According to the study, gastrointestinal problem was reported by 49.7% and the rest reported problem were respiratory problem (35.3%), skin problem (27.3%), urinary problem (18%), eye problem (15%). Age, marital status, number of children, family member, monthly income, job section, working hours and overtime were significantly associated with various types of health problem. Respondents were categorized into underweight (?18.5 kg/m2), normal (18.6-24.9 kg/m2) and overweight and above (?25.0 kg/m2) using BMI. Prevalence of underweight, normal and overweight and above were 3.3%, 61.3% and 35.3% respectively. Conclusions: Female worker’s age, marital status, number of children, monthly income, job duration, job section and overtime showed significant association with their nutritional status (BMI). Findings of this study may play an important role to develop a policy and in commercial sector of our country to reduce health problem of the female garment workers for better productive and healthy lifestyle.

Prevalência e fatores associados à síndrome metabólica em Agentes Comunitários de Saúde / Prevalence and factors associated with metabolic syndrome in Community Health Workers

A síndrome metabólica é um distúrbio metabólico complexo, caraterizada pela associação de fatores de risco cardiovascular e resistência à insulina. Na Atenção Primária à Saúde, algumas condições laborais as quais os profissionais estão expostos podem ser fonte de adoecimento, e a literatura evidencia que aspectos laborais estão associados à síndrome metabólica, ou seja, que o contexto ocupacional é capaz de ser um fator de exposição para o desenvolvimento deste problema. O objetivo deste estudo foi estimar a prevalência de síndrome metabólica e os fatores associados em Agentes Comunitários de Saúde de uma cidade do Norte de Minas Gerais, Brasil. Estudo transversal, no qual coletaram dados sociodemográficos, estilo de vida, laborais, antropométricos, bioquímicos e aspectos emocionais. A variável dependente síndrome metabólica foi definida conforme o critério do National Cholesterol Education Program Adult Treatment Panel III. Realizaram-se análises descritivas e de regressão múltipla de Poisson, com variância robusta, considerando um nível de significância de 5% (p<0,05) para o modelo final. Foram avaliados 673 Agentes Comunitários de Saúde, a prevalência de síndrome metabólica foi de 20,8% e associou-se à faixa etária ≥40 anos, menor escolaridade (Fundamental e/ou Médio), sobrepeso/obesidade, lipoproteína de baixa densidade ≥130 mg/dl e proteína C-reativa >5,0 mg/dl. Constatou-se uma elevada prevalência de síndrome metabólica em Agentes Comunitários de Saúde. Verifica-se a necessidade de estudos para o aprofundamento sobre a temática e o desenvolvimento de ações que visem a promoção de hábitos comportamentais saudáveis, bem como a prevenção de fatores de riscos.

Metabolic syndrome is a complex metabolic disorder, characterized by the association of cardiovascular risk factors and insulin resistance. In Primary Health Care, some work conditions to which professionals are exposed can be a source of illness and the literature shows that work aspects are associated with metabolic syndrome, that is, that the occupational context is capable of being an exposure factor for the development of this problem. The objective of this study was to estimate the prevalence of metabolic syndrome and associated factors among community health workers in a city in the North of Minas Gerais, Brazil. Cross-sectional study, in which sociodemographic, lifestyle, work, anthropometric, biochemical, and emotional aspects of data were collected. The dependent variable metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Descriptive and multiple Poisson regression analyzes were carried out with robust variance, considering a significance level of 5% (p<0.05) for the final model. 673 community health workers were evaluated, the prevalence of metabolic syndrome was 20.8% and was associated with the age group ≥40 years, lower education (elementary and/or secondary), overweight/obesity, low-density lipoprotein ≥130 mg/dl and C-reactive protein >5.0 mg/dl. A high prevalence of metabolic syndrome was found in community health workers. There is a need for studies to delve deeper into the topic and develop actions aimed at promoting healthy behavioral habits, as well as preventing risk factors.

Determinants of human immuno-deficiency virus pre-exposure prophylaxis uptake and retention among sex workers in Nakuru town Kenya

Background: The purpose of this study was to assess factors associated with human immunodeficiency virus (HIV) pre-exposure prophylaxis uptake and retention among sex workers in Nakuru town, Kenya. The theory of planned behavior and the acquired immunodeficiency syndrome (AIDS) risk reduction model served as the study's theoretical framework. Methods: A cross-sectional research design was adopted for this study. The study targeted all the sex workers in Nakuru town who were 18 years old and above. A random sampling technique was used to get the hotspots where the sex workers were to be found. Snow balling sampling technique was then adopted to identify and recruit the study participants. Using primary sources. The quantitative data was obtained from the respondents using a questionnaire. Quantitative data was analyzed using descriptive and inferential statistics (regression analysis). The findings presented in table and graphical formats. Results: The analysis using multiple linear regression indicated that there was a collective significant effect between the awareness, health system factors, socio economic individual factors and use of pre-exposure prophylaxis (PrEP) among sex workers. A further analysis showed that, put together, the four predictor variables explained 35.7% of variation on PrEP uptake and retention. Conclusions: The study concluded that while use and none use PrEP can be explained by the four factors evaluated in this study, there are a lot of other factors that influence utilization of PrEP.

Assessment of Hand Grip Strength and Pinch Grip Strength among Healthy Embroidery Workers: Cross-Sectional Study

Background: Embroidery is a craft that decorates fabric or other materials by using a needle to apply thread or yarn. Hand and finger strength is essential during embroidery design to minimize discomfort and risk of upper extremity injuries Aims and objective: This study aims to assess hand grip strength and pinch grip strength among healthy embroidery workers. Methodology: 100 embroidery workers were recruited. Demographic details including BMI were taken in self-designed form. Hand grip strength was assessed by Jamar Hand Held Dynamometer. Pinch grip strength was assessed by a Pinch Guage Dynamometer. Statistical analysis was done using the Python software. Results: The study included 100 subjects that involved all female subjects aged 20 to 40 yrs. with 4 or more than 4 years of experience. The study showed that the hand grip strength of embroidery workers was more affected than the pinch grip strength. This study also showed that age is not related to the hand grip and pinch grip strength. It also showed that an increase in the years of experience increases hand grip and pinch grip strength (p< 0.05) as well as grip strength was more in the dominant hand(p<0.0001).Conclusion: Hand grip strength was found to be affected more than the pinch grip strength. They found no correlation with the age and there was a correlation with years of experience.

Efectividad de un programa de rehabilitación cardiopulmonar en trabajadores de la salud con infección por COVID-19 / Changes in functional and cardiopulmonary outcomes in patients with COVID-19 infection after a cardiopulmonary rehabilitation program

Resumen Objetivo: evaluar, en una población trabajadora de la salud con COVID-19, la gravedad de la enfermedad y el impacto de un programa de rehabilitación cardiopulmonar ambulatorio fase II basado en ejercicio, en la capacidad funcional, la función medida con la Escala de Estado Funcional posCOVID y el reintegro laboral. Materiales y método: se realizó un estudio cuasiexperimental en 48 trabajadores de la salud con infección por COVID-19. Al inicio y al final se les evaluó gravedad de la infección, función cardiopulmonar y escala de estado funcional post-COVID-19 (PCFS). Se hizo un programa de rehabilitación cardiopulmonar con tres sesiones semanales de ejercicio continuo e interválico individualizado, con una duración de 20 a 60 minutos y una intensidad del 60 al 80% de la frecuencia cardíaca máxima durante un mes. Resultados: hubo 19 casos moderados y 29 graves. La edad promedio fue 54 (DE: 15.5) años, 41.7% eran empleados, 47.9% obesos y 39.6% hipertensos. El 68.8% tuvo neumonía típica, el 29.2% estrés postraumático, el 43.8% síndrome depresivo y el 50% trastornos de ansiedad. La capacidad cardiopulmonar pasó de NYHA II (5.7 DE: 1.2) a NYHA I (8.2: DE: 2.0). Mejoró la independencia en actividades de la vida diaria (ADV) (escala PCFS) y 36 pacientes regresaron a su trabajo. No hubo complicaciones graves. Conclusión: este estudio demostró el impacto positivo de un programa de rehabilitación cardiopulmonar en la función cardiopulmonar y la independencia en actividades diarias e instrumentales en trabajadores de la salud con COVID-19, pues un 75% de estos regresó a sus labores habituales.

Abstract Objective: to evaluate, in a health worker population with COVID-19, the severity of the disease and the impact of an outpatient phase II PRCP based on exercise, on functional capacity, function measured with the post-COVID Functional Status Scale and job reinstatement. Materials and method: a quasi-experimental study was conducted involving 48 healthcare workers with COVID-19. Severity of infection, cardiopulmonary function, and PCFS were assessed at the beginning and end. The CPRP included a program of three weekly sessions of individualized continuous and interval exercises lasting 20 to 60 minutes, with an intensity of 60 to 80% of maximum heart rate over one month. Results: there were 19 moderate cases and 29 severe cases. The average age was 54 (SD: 15.5) years, with 41.7% being employees, 47.9% obese, and 39.6% hypertensive, 68.8% had typical pneumonia, 29.2% experienced post-traumatic stress, 43.8% had depressive syndrome, and 50% had anxiety disorders. Cardiopulmonary capacity improved from NYHA II (5.7 SD: 1.2) to NYHA I (8.2 SD: 2.0). Independence in activities of daily living (PCFS scale) improved and 36 patients returned to work. There were no severe complications. Conclusion: This study demonstrated a positive impact of the CPRP on cardiopulmonary function and independence in daily and instrumental activities among healthcare workers with COVID-19, with 75% returning to their regular duties.

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.

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.

Factors affecting the participation and utilization of breast cancer screening services among health care workers Kolar: a qualitative study

Background: India is going through epidemiologic transition with a shift of disease burden from communicable to non-communicable diseases. There is no organized screening programme for breast cancer in the country. Hence, a large proportion of women with cancer of the breast present in advanced stages of cancer. The integrated cancer control programme calls for early detection of cancer, opportunistic screening and cancer outreach camps that are to be promoted and carried out by health care providers. The objective of this study was thus designed to understand the various factors preventing the participation and utilisation of breast cancer screening. Methods: It was a qualitative method with two groups. The study was conducted between two taluks out of 6, Kolar and Bangarpete. All Angawadi workers and helpers aged more than 30 years were invited and those who have history of breast cancer and family history of breast cancer were excluded from the study. All the subjects who did not attend the screening were included to elicit the reasons for non-attendance. Results: The theme ‘barriers to screening uptake’ were broadly divided into three main categories- namely ‘worry’, ‘transport’ and ‘work commitment’. The sub-category ‘anxiety’ (31.9%) was reported to be the highest barrier and least was in the sub-category ‘no replacement’ (4.3%). The frequency of response categorized into different sub-categories. Conclusions: The reasons were identified by using ‘single question’ interview guide, and were categorized into ‘worry’, ‘transport’ and ‘work-commitment’. Barrier in ‘worry’ category was found to be highest.

An evidence-based tuberculosis patient’s nutrition assessment tool and intervention guidelines for DOTS providers: a modified Delphi study

Background: An individual's nutritional state is an indicator of their overall health. Poor nutrition, under nutrition, vitamin deficiency and protein energy malnutrition a form of nutritional problems. In low and middle-income countries, the linkage between infectious diseases such as tuberculosis and under nutrition is critical to public health. Thus, the current study aims to explore the DOTS Providers' concerns and develop evidence-based tuberculosis patient’s nutrition assessment tool and intervention guidelines for DOTS providers, which can be quick and easy to assess. Methods: A modified Delphi process was used to develop the nutrition assessment tool and intervention guidelines through mixed-method approach. Three rounds of the Delphi process were carried out via email, with a letter requesting to participate in the Delphi process. Result: An in-depth interview schedule was conducted to extract themes and subthemes generating an item pool in the initial phase. The main themes identified were Perception of disease, TB cure, Association of under nutrition and TB management, Problems or difficulties encountered, Counsel, Assessment and intervention. Quantitative data analysis was performed manually by calculating the content validity index (CVI). The CVI was found to be >80% for all the items with I-CVI?0.8 and S-CVI?0.9. All the items were considered very essential with a score of 1. Conclusions: The assessment tool should be subjected to other levels of evaluation that measures the suitability of the tool and interventional guidelines for the intended field.

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).

Knowledge attitude and practice towards COVID-19 booster dose among health care workers: a cross sectional study

Background: Amidst the emerging COVID-19 variants worldwide, India started the COVID precautionary or booster dose vaccination by early 2022. Protecting the healthcare force is crucial, as they are critical drivers in increasing vaccine uptake among the public. Objective was to assess COVID-19 Booster dose vaccine coverage among Health Care Workers (HCWs) and to know the reasons for vaccine booster dose hesitancy. Methods: A cross-sectional study was conducted among health care workers in Vijayapura city, during April-May 2022. The questionnaire in google form was shared to the target population, wherever necessary phone in interview was done. Data was tabulated in MS office Excel and analyzed using appropriate statistical tests. Results: Out of 275 participants from different levels of health care system, 50% were males, 75% in age group <40 years and 67% were from urban area. 37% of the participants took precautionary dose of vaccine against COVID-19. Among those who did not take a booster shot, 22.5% were hesitant to take the vaccine and the reasons were: “Lack of faith in vaccination”, “two doses are sufficient”, and “Fear of side effects”. Socio demographic factors such as age, gender and residence were found to be statistically significant with the COVID Booster vaccination status. Conclusions: Majority health workers are aware of booster dose vaccination, reasons for not taking booster dose were mainly lack of need and fear of side effects.

A case study of hospital contraceptive waste management practices in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Anambra State

Background: Effective management of hospital waste is a critical component of a hospital’s infection control program and is central to occupational safety for healthcare workers. Thus, this study focused on the assessment of hospital contraceptive waste management practices at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Awka, Anambra state, Nigeria. Methods: A cross sectional analytical study was carried out among healthcare workers selected using multistage sampling technique in 6 categories of healthcare workers in COOUTH. Data was collected using a pre-tested semi-structured interviewer-administered questionnaire and a World Health Organization (WHO) checklist and analyzed using statistical package for the social sciences (SPSS) version 22. Associations and correlations between variables were tested at the bivariate level using Chi-square and t-test. Results: A total of 86 healthcare workers were surveyed. The majority of the respondents were females, nurses with RN qualification. The mean knowledge score of the respondents was 94.8%. The attitude of healthcare workers towards segregation of hospital contraceptive waste at source point was 71% while the usage of gloves in handling hospital waste was 95.3%. The major factor affecting contraceptive waste management practices in the facility was the respondent’s cultural beliefs. The lack of funds to finance standard waste disposal methods was noted to be a significant barrier to optimum waste management practices. Conclusions: This study showed that despite the high level of knowledge of healthcare workers on hospital contraceptive waste management practice in COOUTH, the hospital contraceptive waste management practice is not functioning optimally in Anambra state. Hence, the need to reform the hospital waste management practice to achieve functional results.

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

Financial incentive for community health workers, a necessity for achieving universal health coverage: integrated literature review

Community health workers (CHWs) are vital to achieve universal health coverage (UHC). They have been identified as effective workforce to improve access to primary health care particularly for underserved and hard to reach populations. Lack of appropriate incentives, with resulting high rates of turnover are common challenges in large-scale CHW program. Debates about paying community health workers typically focus on the trade-offs between reliance on volunteerism underpinned by intrinsic motivation of volunteers and the need to recognise and remunerate work fairly. Financial payment for CHWs will also help in increased employment, and women’s economic empowerment, tackling gender-based inequities, as seventy percent of CHWs globally are women. This study reviewed existing literature- published peer reviewed articles and grey literatures on financial incentives for community health workers and program considerations for effective implementation. Synthesis from the relevant studies revealed four relevant themes: need for financial incentives, categories of financial incentives, funding mechanisms for financial incentives and program considerations for effective implementation of financial incentives. The study provides program considerations for effective implementation of financial incentive for community health workers. There is need for countries to review their community health worker program design and establish enabling policy environment and implementation mechanisms for realistic and appropriate financial incentives for the community health workers based on their workload, responsibilities, and local context. Appropriate tools should be used to model the community health workers working hours which will guide in determining fair and commensurate renumeration and effective monitoring system established.

Perception of local health functionaries regarding the impact of COVID-19 on health-seeking behaviour of presumptive tuberculosis patients in tricity

Background: The COVID-19 pandemic has affected every domain of human life globally and has presented an unprecedented challenge to public health, work, education, and social life. The healthcare services were prioritized and indirectly affected by that. The current study assumed the perception of healthcare functionaries regarding the impact of COVID-19 on the health-seeking behavior of presumptive TB patients in tricity (Chandigarh, Panchkula, and Mohali). Methods: A concurrent mixed method study design was conducted among 100 randomly selected healthcare functionaries from public health facilities in tricity. A self-structured and validated questionnaire was used and analyzed using SPSS v24 by both qualitative (frequencies, Chi-square, odd ratio) and quantitative (themes) approach. Results: Among 100 respondents 62% participants responded that there was a disruption of the normal functioning of testing and treatment under the National Tuberculosis Elimination Program (NTEP). The logistics and manpower were shifted to COVID-19 management and testing of PTB patients was mostly affected. The in-depth interview found that factors like social stigma, downplaying of TB disease, and less knowledge about TB were the reasons behind the disruption of PTB services. The health functionaries also gave suggestions for the betterment of PTB services if these kinds of pandemics arise in the future. Conclusions: Having national programs such as NTEP should be not kept on back foot while dealing with the pandemic, as TB is considered to be the greatest challenge for Health System and human beings as well.

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.