O trabalho terceirizado e por turnos está associado ao aumento do risco de COVID-19? Descobertas de um estudo com trabalhadores da mineração / Is outsourced and shift work associated with an increased risk of COVID-19? Findings from a study about mining workers

Resumo Objetivos: investigar os fatores de risco sociodemográficos e ocupacionais associados à infeção por COVID-19 em trabalhadores da mineração. Métodos: estudo de coorte retrospectivo com dados secundários dos trabalhadores de uma empresa multinacional de mineração, de março de 2020 a abril de 2021. Casos de COVID-19 foram definidos por meio do resultado do teste reação em cadeia da polimerase (PCR) positivo para SARS-CoV-2. Riscos relativos (RR) para testes positivos foram obtidos por regressão de Poisson. Resultados: dos 10.484 trabalhadores testados, 2.578 (24,6%) tiveram pelo menos um resultado positivo. Foi realizada uma média de 4,0 (desvio-padrão: 3,6) testes para cada trabalhador, totalizando 41.962 testes. A maioria dos trabalhadores eram do sexo masculino (88,3%), com idade entre 30 e 39 anos (38,7%), terceirizados (74,1%) e que não trabalhavam em turnos (70,5%). No modelo múltiplo, os trabalhadores terceirizados (RR: 1,39; intervalo de confiança de 95% [IC95%]: 1,27;1,51) e trabalhadores por turnos (RR: 1,10; IC95%: 1,01;1,20) apresentavam maior risco de infecção quando comparados com seus homólogos. Conclusões: os trabalhadores terceirizados e por turnos exibiram maior risco de infecção pelo SARS-CoV-2 quando comparados com seus homólogos. Portanto, é necessário fornecer monitoramento contínuo com oferta regular e adequada de testes para mitigação e prevenção da COVID-19 nestes grupos ocupacionais.

Abstract Objectives: to investigate the sociodemographic and occupational risk factors associated with COVID-19 infection in mining workers. Methods: a retrospective cohort study, using secondary workers' health data from a multinational mining company, from March 2020 to April 2021. A COVID-19 case was defined based on a SARS-CoV-2 positive result in a polymerase chain reaction (PCR) test. Risk ratios (RRs) for positive testing were estimated using Poisson's regression model. Results: of 10,484 workers, 2,578 (24.6%) had at least one positive result for COVID-19. Each worker underwent an average of 4.0 (standard deviation: 3.6) tests, totaling 41,962 PCR tests. Most of the evaluated workers were male (88.3%), aged from 30 to 39 years (38.7%), outsourced (74.1%) and non-shift workers (70.5%). Our multivariate model showed that outsourced (RR: 1.39; 95% confidence interval [95%CI]: 1.27;1.51) and shift workers (RR: 1.10; 95%CI: 1.01;1.20) had a higher risk of SARS-CoV-2 infection than their counterparts. Conclusions: outsourced and shift workers have a higher risk of COVID-19 infection than their counterparts. Therefore, it is necessary to provide continuous monitoring with regular and adequate testing for mitigation and prevention of COVID-19 in these occupational groups.

COVID-19: perfil de trabalhadores brasileiros em uma companhia de mineração e a dinâmica dos casos comunitários / COVID-19: profile of Brazilian workers of a mining company and the dynamic of community cases

Resumo Objetivo: descrever o perfil de desfechos de COVID-19 em trabalhadores da mineração e a dinâmica dos casos nas unidades de mineração e seus respectivos municípios. Métodos: estudo de coorte e ecológico, com dados secundários clínico-epidemiológicos, sociodemográficos e ocupacionais de trabalhadores de mineradora multinacional no Brasil e de casos de COVID-19 nos cinco municípios onde as unidades estavam localizadas, de março de 2020 a abril de 2021. A incidência acumulada e média móvel (MM) de 7 dias dos casos foram calculadas e comparadas na unidade e respectivo município. Resultados: foram incluídos 17.523 trabalhadores; 88,4% eram do sexo masculino; e 22,6% tiveram pelo menos um resultado positivo. Os trabalhadores mais testados, com casos positivos, colocados em quarentena e com sintomas foram do sexo feminino, de meia-idade, morando e trabalhando no Rio de Janeiro, diretamente contratados pela mineradora, em turnos e ocupações de alto risco. Todas as unidades apresentaram uma incidência acumulada superior aos seus respectivos municípios. Três municípios apresentaram picos de COVID-19 com MM coincidindo com o aumento de casos entre trabalhadores de mineração. Conclusão: aproximadamente um quinto dos trabalhadores foram diagnosticados com COVID-19, e a distribuição temporal dos casos nas unidades de mineração foi semelhante àquela dos municípios onde estavam localizadas.

Abstract Objective: to describe the COVID-19 clinical outcomes profile from mining workers and the cases dynamic within the mining units and their respective municipalities. Methods: a cohort and ecological study using workers clinical-epidemiological, sociodemographic, and occupational secondary data of a multinational mining company, and of COVID-19 cases from five municipalities where the mining units were located, in Brazil, between March 2020 to April 2021. We calculated the cases cumulative incidence and the 7-day moving average (MA), and compared at the mining unit and respective municipality. Results: the study included 17,523 workers, 88.4% male, and 22.6% had at least one positive result for COVID-19. The workers most tested, with positive results, placed in quarantine, and with symptoms were female, middle-aged, living and working in Rio de Janeiro state, directly hired by the mining company, in shift-work, and in high-risk occupations. All mining units presented a cumulative incidence higher than their respective municipalities. Three municipalities showed peaks of COVID-19 with MA cases coinciding with an increase in cases among mining workers. Conclusion: approximately one-fifth of workers were diagnosed with COVID-19. The mining units had a similar temporal distribution of COVID-19 cases to the municipalities where they were located.

Public Programs for Essential Medicine Access in a Small Municipality: A Cross-Sectional Analysis

Abstract Background: Public programs that provide access to essential medications have played an important role in the care of hypertensive and diabetic patients. However, access in small municipalities has been poorly studied. Objectives: To describe the sociodemographic profile and the medication and health service usage of patients with systemic arterial hypertension and/or diabetes mellitus in a small municipality who use the public medication access programs Health has no Price (Saúde Não Tem Preço - SNTP) and the Minas Pharmacy Network. Methods: This cross-sectional study with 341 participants was conducted in 2019. Home interviews were conducted using a standardized, semi-structured questionnaire. The data are expressed as absolute and relative frequencies, and Pearson's chi-square test was used for comparisons between proportions (α = 5%). Results: Most of the participants (70.68%) had hypertension only, 11.14% had diabetes only, and 18.18% had both. Regarding the origin of the hypertension medications, 82.67% were provided by the Minas Pharmacy Network and/or SNTP programs. Regarding oral hypoglycemic agents and insulins, 88.61% were provided by the Minas Pharmacy Network and/or SNTP. Most participants were female (63.1%), at least 65 years of age (50.30%), non-White (66.96%), resided in an urban area (67.16%), were illiterate or had a low education level (89.94%), and had a maximum income ≤ 2 times the federal minimum salary (89.19%). Overall user perception was significantly better for SNTP (p=0.010). Conclusion: The results of this study indicate that programs which provide access to essential medications are important sources of hypertension and diabetes medications in the study area, especially for people with low incomes.

Prevalence of vitamin D deficiency and its relationship with factors associated with recurrent wheezing.

OBJECTIVE: To determine the prevalence of vitamin D deficiency/insufficiency in children 0-18 years of age with recurrent wheezing and/or asthma residing in the microregion of Viçosa, Minas Gerais, Brazil, and treated at a referral center, and to determine its association with major risk factors for wheezing. METHODS: A cross-sectional study was performed using a semi-structured questionnaire, which was administered by trained interviewers to the legal guardians of the study participants. Data were obtained regarding general characteristics of recurrent wheezing; general sociodemographic, environmental, and biologic factors; and atopy-related factors. The magnitude of the statistical association was assessed by calculating ORs and their corresponding 95% CIs by using multiple logistic regression. RESULTS: We included 124 children in the study. The prevalence of vitamin D deficiency/insufficiency in the sample was 57.3%. Vitamin D deficiency/insufficiency was found to be associated with wheezing in the first year of life, personal history of atopic dermatitis, environmental pollution, and vitamin D supplementation until 2 years of age. CONCLUSIONS: The prevalence of vitamin D deficiency/insufficiency was high in our sample. Vitamin D concentrations were directly associated with vitamin D supplementation until 2 years of age and were inversely associated with wheezing events in the first year of life, personal history of atopic dermatitis, and environmental pollution.

Prevalence of vitamin D deficiency and its relationship with factors associated with recurrent wheezing / Prevalência de deficiência de vitamina D e sua relação com fatores associados à sibilância recorrente

ABSTRACT Objective: To determine the prevalence of vitamin D deficiency/insufficiency in children 0-18 years of age with recurrent wheezing and/or asthma residing in the microregion of Viçosa, Minas Gerais, Brazil, and treated at a referral center, and to determine its association with major risk factors for wheezing. Methods: A cross-sectional study was performed using a semi-structured questionnaire, which was administered by trained interviewers to the legal guardians of the study participants. Data were obtained regarding general characteristics of recurrent wheezing; general sociodemographic, environmental, and biologic factors; and atopy-related factors. The magnitude of the statistical association was assessed by calculating ORs and their corresponding 95% CIs by using multiple logistic regression. Results: We included 124 children in the study. The prevalence of vitamin D deficiency/insufficiency in the sample was 57.3%. Vitamin D deficiency/insufficiency was found to be associated with wheezing in the first year of life, personal history of atopic dermatitis, environmental pollution, and vitamin D supplementation until 2 years of age. Conclusions: The prevalence of vitamin D deficiency/insufficiency was high in our sample. Vitamin D concentrations were directly associated with vitamin D supplementation until 2 years of age and were inversely associated with wheezing events in the first year of life, personal history of atopic dermatitis, and environmental pollution.

RESUMO Objetivo: Determinar a prevalência da deficiência/insuficiência de vitamina D em indivíduos com sibilância recorrente e/ou asma com idade de 0-18 anos e residentes na microrregião de Viçosa (MG) atendidos em um centro de referência e determinar sua associação com os principais fatores de risco para sibilância. Métodos: Estudo transversal utilizando um questionário semiestruturado por entrevistadores treinados, aplicado aos responsáveis pelos participantes do estudo. Foram obtidas informações sobre características gerais da sibilância recorrente, fatores sociodemográficos, ambientais e biológicos gerais e aqueles relacionados à atopia. A magnitude da associação estatística foi avaliada por meio do cálculo da OR e IC95% obtidos por regressão logística múltipla. Resultados: Foram incluídos 124 indivíduos no estudo. A prevalência da deficiência/insuficiência de vitamina D na amostra foi de 57,3%. Observaram-se associações da deficiência/insuficiência de vitamina D com sibilância no primeiro ano de vida, antecedentes pessoais de dermatite atópica, poluição ambiental e suplementação de vitamina D até os 2 anos de idade. Conclusões: A prevalência de deficiência/insuficiência de vitamina D foi alta em nossa amostra. As concentrações de vitamina D foram associadas diretamente com a suplementação de vitamina D até os 2 anos de idade e inversamente com eventos de sibilância no primeiro ano de vida, antecedentes pessoais de dermatite atópica e poluição ambiental.

Knowledge about Stroke in Belo Horizonte, Brazil: A Community-Based Study Using an Innovative Video Approach.

BACKGROUND AND PURPOSE: Stroke is a leading cause of death in Brazil. Knowledge about the clinical manifestations of stroke as well as its risk factors and its management is still poor in the country. We intended to assess the stroke knowledge of an urban population in Belo Ho-rizonte, Brazil. METHODS: Individuals assisted by a basic health unit were interviewed between February and August 2014. After demographic data collection, the participants were asked to watch a video that consisted of a person presenting stroke signals and they were asked to answer questions about the condition shown on the video. Afterwards, they answered a semi-structured questionnaire to evaluate their stroke knowledge. RESULTS: A total of 703 people were interviewed (62.1% female, mean age 46.7 years). Recognition of a person having a stroke on the presented video was achieved by 56.1% of the subjects. Female sex (p = 0.029) and contact with someone who had had a stroke (family member [p < 0.01], neighbor [p < 0.05]) increased the odds of correctly identifying the condition showed on the video. The most commonly mentioned clinical manifestations of stroke were weakness (34.7%) and speech disturbance (31.6%). Stroke risk factors that were most named were "unbalanced diet" (42.3%) and hypertension (33.7%). Most participants (66.8%) said they would call the emergency medical services, while 17.8% would go directly to a hospital. Only 17 subjects knew thrombolytic therapy for acute stroke. CONCLUSION: Female sex and a family history of stroke increased the odds of recognizing the signs of stroke. Knowledge about the clinical manifestations, risk factors, and management of stroke was low in the studied population.

Health-related quality of life and working conditions on public transport workers in the Metropolitan Region of Belo Horizonte, Brazil, 2012.

OBJECTIVES: Drivers and conductors working in public transport are frequently exposed to inadequate working conditions and consequently to health problems relating to their work activities. This study investigates the relationship between the working conditions of drivers and conductors in the Metropolitan Region of Belo Horizonte and their perception of health-related quality of life. METHOD: Health-related quality of life was measured in a sample of 1,607 public transport workers in the city of Belo Horizonte using the SF-12 (Medical Outcomes Study Short-Form General Health Survey). The presence and magnitude of independent associations between the SF-12 domains and the exposure variables were determined by means of odds ratios obtained through logistic regression. RESULTS: After adjustments, the PCS (Physical Component Score) was found to be negatively associated with the existence of breaks during the working day and positively associated with unavailability of technical resources for meeting needs. The MCS (Mental Component Score) was positively associated with being female, having two or more medical diagnoses of illnesses, absenteeism and recent episodes of aggression or threats, and feeling vibration in the whole body. The MCS was negatively associated with the practice of physical exercise. Both components were negatively associated with older age and positively associated with having a poor self-assessment of health. CONCLUSIONS: Exposure to a variety of risk factors while performing work worsened health-related quality of life. The results obtained may provide support for rethinking and guiding public policies directed towards metropolitan populations.

[Working conditions on public buses and common mental disorders among drivers and fare collectors: Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil, 2012]. / Condições de trabalho nos ônibus e os transtornos mentais comuns em motoristas e cobradores: Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil, 2012.

Common mental disorders (CMD) contribute to overall burden of disease. The current study aimed to describe the prevalence of CMD among a sample of bus drivers and fare collectors in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil, and investigate whether traffic conditions and conditions inside buses were associated with the outcome. This non-probabilistic sample of 1,607 workers was estimated from the size of the effective workforce (n = 17,470). Face-to-face interviews used a digital questionnaire with online data processing. Overall prevalence of CMD was 23.6%. Bad traffic conditions lost statistical significance in the multivariate analysis, while higher income and adverse working conditions and inadequate safety remained associated with the outcome. Harmful behavior and vulnerable health situations were associated with CMD. This study of urban bus workers' health is a unique contribution that can provide backing for public policies targeting metropolitan populations.

Condições de trabalho nos ônibus e os transtornos mentais comuns em motoristas e cobradores: Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil, 2012 / Working conditions on public buses and common mental disorders among drivers and fare collectors: Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil, 2012 / Condiciones de trabajo y trastornos mentales en los conductores y cobradores: área metropolitana de Belo Horizonte, Minas Gerais, Brasil, 2012

A prevalência de transtornos mentais comuns (TMC) contribui para a carga mundial de doenças. O objetivo foi descrever a prevalência de TMC numa amostra de motoristas e cobradores da Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil, e verificar se as condições do trânsito e as condições internas aos ônibus estavam associadas ao desfecho. Os respondentes foram 1.607 trabalhadores. A amostra não probabilística foi estimada de acordo com as quotas do efetivo distribuído nas empresas de ônibus (n = 17.470). As entrevistas face a face utilizaram o questionário digital. Trânsito ruim perdeu significância estatística na análise multivariável; renda mais elevada e condições de trabalho e de segurança inadequadas mantiveram-se associadas ao desfecho. Comportamentos nocivos e situação vulnerável de saúde foram associados com TMC. Abordar a saúde dos trabalhadores dos ônibus urbanos é uma rara contribuição que pode amparar a elaboração de políticas públicas dirigidas às populações metropolitanas.

Common mental disorders (CMD) contribute to overall burden of disease. The current study aimed to describe the prevalence of CMD among a sample of bus drivers and fare collectors in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil, and investigate whether traffic conditions and conditions inside buses were associated with the outcome. This non-probabilistic sample of 1,607 workers was estimated from the size of the effective workforce (n = 17,470). Face-to-face interviews used a digital questionnaire with online data processing. Overall prevalence of CMD was 23.6%. Bad traffic conditions lost statistical significance in the multivariate analysis, while higher income and adverse working conditions and inadequate safety remained associated with the outcome. Harmful behavior and vulnerable health situations were associated with CMD. This study of urban bus workers' health is a unique contribution that can provide backing for public policies targeting metropolitan populations.

La prevalencia de enajenaciones mentales comunes contribuye a la carga mundial de enfermedades. El objetivo fue retratar la prevalencia de trastornos mentales comunes (TMC) en una muestra de conductores y cobradores del área metropolitana de Belo Horizonte, Minas Gerais, Brasil, y verificar si las condiciones del tráfico y las condiciones del interior de los autobuses estaban asociadas al resultado. Los entrevistados fueron 1.607 trabajadores. La muestra no probabilística fue estimada de acuerdo con las cuotas del efectivo distribuido en las empresas de autobuses (n = 17.470). Las encuestas cara a cara utilizaron el cuestionario digital. El tráfico malo perdió significación estadística en el análisis multivariable; renta más elevada y condiciones de trabajo y de seguridad inadecuados se mantuvieron asociados al resultado. Comportamientos nocivos y situación vulnerable de salud se asociaron con TMC. Plantear la salud de los trabajadores de autobuses urbanos es una contribución rara que puede apoyarse la elaboración de políticas públicas dirigidas a las poblaciones metropolitanas.

Substituição do tronco da artéria pulmonar em carneiros utilizando heteroenxerto tubular valvado com preservação não-aldeídica / Replacement of pulmonary artery trunk in sheep using tubular valved heterograft in non-aldehydic preservation

INTRODUÇÃO: As biopróteses valvares cardíacas estão relacionadas a eventos tromboembólicos, infecciosos e degenerativos. Seu desgaste é atribuído principalmente à desnaturação do colágeno. O glutaraldeído, método predominante de preservação de biopróteses, favorece o processo de calcificação e limita sua durabilidade. Diversas técnicas tentam conter o processo degenerativo das biopróteses. OBJETIVO: Avaliar o processo de calcificação, in vivo, de heteroenxertos pulmonares valvados, preservados em meio não-aldeídico (L-Hydro®). MÉTODOS: Dezessete carneiros foram submetidos à substituição do tronco da artéria pulmonar por enxerto tubular valvado de pericárdio bovino. Os animais foram distribuídos em dois grupos: Grupo L-Hydro® (teste / n=14) e Grupo Glutaraldeído (controle /n=3). Cerca de 150 dias pós-implante os animais foram sacrificados, necropsiados e as próteses submetidas a estudo anatomopatológico, avaliação radiológica e dosagem do cálcio por espectrofotometria de absorção atômica. A análise estatística foi obtida por meio dos testes exato de Fisher, T de Student ou Mann-Whitney (significância: 5%). RESULTADOS: A avaliação radiológica, macroscopia, microscopia e dosagem de cálcio por espectrofotometria de absorção atômica demonstraram maior calcificação nas próteses do Grupo Glutaraldeído, quando comparadas às próteses do Grupo L-Hydro® (P=0,001). Sete animais do Grupo L-Hydro® (50%) apresentaram aderência das cúspides à parede do tubo (P=0,228). CONCLUSÕES: As próteses preservadas em L-Hydro® demonstraram-se mais resistentes à calcificação, quando comparadas às preservadas em glutaraldeído.

INTRODUCTION: The cardiac bioprostheses are related to thromboembolic events, infectious and degenerative diseases. Wear is mainly attributed to the denaturation of collagen. Glutaraldehyde, the predominant method of preservation of bioprostheses, favors the calcification process and limits their durability. Several techniques try to contain the degenerative process of bioprostheses. OBJECTIVES: To evaluate the process of calcification in vivo pulmonary valve heterografts preserved in non-aldehydic (L-Hydro®). METHODS: Seventeen sheep underwent replacement of the pulmonary artery valved tubular grafts of bovine pericardium. The animals were divided into two groups: Group L-Hydro® (test / n = 14) and Group Glutaraldehyde (control / n = 3). About 150 days after implantation the animals were sacrificed, necropsied and implants subjected to a pathological study, radiological evaluation and measurement of calcium by atomic absorption spectrophotometry. Statistical analysis was obtained through the Fisher's exact test, Student's t or Mann-Whitney test (significance: 5%). RESULTS: The radiological evaluation, the macroscopic and microscopic measurement of serum calcium by atomic absorption spectrophotometry showed increased calcification of the prosthetic group Glutaraldehyde, when compared to denture-HydroR Group L (P = 0.001). Seven animals in Group L-Hydro® (50%) had adherence of the leaflets to the wall of the tube (P = 0.228). CONCLUSIONS: Prostheses preserved in L-Hydro® were more resistant to calcification when compared with glutaraldehyde preserved.

Stressful working conditions and poor self-rated health among financial services employees / Condições estressantes no trabalho e pior auto avaliação de saúde entre bancários

OBJECTIVE: To assess the association between exposure to adverse psychosocial working conditions and poor self-rated health among bank employees. METHODS: A cross-sectional study including a sample of 2,054 employees of a government bank was conducted in 2008. Self-rated health was assessed by a single question: "In general, would you say your health is (...)." Exposure to adverse psychosocial working conditions was evaluated by the effort-reward imbalance model and the demand-control model. Information on other independent variables was obtained through a self-administered semi-structured questionnaire. A multiple logistic regression analysis was performed and odds ratio calculated to assess independent associations between adverse psychosocial working conditions and poor self-rated health. RESULTS: The overall prevalence of poor self-rated health was 9%, with no significant gender difference. Exposure to high demand and low control environment at work was associated with poor self-rated health. Employees with high effort-reward imbalance and overcommitment also reported poor self-rated health, with a dose-response relationship. Social support at work was inversely related to poor self-rated health, with a dose-response relationship. CONCLUSIONS: Exposure to adverse psychosocial work factors assessed based on the effort-reward imbalance model and the demand-control model is independently associated with poor self-rated health among the workers studied.

OBJETIVO: Analisar a associação entre exposição a condições psicossociais adversas no trabalho e avaliação ruim de saúde entre bancários. MÉTODO: Foi realizado estudo transversal com 2.054 trabalhadores de um banco estatal brasileiro em 2008. Utilizou-se uma pergunta simples e direta: "Em geral, você diria que a sua saúde é" para aferir como eles avaliam seu estado de saúde atual. As condições psicossociais adversas no trabalho foram avaliadas pelos modelos desequilíbrio esforço-recompensa e demanda-controle. Informações sobre as demais variáveis independentes foram obtidas por meio de questionário semiestruturado, autoadministrado. A presença e a magnitude das associações independentes entre avaliação ruim do próprio estado de saúde e as condições psicossociais adversas no trabalho foram determinadas por meio de odds ratio obtidos por regressão logística. RESULTADOS: A prevalência geral de auto-avaliação ruim de saúde foi de 9%, sem diferença estatística entre os sexos. A exposição a ambientes de trabalho com alta demanda e baixo controle esteve associada à pior auto-avaliação da saúde. O mesmo foi verificado para trabalhadores com desequilíbrio esforço-recompensa e comprometimento excessivo, com gradiente dose-resposta. A presença de suporte social no trabalho apresentou associação inversa com pior auto avaliação de saúde, também com gradiente dose-resposta. CONCLUSÕES: A exposição a fatores psicossociais adversos no trabalho, avaliada pelos modelos desequilíbrio esforço-recompensa e demanda-controle, está associada de forma independente à pior auto-avaliação da saúde entre os trabalhadores estudados.

Stressful working conditions and poor self-rated health among financial services employees.

OBJECTIVE: To assess the association between exposure to adverse psychosocial working conditions and poor self-rated health among bank employees. METHODS: A cross-sectional study including a sample of 2,054 employees of a government bank was conducted in 2008. Self-rated health was assessed by a single question: "In general, would you say your health is (...)." Exposure to adverse psychosocial working conditions was evaluated by the effort-reward imbalance model and the demand-control model. Information on other independent variables was obtained through a self-administered semi-structured questionnaire. A multiple logistic regression analysis was performed and odds ratio calculated to assess independent associations between adverse psychosocial working conditions and poor self-rated health. RESULTS: The overall prevalence of poor self-rated health was 9%, with no significant gender difference. Exposure to high demand and low control environment at work was associated with poor self-rated health. Employees with high effort-reward imbalance and overcommitment also reported poor self-rated health, with a dose-response relationship. Social support at work was inversely related to poor self-rated health, with a dose-response relationship. CONCLUSIONS: Exposure to adverse psychosocial work factors assessed based on the effort-reward imbalance model and the demand-control model is independently associated with poor self-rated health among the workers studied.

Adverse psychosocial working conditions and poor quality of life among financial service employees in Brazil.

OBJECTIVES: Workers in the financial services sector are exposed to great stress at work. This study investigates whether exposure to adverse psychosocial work conditions is independently associated with poor health-related physical and mental quality of life among financial services workers. METHODS: We studied a nationwide representative sample of 2,054 workers of a large Brazilian state bank in 2008. Adverse psychosocial work conditions were investigated by the Effort-reward imbalance (ERI) scale and the Job content questionnaire (JCQ). Health-related quality of life (HRQL) was assessed using the Medical Outcomes Study Short-Form General Health Survey (SF-12). Poor mental and physical HRQL was defined by the lowest quartiles of the SF-12 final score distributions. Associations were investigated using multiple logistic regression analysis. RESULTS: In the multivariate analysis, exposures to low control and lack of social support at work (JCQ) were associated with poor HRQL in the physical domain. Increasing effort-reward imbalance and overcommitment (ERI), on the other hand, were associated with poor HRQL in the mental domain, with a significant statistical trend. Overcommitment was also associated with poor physical HRQL. CONCLUSION: The results suggest that exposure to adverse psychosocial work conditions has a negative impact on both domains of HRQL among financial service workers. They also indicate that ERI and DC models capture different aspects of job strain.

Replacement of pulmonary artery trunk in sheep using tubular valved heterograft in non-aldehydic preservation.

INTRODUCTION: The cardiac bioprostheses are related to thromboembolic events, infectious and degenerative diseases. Wear is mainly attributed to the denaturation of collagen. Glutaraldehyde, the predominant method of preservation of bioprostheses, favors the calcification process and limits their durability. Several techniques try to contain the degenerative process of bioprostheses. OBJECTIVES: To evaluate the process of calcification in vivo pulmonary valve heterografts preserved in non-aldehydic (L-Hydro®). METHODS: Seventeen sheep underwent replacement of the pulmonary artery valved tubular grafts of bovine pericardium. The animals were divided into two groups: Group L-Hydro® (test / n = 14) and Group Glutaraldehyde (control / n = 3). About 150 days after implantation the animals were sacrificed, necropsied and implants subjected to a pathological study, radiological evaluation and measurement of calcium by atomic absorption spectrophotometry. Statistical analysis was obtained through the Fisher's exact test, Student's t or Mann-Whitney test (significance: 5%). RESULTS: The radiological evaluation, the macroscopic and microscopic measurement of serum calcium by atomic absorption spectrophotometry showed increased calcification of the prosthetic group Glutaraldehyde, when compared to denture-HydroR Group L (P = 0.001). Seven animals in Group L-Hydro® (50%) had adherence of the leaflets to the wall of the tube (P = 0.228). CONCLUSIONS: Prostheses preserved in L-Hydro® were more resistant to calcification when compared with glutaraldehyde preserved.

[Transcultural adaptation into Brazilian Portuguese of the effort-reward imbalance scale: a study with bank workers]. / Adaptação transcultural para o português brasileiro da escala effort-reward imbalance: um estudo com trabalhadores de banco.

OBJECTIVE: To describe the transcultural adaptation of the effort-reward imbalance scale into Brazilian Portuguese and to examine the resulting construct's validity and reliability. METHOD: Forward and backward translation was used. Internal consistency, test-retest reliability, and factor structure were tested in a sample of 100 individuals of both sexes working at a large government-owned Brazilian bank. The sample included different age groups and schooling levels. RESULTS: The adapted version was named escala de desequilíbrio esforço-recompensa. Cronbach's alpha for the three scale dimensions--effort, reward, and overcommitment--was 0.70, 0.95 and 0.86, respectively. Intraclass correlation coefficients for these dimensions were 0.82, 0.96, and 0.91, respectively. Factor analysis kept all the initial questionnaire items and was consistent with the theoretical construct of the model. CONCLUSION: The results indicate that the transcultural adaptation into Brazilian Portuguese of the effort-reward imbalance scale was successful and is adequate to assess this situation in work environments.

Adaptação transcultural para o português brasileiro da escala effort-reward imbalance: um estudo com trabalhadores de banco / Transcultural adaptation into Brazilian Portuguese of the effort-reward imbalance scale: a study with bank workers

OBJETIVO: Descrever a adaptação transcultural da escala effort-reward imbalance para o português brasileiro e analisar a validade e a confiabilidade da adaptação. MÉTODO: Foi utilizado o método da tradução/retrotradução. A consistência interna, a confiabilidade teste-reteste e a estrutura fatorial da escala adaptada foram testadas em uma amostra de 100 trabalhadores de um banco estatal brasileiro, de ambos os sexos, com diferentes idades e níveis educacionais. RESULTADOS: A versão adaptada foi denominada escala de desequilíbrio esforço-recompensa. Dos 100 trabalhadores, 62 por cento eram do sexo masculino. A idade variou entre 23 e 65 anos (média de 39 anos); a escolaridade, entre 3 e 27 anos (média de 15 anos); e o tempo de trabalho na empresa, entre 1 e 31 anos (média de 11 anos). O alfa de Cronbach para as três dimensões da escala - esforço, recompensa e comprometimento excessivo - foi de 0,70, 0,95 e 0,86, respectivamente. Os coeficientes de correlação intraclasse para as mesmas dimensões foram 0,82, 0,96 e 0,91. A análise fatorial manteve todos os itens iniciais da escala e foi consistente com os componentes de construto do modelo teórico. CONCLUSÃO: Os resultados indicam que a adaptação transcultural para português brasileiro da escala de desequilíbrio esforço-recompensa foi bem-sucedida e é adequada para avaliar esse desequilíbrio em ambientes de trabalho.

OBJECTIVE: To describe the transcultural adaptation of the effort-reward imbalance scale into Brazilian Portuguese and to examine the resulting construct's validity and reliability. METHOD: Forward and backward translation was used. Internal consistency, test-retest reliability, and factor structure were tested in a sample of 100 individuals of both sexes working at a large government-owned Brazilian bank. The sample included different age groups and schooling levels. RESULTS: The adapted version was named escala de desequilíbrio esforço-recompensa. Cronbach's alpha for the three scale dimensions-effort, reward, and overcommitment-was 0.70, 0.95 and 0.86, respectively. Intraclass correlation coefficients for these dimensions were 0.82, 0.96, and 0.91, respectively. Factor analysis kept all the initial questionnaire items and was consistent with the theoretical construct of the model. CONCLUSION: The results indicate that the transcultural adaptation into Brazilian Portuguese of the effort-reward imbalance scale was successful and is adequate to assess this situation in work environments.

Frequency of left ventricular diastolic dysfunction by mitral doppler in healthy elderly individuals.

BACKGROUND: Healthy elderly individuals present alterations in mitral Doppler velocities, which are characteristic of left ventricular (LV) diastolic dysfunction with impaired relaxation. OBJECTIVE: To determine the frequency of LV diastolic dysfunction by mitral Doppler in healthy elderly individuals and identify clinical and echocardiographic characteristics associated to this finding. METHODS: Seventy-three apparently healthy individuals (64% women, aged 60 to 80) were carefully selected and submitted to clinical, laboratory and Doppler-echocardiographic assessment, with particular regard to the characteristics of the mitral flow. RESULTS: A total of 33 patients (45%) presented an impaired LV relaxation pattern (group I), characterized by the association between the maximum velocities of the mitral wave flow (E/A ratio) <0.75 or E-wave deceleration time >240 ms, and 40 (55%) with a normal pattern (group II). Group I presented a larger aortic root diameter (32.1 + or - 4.2 vs 30.3 + or - 3.3 mm; p = 0.044) and a longer PR interval (156 + or - 22 vs 139 + or - 23 ms; p = 0.002). CONCLUSION: A large proportion of individuals aged 60 to 80 years present normal diastolic function at the Doppler-echocardiographic assessment of the mitral flow. Healthy elderly individuals with impaired LV relaxation filling have a larger aortic root diameter and longer PR interval.

Frequência de disfunção diastólica do ventrículo esquerdo pelo doppler mitral em idosos sadios / Frequency of left ventricular diastolic dysfunction by mitral doppler in healthy elderly individuals

FUNDAMENTO: Idosos sadios frequentemente apresentam alterações nas velocidades do Doppler mitral, características de disfunção diastólica do ventrículo esquerdo (VE) do tipo alteração do relaxamento. OBJETIVO: Determinar a frequência de disfunção diastólica do VE pelo Doppler mitral em idosos sadios e identificar características clínicas e ecocardiográficas associadas a esse achado. MÉTODOS: O total de 73 indivíduos aparentemente sadios e rigorosamente selecionados (64 por cento de mulheres), com idade entre 60 e 80 anos, foram submetidos à avaliação clínica, laboratorial e Doppler-ecocardiográfica, com especial atenção às características do fluxo mitral. RESULTADOS: Encontramos 33 pacientes (45 por cento) com padrão diastólico do VE do tipo alteração do relaxamento (grupo 1), caracterizados pela relação entre as velocidades máximas das ondas do fluxo mitral (relação E/A) <0,75 ou pelo tempo de desaceleração da onda E >240 ms. Outros 40 pacientes (55 por cento) apresentaram padrão normal (grupo 2). O grupo/ 1 apresentou maior diâmetro da raiz da aorta (32,1±4,2 vs 30,3±3,3 mm; p=0,044) e intervalo PR mais longo (156±22 vs 139±23 ms; p=0,002). CONCLUSÃO: Uma grande proporção de indivíduos, com idade entre 60 e 80 anos, apresenta função diastólica normal pela análise Doppler-ecocardiográfica do fluxo mitral. Idosos sadios, portadores de disfunção diastólica do VE do tipo alteração do relaxamento, exibem maior diâmetro da raiz da aorta e intervalo PR mais longo.

BACKGROUND: Healthy elderly individuals present alterations in mitral Doppler velocities, which are characteristic of left ventricular (LV) diastolic dysfunction with impaired relaxation. OBJECTIVE: To determine the frequency of LV diastolic dysfunction by mitral Doppler in healthy elderly individuals and identify clinical and echocardiographic characteristics associated to this finding. METHODS: Seventy-three apparently healthy individuals (64 percent women, aged 60 to 80) were carefully selected and submitted to clinical, laboratory and Doppler-echocardiographic assessment, with particular regard to the characteristics of the mitral flow. RESULTS: A total of 33 patients (45 percent) presented an impaired LV relaxation pattern (group I), characterized by the association between the maximum velocities of the mitral wave flow (E/A ratio) <0.75 or E-wave deceleration time >240 ms, and 40 (55 percent) with a normal pattern (group II). Group I presented a larger aortic root diameter (32.1±4.2 vs 30.3±3.3 mm; p=0.044) and a longer PR interval (156±22 vs 139±23 ms; p=0.002). CONCLUSION: A large proportion of individuals aged 60 to 80 years present normal diastolic function at the Doppler-echocardiographic assessment of the mitral flow. Healthy elderly individuals with impaired LV relaxation filling have a larger aortic root diameter and longer PR interval.

[Absenteeism profile in a state bank in Minas Gerais between 1998-2003]. / Perfil do absenteísmo em um banco estatal em Minas Gerais: análise no período de 1998 a 2003.

The purpose of this paper was to study the profile of absenteeism in a state bank and to establish the more frequent causes for sick leaves among the members of the staff. A cross-cut, descriptive and quantitative study was developed for approaching absenteeism and its most frequent causes in a state bank in the state of Minas Gerais between 1998 and 2003. The absenteeism rates were homogenous, with a decrease during the period of the study, except for the frequency rates, as a result of alterations in their numerators and denominators. The prevalence of musculoskeletal diseases and mental disorders was of 33,25 and 22,21 leaves per 1,000 workers respectively. Leaves of women and workers in relatively low-pay positions, aged between 40 and 49, married, working in the institution for over 21 years predominated. The study indicated that sick leaves due to musculoskeletal diseases that where predominating before in the company are decreasing. On the other hand, there was an increase of cases of mental and behavioral disorders, indicating a possible change in the health profile. However, further studies will be necessary to corroborate these results.

Perfil do absenteísmo em um banco estatal em Minas Gerais: análise no período de 1998 a 2003 / Absenteeism profile in a state bank in Minas Gerais between 1998 a 2003

O objetivo dessa pesquisa foi estudar o perfil do absenteísmo em uma empresa bancária estatal e estimar a prevalência de afastamentos pelas doenças que mais acometeram seus trabalhadores. Foi realizado um estudo transversal, descritivo e quantitativo abordando absenteísmo e prevalência de causas de afastamento em um banco estatal no estado de Minas Gerais, no período de 1998 a 2003. Os índices de absenteísmo apresentaram distribuição heterogênea, estando em queda no período estudado, exceto a taxa de freqüência, devido a modificações nos números que compõem seus numeradores e denominadores. As prevalências das doenças osteomusculares e dos distúrbios mentais e comportamentais foram 33,25 e 22,21 afastamentos por 1.000 trabalhadores, respectivamente. Houve predomínio de afastamentos de trabalhadores do sexo feminino, com idade entre 40 e 49 anos de idade, com tempo de empresa superior a 21 anos e com funções com menores valores de remuneração. O estudo indicou que as doenças osteomusculares e do tecido conjuntivo que antes predominavam na empresa estão em queda. Houve também ascensão dos distúrbios mentais e comportamentais, indicando possível mudança no perfil de adoecimento. Mais estudos são necessários para a explicação dos resultados observados.

The purpose of this paper was to study the profile of absenteeism in a state bank and to establish the more frequent causes for sick leaves among the members of the staff. A cross-cut, descriptive and quantitative study was developed for approaching absenteeism and its most frequent causes in a state bank in the state of Minas Gerais between 1998 and 2003. The absenteeism rates were homogenous, with a decrease during the period of the study, except for the frequency rates, as a result of alterations in their numerators and denominators. The prevalence of musculoskeletal diseases and mental disorders was of 33,25 and 22,21 leaves per 1,000 workers respectively. Leaves of women and workers in relatively low-pay positions, aged between 40 and 49, married, working in the institution for over 21 years predominated. The study indicated that sick leaves due to musculoskeletal diseases that where predominating before in the company are decreasing. On the other hand, there was an increase of cases of mental and behavioral disorders, indicating a possible change in the health profile. However, further studies will be necessary to corroborate these results.