PAHO Forward Plan of Action 2.0: An Organization-wide approach to strengthening efficiency, transparency, and accountability

PAHO Forward is a results-based, Organization-wide initiative to systematically innovate and modernize management practices to increase efficiency, transparency, and accountability internally and externally. The PAHO Forward Plan of Action 2.0 operationalizes the PAHO Forward framework and includes the specific objectives of strengthening the Pan American Sanitary Bureau (PASB) efficiency, transparency, and accountability; bolster the Pan American Health Organization (PAHO) visibility, country focus, and capacity to deliver technical cooperation; enhance the PASB human resources performance and drive innovation to move the Organization forward. This report describes the main components of the updated plan, and outlines the full list of actions and expected results that have been prioritized by PAHO Forward Governance for the period June 2024 to May 2025.

Agências de regularização técnica odontológica em relação ao manejo clínico em crianças: uma revisão de literatura / Dental technical regularization agencies in relation to management clinic in children: a review of the literature

O manejo clínico em Odontopediatria é individual, podendo variar nas diversas culturas mundiais. O objetivo desta revisão de literatura é reunir as principais diretrizes de diferentes países ao redor do mundo, incluindo o Brasil, visando identificar como em cada lugar o uso das técnicas de comportamento são aplicadas e sua eficiência. Inicialmente, foram selecionados os principais guias nacionais e internacionais, sendo eles retirados da Associação Internacional de Odontopediatria (IAPD) e Associação Americana de Odontopediatria (AAPD), além de artigos de diferentes países e continentes, como Argentina, Brasil, Europa e Ásia, também foram analisados se o protocolo dos principais guias estão condizentes com os protocolos do Departamento de Clínica Infantil da Faculdade de Odontologia de Ribeirão Preto - USP. Os resultados obtidos nos guias para manejo clínico odontológico brasileiro, americano, internacional e os artigos estudados recomendam inicialmente utilizar técnicas menos invasivas, com o intuito proporcionar um atendimento tranquilo e sem criar traumas para a criança, uma vez que muito do comportamento não cooperativo vem de experiências anteriores traumáticas. Entretanto, técnicas avançadas podem ser utilizadas para casos mais desafiadores. Concluímos com o estudo dos guias e artigos, que o cirurgião dentista possui diversas técnicas a serem aplicadas para que o atendimento infantil seja atraumático e restabelecer saúde ao paciente.

Clinical management in Pediatric Dentistry is individual and varies across different cultures around the world. The objective of this literature review is to bring together the main guidelines from different countries around the world, including Brazil, aiming to identify how the use of behavioral techniques are applied and their efficiency in each place. Initially, the main national and international guides were selected, taken from the International Association of Pediatric Dentistry (IAPD) and the American Association of Pediatric Dentistry (AAPD), as well as articles from different countries and continents, such as Argentina, Brazil, Europe and Asia, as well as It was analyzed whether the protocols of the main guides are consistent with the protocols of the Children's Clinic Department of the Faculty of Dentistry of Ribeirão Preto - USP. The results obtained in the guides for Brazilian, American and international dental clinical management and the articles studied recommend initially using less invasive techniques, with the aim of providing calm care and without creating trauma for the child, since much of the uncooperative behavior comes from previous traumatic experiences. However, advanced techniques can be used for more challenging cases. We conclude from studying the guides and articles that the dental surgeon has several techniques to be applied so that child care is atraumatic and restores health to the patient.

Cross-cultural adaptation and validation of Work Productivity and Activity Impairment questionnaires for caregivers of patients with pediatric inflammatory bowel disease in Spain. A multicenter study. / Adaptación transcultural y validación de cuestionarios WPAI (Work Productivity and Activity Impairment) para cuidadores de pacientes con enfermedad inflamatoria intestinal pediátrica en España. Estudio multicéntrico.

Introduction. The WPAI-UC/CD-Caregiver questionnaires assess the impact of ulcerative colitis (UC) or Crohn's disease (CD) on parents'/caregivers' work life and daily activities. Our objective was to adapt and validate these questionnaires in the Spanish population. Methods. A translation and back-translation were done. The document was assessed by an expert committee and a pilot group of families of patients with pediatric inflammatory bowel disease (p-IBD). For validation, the parents/caregivers of patients with p-IBD (10-18 years old) were recruited. The expert committee and the pilot group conducted a subjective assessment of the format and time necessary to complete the questionnaires. Cronbach's alpha coefficient was estimated and a factor analysis with varimax rotation was done. Kaiser- Meyer-Olkin (KMO) coefficients and Bartlett's sphericity test were estimated to test the adequacy of the factor analysis. Results. A total of 370 patients (median age: 14.1 years) and 263 parents/caregivers of patients with UC or unclassified IBD and 261 parents/caregivers of patients with CD were included. The KMO coefficients (0.6947 and 0.7179) and Bartlett's sphericity test (p < 0.001) confirmed the adequacy of the factor analysis. The 6 items targeted the same domain. The factor model accounted for 99.99% and 94.68% of variance, and Cronbach's alpha coefficients (0.6581 and 0.6968) showed an adequate consistency. The format and the median time of 2 minutes to complete the questionnaires were considered optimal. Conclusions. The versions of the WPAI-Caregiver questionnaires validated in the Spanish population may be used in families whose children have IBD.

Introducción. Los cuestionarios WPAI-UC/CD-Caregiver evalúan la repercusión laboral y en actividades cotidianas de los padres/cuidadores de pacientes con colitis ulcerosa (CU) o enfermedad de Crohn (EC). El objetivo fue adaptar y validar estos cuestionarios en la población española. Métodos. Se realizó la traducción y la retrotraducción. El documento fue evaluado por un comité de expertos y por un grupo piloto de familias de pacientes con enfermedad inflamatoria intestinal pediátrica (EII-p). Para la validación, se reclutaron padres/cuidadores de pacientes con EII-p (10-18 años). El comité de expertos y el grupo piloto evaluaron subjetivamente el formato y el tiempo necesario para completar los cuestionarios. Se calculó el coeficiente alfa de Cronbach y se realizó el análisis factorial con rotación Varimax. Se calcularon los coeficientes de Kaiser-Meyer-Olkin (KMO) y la prueba de esfericidad de Bartlett para comprobar la adecuación del análisis factorial. Resultados. Se incluyeron 370 pacientes (mediana 14,1 años), y 263 padres/cuidadores de pacientes con colitis ulcerosa o EII no clasificada y 261 padres/cuidadores de pacientes con enfermedad de Crohn. Los coeficientes KMO (0,6947 y 0,7179) y la prueba de esfericidad de Barttlet (p <0,001) confirmaron la adecuación del análisis factorial. Los 6 ítems se dirigieron a la misma dimensión. El modelo factorial explicó el 99,99 % y el 94,68 % de la varianza, y los alfa de Cronbach (0,6581 y 0,6968) indicaron buena consistencia. El formato y la mediana de 2 minutos para completarlos se consideraron óptimos. Conclusiones. Las versiones validadas en la población española de los cuestionarios WPAI-Caregiver pueden considerarse para su uso en familias con hijos con EII.

Gender disparities in lost productivity resulting from non-communicable diseases in Mexico, 2005-2021.

Background: Non-communicable diseases (NCDs) cause long-term impacts on health and can substantially affect people's ability to work. Little is known about how such impacts vary by gender, particularly in low- and middle-income countries (LMICs), where productivity losses may affect economic development. This study assessed the long-term productivity loss caused by major NCDs among adult women and men (20-76 years) in Mexico because of premature death and hospitalisations, between 2005 and 2021. Methods: We conducted an economic valuation based on the Human Capital Approach. We obtained population-based data from the National Employment Survey from 2005 to 2021 to estimate the expected productivity according to age and gender using a two-part model. We utilised expected productivity based on wage rates to calculate the productivity loss, employing Mexican official mortality registries and hospital discharge microdata for the same period. To assess the variability in our estimations, we performed sensitivity analyses under two different scenarios. Results: Premature mortality by cancers, diabetes, chronic cardiovascular diseases (CVD), chronic respiratory diseases (CRD) and chronic kidney disease (CKD) caused a productivity loss of 102.6 billion international US dollars (Intl. USD) from 2.8 million premature deaths. Seventy-three percent of this productivity loss was observed among men. Cancers caused 38.3% of the productivity loss (mainly among women), diabetes 38.1, CVD 15.1, CRD 3.2, and CKD 5.3%. Regarding hospitalisations, the estimated productivity loss was 729.7 million Intl. USD from 54.2 million days of hospitalisation. Men faced 65.4 and women 34.6% of these costs. Cancers caused 41.3% of the productivity loss mainly by women, followed by diabetes (22.1%), CKD (20.4%), CVD (13.6%) and CRD (2.6%). Conclusions: Major NCDs impose substantial costs from lost productivity in Mexico and these tend to be higher amongst men, while for some diseases the economic burden is higher for women. This should be considered to inform policymakers to design effective gender-sensitive health and social protection interventions to tackle the burden of NCDs.

Estimated Loss of Productivity Attributed to Cardiovascular Diseases in South America. / Estimativa de Produtividade Perdida Atribuída a Doenças Cardiovasculares na América do Sul.

BACKGROUND: Cardiovascular diseases (CVD) have significant health and economic burdens. In South America, the loss of productivity related to these diseases has not yet been well explored. OBJECTIVE: Estimate the potentially productive years of life lost (PPYLL) and loss of productivity related to premature mortality associated with CVD in South America, in 2019. METHODS: Mortality data available from the 2019 Global Burden of Disease Study were used to estimate the burden of disease attributable to CVD. For monetary calculations of productivity loss, a proxy of the human capital approach was used. Data were stratified by sex, in working age groups. RESULTS: The total number of deaths due to CVD in South America in 2019 was 754,324, and the total number of PPYLL was 2,040,973. The total permanent loss of productivity was approximately US$ 3.7 billion and US$ 7.8 billion in purchasing power parity, equivalent to 0.11% of the gross domestic product. The cost per death was US$ 22,904, and the ratio between men and women for the cost per death was 1.45. The variation in scenarios indicates that the estimates are robust, even with important differences between countries. CONCLUSIONS: CVD impose a significant economic burden on countries in South America. The characterization of this burden can support governments in the allocation of resources for the planning and execution of health policies and interventions in promotion, prevention, and recovery.

FUNDAMENTO: As doenças cardiovasculares (DCV) têm ônus sanitário e econômico significativos. Na América do Sul (AS), a perda de produtividade relacionada a estas enfermidades ainda não foi bem explorada. OBJETIVO: Estimar os anos de vida produtiva perdidos (AVPP) e a perda de produtividade relacionados a mortalidade prematura associada as DCV na AS, em 2019. MÉTODOS: Empregou-se dados de mortalidade disponíveis no Global Burden of Disease Study 2019 na estimativa da carga de doença atribuível a DCV. Para os cálculos monetários da perda da produtividade usou-se uma proxy da abordagem de capital humano. Estratificou-se por sexo, nas faixas etárias de trabalho. RESULTADOS: O número total de mortes por DCV na AS no ano de 2019 foi de 754.324 e os AVPP foram 2.040.973. A perda permanente de produtividade total foi de aproximadamente US$ 3,7 bilhões e US$ 7,8 bilhões em paridade do poder de compra, equivalente a 0,11% do produto interno bruto. O custo por morte foi de US$ 22.904, e a razão desse custo por óbito, entre homens e mulheres foi 1,45. A variação dos cenários aponta robustez nas estimativas, mesmo com diferenças importantes entre os países. CONCLUSÕES: As DCV impõem um ônus econômico significativo a este bloco de países. A caracterização deste fardo pode amparar os governos na alocação de recursos destinados ao planejamento e execução de políticas e intervenções sanitárias, sejam de promoção, prevenção ou recuperação.

Clinical, psychological and environmental factors that affect sleep quality of in surgical patients / Fatores clínicos, psicológicos e ambientais que afetam a qualidade de sono do doente cirúrgico

Objective: To assess the quality of sleep among surgical inpatients and to determine the associated clinical, environmental, and psychological factors. Method: A cross-sectional observational study using descriptive correlation analysis was conducted on 150 surgical inpatients at a Portuguese hospital center. A sociodemographic and clinical questionnaire and the Pittsburgh Sleep Quality Index - Portuguese version (PSQI-PT) were administered. Result: Most participants seemed to experience poor sleep quality (PSQI > 5 = 89.3%) during hospitalization.Factors associated with poor sleep quality include several clinical variables whose scores were significantly worse among cancer patients, patients undergoing colorectal surgery or esophagogastroduodenoscopies, those with longer hospital stays, and those experiencing pain and health-related complications. Variables related to sleep disturbances included noise, persistent changes in sleeping position, feelings of anxiety, and health concerns. Conclusion: Findings revel a high prevalence of poor sleep quality during hospitalization caused by an increased sleep latency period, a decline in total sleep time, and lower sleep efficiency

Objetivo: Avaliar a qualidade de sono do doente cirúrgico internado e determinar os fatores clínicos, ambientais e psicológicos associados. Método: Estudo observacional com matriz transversal e análise descritivo-correlacional, realizado com 150 doentes internados para procedimento cirúrgico, num centro hospitalar português. Foi aplicado um questionário para caracterização sociodemográfica e clínica, bem como o Índice de Qualidade do Sono de Pittsburgh ­ versão portuguesa (PSQI-PT). Resultado: A maioria dos participantes apresentou uma má qualidade de sono (PSQI > 5 = 89,3%) durante o internamento. Os fatores associados à má qualidade de sono incluem variáveis clínicas com piores escores nos doentes oncológicos, submetidos a cirurgia colorretal e esofagogastroduodenal, maior tempo de internamento, presença de dor e complicações. Como variáveis perturbadoras do sono destacam-se o ruído, a alteração da posição para dormir, sentir-se ansioso e a preocupação com a própria saúde. Conclusão: Observou-se uma elevada prevalência da má qualidade de sono, resultante do aumento do período de latência, diminuição do tempo total de sono e da sua eficiência durante o internamento

Health promotion and prevention actions in the Brazilian Unified Health System (SUS): evaluation of the temporal trend and impact of the COVID-19 pandemic / Ações de promoção e prevenção em saúde no Sistema Único de Saúde (SUS): avaliação da tendência temporal e do impacto da pandemia da COVID-19

Objective: To evaluate health promotion and prevention in the Brazilian Unified Health System (SUS) between 2008 and 2022. Method: An epidemiological study was conducted, with an ecological approach, as a time series. APPS-related data available in the Outpatient Information System of the SUS (SIA/SUS) over the last 15 years were used, normalized to every 100,000 Brazilian residents, characterizing the incidence. COVID-19 pre- and post-pandemic periods were outlined to verify its impact on productivity. The data were analyzed with a significance level of 5%. Result: Between 2008 and 2022, 6,933,081,931 APPS were carried out in the SUS. The most frequent modality was home visits (56.3%), and the most common health professionals were health and endemic agents (59.8%). For the entire study period, the incidence was 3,407,327 APPS per 100,000 Brazilian residents, with an annual median of 281,999. Furthermore, there was a significant decreasing trend over the last 15 years (p <0.001), whose annual percentage change was estimated at -6.7%. Disregarding COVID-19 pandemic years, the trend remained to decrease (p = 0.028). At last, when comparing it to the pre-pandemic period, the incidence of APPS were 32% lower in the first, 26% lower in the second, and 21% lower in the third year after the COVID-19 pandemic onset (p <0.001). Conclusion: It was possible to conclude that APPS in the SUS have reduced in the last 15 years

Objetivo: Avaliar as ações de promoção e prevenção em saúde (APPS) realizadas no Sistema Único de Saúde (SUS) entre 2008 e 2022. Método: Foi conduzido um estudo epidemiológico, com abordagem ecológica, do tipo série temporal. Foram utilizados os dados relativos às APPS no Sistema de Informações Ambulatoriais do SUS (SIA/SUS) nos últimos 15 anos, normalizada a cada 100.000 residentes brasileiros, caracterizando a incidência. Foram delineados períodos pré e pós-pandemia da COVID-19 para verificar o seu impacto na produtividade. Os dados foram analisados com nível de significância de 5%. Resultado: Entre 2008 e 2022, 6.933.081.931 APPS foram realizadas no SUS. A modalidade mais frequente foram as visitas domiciliares (56,3%) e os profissionais da saúde mais comuns foram os agentes de saúde e endemias (59,8%). Para todo o período, a incidência foi de 3.407.327 APPS a cada 100.000 residentes brasileiros, com mediana anual de 281.999. Ademais, houve uma tendência de redução ao longo dos últimos 15 anos (p <0,001), cuja variação percentual anual foi estimada em -6,7%. Desconsiderando o período da pandemia da COVID-19, a tendência permaneceu decrescente (p = 0,028). Por fim, ao compará-la com o período pré-pandemia, a incidência de APPS foi 32% menor no primeiro, 26% menor no segundo e 21% menor no terceiro ano após o início da pandemia da COVID-19 (p <0,001). Conclusão: Foi possível concluir que as APPS no SUS reduziram nos últimos 15 anos

Pointing out geographic and gender disparities related to productivity indicators among Brazilian ecotoxicologists.

Policies and actions related to diversity, equity, and inclusion have been discussed recently in Brazil, but there is still limited information available for most academic and knowledge fields, including ecotoxicology. This study aimed to describe the profile of Brazilian ecotoxicologists and assess gender and geographical disparities, especially regarding productivity indicators. An ecological study was conducted using data of the researchers registered in the open-access database of the Brazilian Society of Ecotoxicology, along with their respective curriculum data available on the Lattes Platform, which is the main registry portal for Brazilian researchers. The target population of our study was ecotoxicology researchers in academic educational institutions with a focus on human resource training. The data, collected in 2021, led to the inclusion of a total of 177 researchers in this study, with 62 men and 115 women, and 42.37% working in the southeastern region. Female researchers generally showed lower rates of scientific productivity when the analyzed metrics included research productivity scholarships, the number of articles published in scientific journals, and the number of articles published with international collaborations, compared to male researchers. Researchers from the southeastern and southern regions also had higher rates of productivity and human resource training compared to those from other regions of the country. The proportion of funding grants received was significantly higher among men, and this profile was also observed among researchers from the southern and southeastern regions, although with a smaller disparity. This means that there is an uneven distribution of funding grants from funding organizations, which favors men and urban centers. Our findings highlight gender and geographic disparities in the scientific production of ecotoxicologists working in Brazil and reinforce the existence of complex obstacles that need to be addressed and combated within scientific societies. Integr Environ Assess Manag 2024;20:1209-1216. © 2024 SETAC.

Impact of heat and a rest-shade-hydration intervention program on productivity of piece-paid industrial agricultural workers at risk of chronic kidney disease of nontraditional origin.

OBJECTIVES: Assess the impact of environmental heat and a rest-shade-hydration (RSH) intervention against heat stress on productivity of piece-paid Mesoamerican sugarcane cutters. These workers are at a high risk of chronic kidney disease of non-traditional origin (CKDnt), from the severe heat stress they experience due to heavy work under hot conditions. RSH interventions in these populations improve kidney health outcomes, but their impact on productivity has yet to be examined. METHODS: We accessed routine productivity data from seed (SC, N = 749) and burned (BCC, N = 535) sugarcane cutters observed over five harvest seasons with increasing RSH intervention at a large Nicaraguan sugarcane mill. Hourly field-site wet-bulb globe temperature (WBGT) was recorded by mill staff and summarized as a daily mean. Mixed linear regression was used to model daily productivity, adjusting for age (18-29, 30-44, and >45 years), sex, WBGT (<28, 28-29, 29-30, 30-31, and >31 °C) on the same and preceding day, harvest season (2017-18 to 2021-22), month, and acclimatization status (<1, 1-2, and >2 weeks). RESULTS: There was an inverse dose-response relationship between SC productivity and WBGT on the same and preceding days, decreasing by approximately 3%/°C WBGT. Productivity increased during the study period, i.e. coinciding with RSH scale-up, by approximately 19% in SC and 9% in BCC. CONCLUSION: Agricultural worker productivity was expected lower on hotter days, strengthening the interest in all stakeholders to mitigate increasing global temperatures and their impact. Despite decreasing the total time allocated for work each day, an RSH intervention appears to result in increased productivity and no apparent loss in productivity.

Demandas e recursos para predição da síndrome de burnout em psicólogos clínicos / Demands and resources for burnout syndrome on clinical psychologists / Demandas y recursos para la predicción del síndrome de burnout en psicólogos clínicos

O modelo de demandas e recursos foi utilizado para identificar o poder preditivo do estilo pessoal do terapeuta e do trabalho emocional (demandas), e da inteligência emocional e autoeficácia profissional (recursos) sobre as dimensões da síndrome de Burnout (SB), em uma amostra de 240 psicólogos clínicos brasileiros. Os dados foram coletados por meio de plataforma online, tendo como instrumentos de pesquisa um Questionário de dados sociodemográficos e laborais, o Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo, o Cuestionario del Estilo Personal del Terapeut, o Questionário de Avaliação Relacionado a Demandas Emocionais e Dissonância da Regra da Emoção, Medida de Inteligência Emocional, e Escala de Autoeficácia Geral Percebida. Os resultados obtidos revelaram um modelo preditor das dimensões da SB, constituído pelas variáveis dissonância emocional, automotivação, demandas emocionais, instrução, envolvimento e autoeficácia. Ressalta-se a relevância de estratégias voltadas para a prevenção da SB nessa categoria profissional, bem como a necessidade de ações que visem a promoção e o desenvolvimento da inteligência emocional e da autoeficácia como fortalecimento dos recursos emocionais para atuação na prática clínica.(AU)

The Model of Demands - Resources was used to identify the predictive power of therapist's personal style, emotional work (Demands), Emotional intelligence, and professional self-efficacy (Resources) over the Burnout syndrome dimensions in a sample of 240 Brazilian clinical psychologists. The data was collected by an on-line platform using a Labor and social demographic data questionnaire, a work Burnout Syndrome Evaluation questionnaire (CESQT - Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo), the short version of the Therapist Personal Style Questionnaire (EPT-C Cuestionario del Estilo Personal del Terapeuta), an Evaluation questionnaire related to emotional demands and emotion rule dissonance, and the Emotional Intelligence Measure (EIM) and Perceived General Self-Efficacy Scale (GPSS) as research instruments. Results showed a predictor model of Burnout syndrome constituted by the variables Emotional dissonance, Self-motivation, Emotional demands, Instruction, Involvement, and Self-efficacy. We emphasize the relevance of strategies to prevent Burnout Syndrome in this professional category and the need for actions to promote and develop emotional intelligence and self-efficacy as a strengthening factor of the emotional resources to work as a clinical psychologist.(AU)

Se utilizó el modelo demandas y recursos para identificar el poder predictivo del estilo personal del terapeuta y del trabajo emocional (demandas), y de la inteligencia emocional y autoeficacia profesional (recursos) sobre las dimensiones del síndrome de Burnout (SB), en una muestra de 240 psicólogos clínicos brasileños. Los datos se recolectaron de una plataforma en línea, utilizando como instrumentos de investigación un cuestionario de datos sociodemográficos y laborales, el Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo, el Cuestionario del Estilo Personal del Terapeuta, el Cuestionario de Evaluación Relacionado con Demandas Emocionales y Disonancia de la Regla de la Emoción, la Medida de Inteligencia Emocional y Escala de Autoeficacia General Percibida. Los resultados obtenidos revelaron un modelo predictor de las dimensiones de SB, constituido por las variables disonancia emocional, automotivación, exigencias emocionales, instrucción, implicación y autoeficacia. Se destaca la relevancia de las estrategias dirigidas a la prevención del SB en esta categoría profesional, así como la necesidad de acciones dirigidas a promover y desarrollar la inteligencia emocional y la autoeficacia como fortalecimiento de los recursos emocionales para trabajar en la práctica clínica.(AU)

Estresse ocupacional entre psicólogos atuantes na atenção primária à saúde no contexto pandêmico / Occupational stress in psychologists working in primary health care in the context of the pandemic / Estrés laboral entre los psicólogos que trabajan en atención primaria de salud en el contexto de la pandemia

Este estudo analisa o estresse ocupacional entre psicólogos que atuavam na Atenção Primária à Saúde durante a pandemia ocasionada pela covid-19, assim como as características sociodemográficas e laborais dos participantes e sua relação com o estresse ocupacional. Participaram da pesquisa 70 psicólogos atuantes em 51 unidades básicas de saúde das regiões Oeste e Extremo Oeste catarinense. Para coleta de dados, um questionário sociodemográfico e a versão reduzida da Job Stress Scale (JSS) foram aplicados. A análise dos dados foi realizada por meio da estatística descritiva e inferencial. Identificou-se que 35,7% dos psicólogos apresentaram alto desgaste no trabalho; 28,6% baixo desgaste; 27,1% se mostraram em trabalho passivo; e 8,6% em trabalho ativo. No modelo de regressão linear, os fatores associados à dimensão Demanda da JSS foram: possuir filho (a) (coeficiente -1,49; IC 95% -2,75 a -0,23) e afastamento do trabalho nos últimos 12 meses (coeficiente 1,88; IC 95% 0,60 a 3,15). Os psicólogos com hipertensão arterial sistêmica autorreferida apresentaram, em média, 3,96 pontos a menos no escore de Apoio social (IC 95% -7,06 a -0,85), quando comparados aos não hipertensos, e entre os psicólogos que trabalhavam no turno da manhã identificou-se aumento de 4,46 pontos, em média, no escore de Apoio social (IC 95% 0,90 a 8,02) em relação aos profissionais do turno manhã e tarde. Evidenciou-se que um número significativo de psicólogos apresentava-se em alto desgaste no trabalho, com potenciais implicações para sua saúde e atuação profissional.(AU)

This study analyzed occupational stress among psychologists who worked in Primary Health Care during the COVID-19 pandemic and participants' sociodemographic and work characteristics and their relationship with occupational stress. In total, 70 psychologists working in 51 basic health units in the West and Far West regions of Santa Catarina participated in this research. A sociodemographic questionnaire and the short version of the Job Stress Scale (JSS) were applied to collect data. Data were analyzed by descriptive and inferential statistics. In total, 35.7% of psychologists showed high stress at work; 28.6%, low burn out; 27.1%, passive work; and 8.6%, active work. The factors in the linear regression model that were associated with the JSS demand dimension referred to having children (coefficient −1.49; 95% CI −2.75 to −0.23) and absence from work in the last 12 months (coefficient 1.88; 95% CI 0.60 to 3.15). Psychologists with self-reported systemic arterial hypertension showed, on average, 3.96 points lower in the Social Support score (95% CI −7.06 to −0.85) than non-hypertensive ones and psychologists who worked in the morning shift, an average increase of 4.46 points in the Social Support score (95% CI 0.90 to 8.02) in relation to professionals working in the morning and afternoon shifts. A significant number of psychologists had high stress at work, with potential implications to their health and professional performance.(AU)

Este estudio evalúa el estrés laboral entre los psicólogos que trabajaron en la atención primaria de salud durante la pandemia provocada por la COVID-19, así como las características sociodemográficas y laborales de ellos y su relación con el estrés laboral. En la investigación participaron setenta psicólogos que trabajan en 51 unidades básicas de salud en las regiones oeste y lejano oeste de Santa Catarina (Brasil). Para la recolección de datos se aplicó un cuestionario sociodemográfico y la versión corta de la Job Stress Scale (JSS). El análisis de los datos se realizó mediante estadística descriptiva e inferencial. Se identificó que el 35,7% de los psicólogos presentaban alto estrés en el trabajo; el 28,6% tenían poco desgaste; el 27,1% se encontraban en trabajo pasivo; y el 8,6% en trabajo activo. En el modelo de regresión lineal, los factores asociados a la dimensión demanda de la JSS fueron: tener hijo (coeficiente -1,49; IC 95% -2,75 a -0,23) y baja laboral en los últimos 12 meses (coeficiente 1,88; IC 95% 0,60 a 3,15). Los psicólogos con hipertensión arterial sistémica autoinformada presentaron un promedio de 3,96 puntos más bajo en la puntuación de apoyo social (IC 95% -7,06 a -0,85) en comparación con los no hipertensos, y entre los psicólogos que trabajaban en el turno de la mañana, se identificó un aumento promedio de 4,46 puntos en la puntuación de apoyo social (IC 95% 0,90 a 8,02) con relación a los profesionales que laboran en el turno de mañana y tarde. Quedó evidente que un número significativo de psicólogos se encontraba en situación de alto estrés en el trabajo, con posibles implicaciones para su salud y desempeño profesional.(AU)

Comportamento e desempenho de burocratas de nível de rua: um estudo na Polícia Rodoviária Federal / Comportamiento y desempeño de los burócratas al nivel de calle: un estudio en la Policía Federal de Carreteras / Behavior and performance of street-level bureaucrats: a study at the Federal Highway Police

Resumo A literatura sobre Burocratas de Nível de Rua (BNR) indica diversos motivadores do comportamento que influenciam o desempenho desses profissionais, como discricionariedade, autointeresse, normas e interesse público. Apesar de esses aspectos ocorrerem de maneira simultânea, não se verificam estudos sobre quais agentes do comportamento são determinantes para o desempenho dos BNR. A presente pesquisa tem por objetivo analisar a influência da interação de diferentes motivadores do comportamento do BNR em seu desempenho para implementar políticas públicas. Para isso, foi aplicado um questionário estruturado a 10.014 policiais rodoviários federais ativos no período da pesquisa, sendo 426 o número de respondentes. Os dados foram analisados com modelagem de equações estruturais. Os resultados evidenciaram que discricionariedade, normas e interesse público se associaram positivamente ao desempenho operacional. Para o desempenho institucional, somente as dimensões "normas" e "interesse público" se mostraram positivamente associadas. Os resultados indicam que a relevância dos diferentes motivadores do comportamento dos BNR varia de acordo com o desempenho observado e reiteram a assimetria de percepções entre os diferentes níveis organizacionais.

Resumen La literatura sobre los burócratas a nivel de calle (BNC) indica varios motivadores de comportamiento que influyen en su desempeño, como la discreción, el interés propio, las normas y el interés público. A pesar de la concurrencia de estos aspectos, no hay estudios sobre qué motivadores son determinantes para el desempeño de los BNC. Esta investigación tiene como objetivo analizar la influencia de la interacción de diferentes motivadores de comportamiento del BNC en su desempeño para implementar políticas públicas. Para ello, se aplicó un cuestionario estructurado a 10.014 agentes de la Policía Federal de Caminos activos durante el período de investigación, siendo 426 encuestados. Los datos se analizaron usando análisis de ecuaciones estructurales. Los resultados mostraron que discreción, normas e interés público se asociaron positivamente con el desempeño operativo. Para desempeño institucional, solo las dimensiones normas e interés público se asociaron positivamente. Los resultados indican que la relevancia de los diferentes motivadores del comportamiento de los BNC varía según la variable de desempeño observada y reiteran la asimetría de percepciones entre los diferentes niveles organizacionales.

Abstract The literature on Street-Level Bureaucracy (SLB) points to several behavioral motivators that influence their performance, such as Discretion, Self-interest, Norms, and Public Interest. Although these aspects occur simultaneously, there are no studies on which behavioral motivators are decisive for the performance of SLB. This research aims to analyze the influence of the interaction of different behavioral motivators of the SLB in their performance in implementing public policies. To achieve the proposed objective, a structured questionnaire was applied to 10,014 Federal Highway Police officers active during the research period, with 426 respondents. Data were analyzed using structural equation analysis. The results showed that Discretion, Norms, and Public Interest were positively associated with Operating Performance. For Institutional Performance, only the Norms and Public Interest dimensions were positively associated. The results indicate that the relevance of the different behavioral motivators of the SLB varies according to the performance variable observed and reiterate the asymmetry of perceptions between the different organizational levels.

Determinantes da proatividade e do capital psicológico: fatores individuais e organizacionais / Determinants of proactivity and psychological capital: individual and organizational factors / Determinantes de la proactividad y del capital psicológico: factores individuales y organizacionales

A proatividade e o capital psicológico (PsyCap) são construtos associados às virtudes psicológicas, recursos despertados por fatores individuais e organizacionais, que podem maximizar resultados. Este estudo visou investigar qualitativamente os determinantes e aspectos que podem estimular o PsyCap e a proatividade, a partir da perspectiva de trabalhadores de duas empresas brasileiras. A pesquisa foi realizada por meio de entrevistas semiestruturadas com uma amostra de 26 funcionários. Os resultados revelaram determinantes comuns para a proatividade e o PsyCap, dentre eles a aprendizagem formal e informal, o feedback, a felicidade, a persistência, a curiosidade, os desafios e a estratégia. Foram observados alguns consequentes positivos, como euforia, alegria, realização, entusiasmo, engajamento e gratidão. Notou-se também que a ausência de proatividade e níveis baixos de PsyCap podem desencadear reações negativas, como indignação, tristeza, procrastinação, paralisação, desequilíbrio e frustração. Esses resultados sugerem que intervenções focadas no desenvolvimento da proatividade e do PsyCap podem ser essenciais para potencializar o bem-estar individual e resultados positivos nas organizações.(AU)

Proactivity and psychological capital (PsyCap) are concepts associated with psychological virtues, resources awakened from individual and organizational factors, which can maximize results. This study aimed to investigate qualitatively the determinants and aspects that can stimulate PsyCap and proactivity, from the perspective of workers of two Brazilian businesses. The research was carried out with semi-structured interviews with a sample of 26 employees. The results revealed common determinants for proactivity and PsyCap, among them formal and informal learning, feedback, happiness, persistence, curiosity, challenges, and strategy. Some positive consequences were observed, such as euphoria, joy, fulfillment, enthusiasm, engagement, and gratitude. Also note that the absence of proactivity and low levels of PsyCap could trigger negative reactions, such as indignation, sadness, procrastination, paralysis, imbalance, and frustration. These results suggest that interventions focused on the development of proactivity and PsyCap can be essential to enhance individual well-being and positive results in organizations.(AU)

La proactividad y el capital psicológico (PsyCap) son constructos asociados a las virtudes psicológicas, recursos que pueden ser despertados por factores individuales y organizacionales para maximizar los resultados. Este estudio tuvo como objetivo investigar cualitativamente los determinantes y aspectos que pueden despertar el PsyCap y la proactividad desde la perspectiva de los trabajadores de dos empresas brasileñas. Este estudio se realizó mediante entrevistas semiestructuradas en una muestra de 26 empleados. Los resultados revelaron determinantes comunes para la proactividad y el PsyCap, entre ellos, el aprendizaje formal e informal, la retroalimentación, la felicidad, la persistencia, la curiosidad, los desafíos y la estrategia. Se observaron algunas consecuencias positivas, como euforia, alegría, logro, entusiasmo, compromiso y gratitud. También se señaló que la ausencia de proactividad y los bajos niveles del PsyCap pueden desencadenar reacciones negativas, como indignación, tristeza, procrastinación, parálisis, desequilibrio y frustración. Estos resultados sugieren que las intervenciones centradas en el desarrollo de la proactividad y del PsyCap pueden ser esenciales para mejorar el bienestar individual y los resultados positivos en las organizaciones.(AU)

Psicoterapia breve operacionalizada na adaptação de mulheres com câncer de mama: coletânea de casos / Brief psychotherapy operationalized in adaptation of women with breast cancer: case selection / Psicoterapia breve operacionalizada en la adaptación de mujeres con cáncer de mama: recopilación de casos

O objetivo deste estudo foi investigar os efeitos terapêuticos da Psicoterapia Breve Operacionalizada (PBO) na adaptação de mulheres diagnosticadas com câncer de mama e em tratamento oncológico. O câncer de mama mostra-se mobilizador de sofrimento psíquico para as mulheres tanto no diagnóstico quanto no tratamento, o que justifica identificar intervenções psicológicas adequadas para essa população. As participantes foram 17 mulheres com idade entre 30 e 65 anos. A Escala Diagnóstica Adaptativa Operacionalizada (EDAO) foi o instrumento utilizado para avaliação da adaptação em quatro setores: afetivo-relacional, produtividade, orgânico e sociocultural. Referida avaliação foi feita em três momentos: antes e após a intervenção breve, e no follow-up . A PBO foi a intervenção breve utilizada. Os resultados mostraram que o setor orgânico foi o mais comprometido, seguido do afetivo-relacional, com soluções pouquíssimo adequadas. Como foco da psicoterapia breve, a situação-problema mais recorrente se relacionava ao câncer de mama, que, na compreensão psicodinâmica, mostrou-se associada ao intenso desamparo egóico diante do adoecimento e tratamento oncológico. Na avaliação adaptativa final e follow-up , 82,4% das participantes apresentaram evolução de grupo adaptativo. Concluímos que, neste estudo, a intervenção com a PBO possibilitou efeitos terapêuticos na adaptação, reverberando na solução das situações-problema e na crise adaptativa por perda.(AU)

This study aimed to investigate the therapeutic effects of Operationalized Brief Psychotherapy (PBO) so women diagnosed with breast cancer could adapt to treatment. Breast cancer has mobilized psychological suffering for women during diagnosis and treatment, justifying the identification of the appropriate psychological interventions for this population. Participants included 17 women aged 30 to 65 years. Adaptative Operational Diagnostic Scale (EDAO) was used to evaluated adaptation in four sectors: affective-relational, productivity, organic, and sociocultural before and after a brief psychological intervention and follow-up. The PBO was used as the brief intervention. Results showed that the organic sector was the most compromised, followed by the affective-relational one, which showed very little adequate solutions. As a focus of brief psychotherapy, the most recurring problem-situation was related to breast cancer, which, in yjr psychodynamic understanding, was associated with the intense helplessness of the ego in the face of illness and treatment. In the final adaptative evaluation and follow-up, 82.4% of participants showed evolution in the adaptive group. This study concluded that the intervention with PBO enabled therapeutic effects in these participants' adaptation, reverberating in the solution of problem-situation and in the adaptive crisis by loss.(AU)

El propósito de este estudio fue investigar los efectos terapéuticos de la psicoterapia breve operacionalizada (PBO) en la adaptación de mujeres diagnosticadas con cáncer de mama y en tratamiento oncológico. El cáncer de mama moviliza sufrimiento psicológico para las mujeres tanto en el diagnóstico como en el tratamiento, lo que justifica identificar intervenciones psicológicas adecuadas para esta población. Participaron 17 mujeres de entre 30 y 65 años. El instrumento utilizado fue la Escala de Diagnóstico Adaptativo Operacionalizada (EDAO) para la evaluación adaptativa en cuatro sectores: afectivo-relacional, productividad, orgánico y sociocultural. La evaluación se realizó en tres momentos: antes, después de la intervención breve y en el seguimiento. La PBO fue la intervención breve utilizada. Los resultados mostraron que el sector orgánico fue el más comprometido, seguido por el afectivo-relacional con soluciones poquísimas adecuadas. Como foco de la psicoterapia breve, la situación-problema más recurrente estuvo relacionada con el cáncer de mama, que en la comprensión psicodinámica resultó estar asociada a un intenso desamparo ante la enfermedad y el tratamiento oncológico. En la evaluación adaptativa final y el seguimiento, el 82,4% de las participantes tuvieron evolución grupal adaptativa. Se concluye que la intervención con PBO permitió efectos terapéuticos en la adaptación de estos participantes, repercutiendo en la solución de situaciones-problema y en la crisis adaptativa por pérdida.(AU)

Assessing the dynamic performance of water companies through the lens of service quality.

The measurement of performance within the water industry holds significant importance for policymakers, as it can help guide decision-making for future development and management initiatives. In this study, we apply data envelopment analysis (DEA) cross-efficiency techniques to evaluate the productivity change of the Chilean water industry during the years 2010-2018. Water leakage and unplanned interruptions are included in the analysis as quality of service variables. Moreover, we use cluster analysis and regression techniques to better understand what drives productivity change of water companies. The results indicate that the Chilean water industry is characterized by considerable high levels of inefficiency and low levels of productivity change. This is due to the existence of technical regress whereas gains in efficiency were small. Concessionary water companies were found to be more productive than full private and public water companies. Best and worst performers need to make efforts to reduce production costs and improve service quality. Other factors such as customer density and ownership type statistically affect productivity.

TFP Bioeconomy Impact post Covid-19 on the agricultural economy.

BACKGROUND: This research was focused on measuring the TFP bioeconomy post-Covid-19 in six regions of the world. METHODS: The panel data was organized with FAO Statistics data. Linear programming with an enveloping data analysis (DEA) approach was used to measure the Malmquist TFP indices to determine the inter-annual productivity and technical efficiency changes by region. RESULTS: The results show that the effect of Covid-19 on the bioeconomy productivity during the period 2012-2021 on average decreased by 11.6%. This effect was explained by the decomposition of the productivity change into the changes in technical efficiency. The workers decreased their efficiency by 11.7%. In the Northern American region, it decreased by 21.6%, in the Southern European region by 10.1, and in Western Europe by 11.7%. CONCLUSION: The results show a downward trend that was affected in the year 2019 by Covid-19, however, it was possible to recover in the following year. One of the conclusions of these results is the effect of the immediate strategies that the governments of the region implemented. This effect was a little slower in the North American, Southeastern, and Eastern European regions. Finally, it is concluded that the measures implemented by the governments in the studied regions had an increasing effect in conditions of variable scale returns. In other words, the companies that remained on a constant scale decreased.

The economic impact of cancer mortality among working-age individuals in Brazil from 2001 to 2030.

BACKGROUND: About half of cancer deaths in Brazil occur among individuals of working-age (under 65 years for men, under 60 for women), resulting in a substantial economic impact for the country. We aimed to estimate the years of potential productive life lost (YPPLL) and value the productivity lost due to premature deaths from cancer between 2001 and 2015 and the projected to 2030. METHODS: We used the Human Capital Approach to estimate the productivity losses corresponding to YPPLL for cancer deaths in working age people (15-64 years). Mortality data were obtained from the Mortality Information System from 2001 to 2015 and projected between 2016 and 2030. Economic data were obtained from the Continuous National Household Sample Survey and forecasted to 2030. Productivity lost was calculated as the monetary value arising from YPPLL in Int$(2016). RESULTS: Between 2001 and 2030, a total of 2.3 million premature deaths from all cancers combined were observed and forecasted in Brazil (57% men, 43% women), corresponding to 32 million YPPLL and Int$141.3 billion in productivity losses (men: Int$102.5 billion, women: Int$38.8 billion). Between 2001 and 2030, among men, lung (Int$ 12.6 billion), stomach (Int$ 10.6 billion) and colorectal (Int$ 9.4 billion) cancers were expected to contribute to the greatest productivity losses; and among women, it will be for breast (Int$ 10.0 billion), cervical (Int$ 6.4 billion) and colorectal (Int$ 3.2 billion) cancers. CONCLUSIONS: Many preventable cancers result in high lost productivity, suggesting measure to reduce smoking prevalence, alcohol consumption, physical inactivity and inadequate diet, improving screening programs and increasing vaccination coverage for human papillomavirus and hepatitis B would have a positive impact on the economy, as well as reducing morbidity and mortality from cancer.

Bibliometric and systemic analysis of the relationship between quality of work life and productivity during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic brought with it changes in the way of working and the well-being of workers. OBJECTIVE: To identify research trends on work life quality and its impact on productivity in the context of the COVID-19 pandemic. METHOD: The Proknow-C constructivist methodology was used, with which a bibliographic portfolio of 49 articles obtained from the Web of Science was prepared, resulting from four stages of search between 2012 and 2022; a bibliometric analysis was performed on that database and bibliometric networks were created with the software VOSviewer; the systemic analysis of the articles was carried out, thus showing theories, definitions and indicators; and areas of opportunity of research were identified. RESULTS: The most important high-impact specialized journals and authors, articles considered central, most used keywords such as job satisfaction, quality of work life and COVID-19, as well as the most representative countries such as European and Asian, are presented. CONCLUSION: It was found that the health sector is one of the most studied, allowing researchers from other sectors the opportunity to delve into the issue of the affectations of the quality of work life reflected in productivity and common variables were synthesized such as job satisfaction, well-being, motivation and security, among others.

Common mental disorders, productivity and presenteeism in nursing workers.

OBJECTIVE: To investigate the association between the occurrence of common mental disorders with loss of productivity and presenteeism in nursing workers at a public health service. METHOD: This is a cross-sectional study, with 291 workers from Midwestern Brazil. Data collection carried out from October 2019 to January 2020, with instruments for sociodemographic characterization, labor and health conditions: Self Reporting Questionnaire-20, Standford Presenteeism Scale and Work Limitations Questionnaire. Data were analyzed using descriptive and inferential statistics, with Mann-Whitney tests and logistic regression, respecting a significance level of 5%. RESULTS: The occurrence of common mental disorders was 4.27 times more likely to experience presenteeism, 10.17% of compromised overall productivity, and impairment of mental/interpersonal and production demands. CONCLUSION: The occurrence of common mental disorders was associated with presenteeism, with repercussions in loss of productivity of nursing workers.

Productivity-adjusted life years lost due to non-optimum temperatures in Brazil: A nationwide time-series study.

Non-optimal temperatures are associated with premature deaths globally. However, the evidence is limited in low- and middle-income countries, and the productivity losses due to non-optimal temperatures have not been quantified. We aimed to estimate the work-related impacts and economic losses attributable to non-optimal temperatures in Brazil. We collected daily mortality data from 510 immediate regions in Brazil during 2000 and 2019. A two-stage time-series analysis was applied to evaluate the association between non-optimum temperatures and the Productivity-Adjusted Life-Years (PALYs) lost. The temperature-PALYs association was fitted for each location in the first stage and then we applied meta-analyses to obtain the national estimations. The attributable fraction (AF) of PALY lost due to ambient temperatures and the corresponding economic costs were calculated for different subgroups of the working-age population. A total of 3,629,661 of PALYs lost were attributed to non-optimal temperatures during 2000-2019 in Brazil, corresponding to 2.90 % (95 % CI: 1.82 %, 3.95 %) of the total PALYs lost. Non-optimal temperatures have led to US$104.86 billion (95 % CI: 65.95, 142.70) of economic costs related to PALYs lost and the economic burden was more substantial in males and the population aged 15-44 years. Higher risks of extreme cold temperatures were observed in the South region in Brazil while extreme hot temperatures were observed in the Central West and Northeast regions. In conclusion, non-optimal temperatures are associated with considerable labour losses as well as economic costs in Brazil. Tailored policies and adaptation strategies should be proposed to mitigate the impacts of non-optimal temperatures on the labour supply in a changing climate.