Fatores clínicos do bem-estar de mulheres em parturição: perspectivas deontológicas e da bioética principialista / Clinical factors of women in labor well-being: deontological and bioethical principlism perspectives / Factores clínicos del bienestar de la mujer en trabajo de parto: perspectivas deontológicas y de la bioética principialista

Objetivo: avaliar os fatores clínicos associados ao bem-estar das mulheres durante o trabalho de parto e parto à luz da bioética principialista e da deontologia. Método: estudo transversal com abordagem quantitativa. Participaram 396 puérperas internadas em um hospital municipal do sudoeste da Bahia, e os dados foram coletados no período de janeiro a maio de 2023, após aprovação do comitê de ética em pesquisa. Os dados foram organizados no software Excel e analisados via SPSS v.25. a partir da regressão logística multinomial. Resultados: a maior parte da amostra apresentou bem-estar com assistência em saúde, mulheres que tiveram parto realizado por profissionais não médicos apresentaram mais chances de níveis de bem-estar "adequado". E mulheres que não tiveram a via de parto cesárea apresentaram aumento de chances de bem-estar. Conclusão: é necessário que os profissionais reflitam sobre suas ações, condicionando-as à humanização no parto, em observância aos princípios bioéticos.

Objective: to evaluate the clinical factors associated with women's well-being during labor and delivery in the light of bioethics principlism and deontology. Method: a cross-sectional study with a quantitative approach was conducted. It involved 396 postpartum women admitted to a municipal hospital in the southwest of Bahia. Data were collected from January to May 2023, after approval from the research ethics committee. The data were tabulated using Excel software and analyzed using SPSS v.25 through Multinomial Logistic Regression. Results: majority of the sample exhibited well-being with health care assistance. Women who underwent delivery performed by non-medical professionals showed higher chances of "adequate" levels of well-being. Additionally, women who did not undergo cesarean delivery showed increased chances of well-being. Conclusion: It is necessary for professionals to reflect on their actions, conditioning them to the humanization of childbirth, according to bioethical principles.

Objetivo: evaluar los factores clínicos asociados al bienestar de la mujer durante el trabajo de parto y parto a la luz de la bioética y la deontología principialista. Método: estudio transversal con enfoque cuantitativo. Incluyó 396 puérperas ingresadas en un hospital municipal del suroeste de Bahía. Recolección de datos de enero a mayo de 2023, con aprobación del comité de ética en investigación. Los datos se tabularon en el software Excel y se analizaron mediante SPSS v.25. utilizando regresión logística multinomial. Resultados: la mayoría de las participantes de la muestra presentó bienestar con la atención para la salud; las que tuvieron partos realizados por profesionales no médicos tenían más probabilidades de tener niveles "adecuados" de bienestar; las que no tuvieron parto por cesárea tenían mayores probabilidades de tener bienestar. Conclusión: es necesario que los profesionales reflexionen sobre sus acciones y las adecuen para humanizar el parto, respetando los principios bioéticos.

[Job satisfaction and violence in the clinical relationship in Physical Therapists in Spain]. / Satisfacción laboral y violencia en la relación clínica en Fisioterapia en España.

OBJECTIVE: To assess the job satisfaction (JS) of physiotherapists in Spain and their relationship with occupational violence, as with other socio-demographic, health, and occupational factors. DESIGN: A cross-sectional study was conducted. Setting Primary, community, and hospital attention level at public and private care in Spain. PARTICIPANTS: Physiotherapists in Spain who have been working for at least 3months during the last year, and with complete answer to the required variables (n=2,590). MAIN MEASUREMENTS: Information was collected through a questionnaire distributed online. A descriptive quantitative analysis and 3 logistic regression models were performed. In the first model, sociodemographic and violence variables were included as independent variables, in the second, health-related variables, and in the third, occupational variables. RESULTS: The average JS of physiotherapists is 7.26 points, being 8 or more in 46.8% of the cases, with a higher percentage in men". Referring not having suffered psychological violence was related to a higher probability of having JS, even controlling for the rest of the variables studied (OR1=0.485; OR2=0.611; OR3=0.697, respectively for each model). Variables related to health (state of health, symptoms, consumption of tobacco/alcohol/other substances) and to the work environment (working day, work area, autonomy, relationship with superiors/colleagues) were statistically significantly related to JS. CONCLUSIONS: Almost 47% of the respondents had very high JS values. Certain areas of work as well as positive health factors have been linked to very high JS. Psychological violence is the form of violence that, independently of the other factors analysed, leads to lower JS.

An assessment of potential interventions to reduce the totoaba illegal trade market.

The illegal trade in totoaba (Totoaba macdonaldi) is causing adverse social, ecological, and economic impacts. This illegal activity is accelerating the overexploitation of totoaba and pushing the critically endangered vaquita (Phocoena sinus) closer to extinction. Despite extensive efforts to recover vaquita populations, scant attention has been given to the totoaba trade as an independent issue. As a result, data on the totoaba trade are limited, which hampers robust analyses and development of effective interventions to reduce illegal harvesting. We used a previously developed framework specifically designed to examine dynamics of illegal markets and guide measures to mitigate illegal use of totoaba. This framework separates markets into 3 analytical levels: characterization of participating actors (e.g., fishers, intermediaries); examination of how actors interact within the market (e.g., organization of supply chains); and assessment of the overall market dynamics that result from these interactions (e.g., factors determining price and quantity). We reviewed existing literature (108 initial articles) and interviewed key market actors, academics, and nongovernmental organization experts (14) to obtain data for this framework. Our findings offer an overview of the totoaba illegal market operation, highlighting intervention points (e.g., customs agents) and areas where additional information is required to decrease information gaps (e.g., US local market). We describe the structure and complexity of this market, emphasizing the influential role of organized crime in shaping its dynamics (e.g., controlling prices paid to fishers and stockpiling). By providing a systematic and in-depth understanding of the market operation, we aimed to establish a benchmark for effective interventions and future research aimed at reducing uncertainties. Our results provide a crucial step toward addressing this critical issue and can help facilitate development of effective strategies to combat the illegal totoaba trade and promote biodiversity conservation more broadly.

Evaluación de las intervenciones potenciales para reducir el mercado ilegal de la totoaba Resumen El mercado ilegal de totoaba (Totoaba macdonaldi) causa impactos sociales, ecológicos y económicos adversos. Esta actividad ilegal acelera la sobreexplotación de la totoaba y acerca a la extinción a la vaquita marina (Phocoena sinus), especie en peligro crítico de extinción. A pesar de los grandes esfuerzos por recuperar las poblaciones de vaquita, el comercio de totoaba recibe poca atención como problema independiente. Como resultado, los datos sobre este comercio son limitados, lo que dificulta el análisis sólido y el desarrollo de intervenciones eficaces para reducir la captura ilegal. Utilizamos un marco desarrollado previamente y diseñado específicamente para examinar la dinámica de los mercados ilegales y orientar las medidas para mitigar el uso ilegal de la totoaba. Este marco separa los mercados en tres niveles analíticos: caracterización de los actores participantes (por ejemplo, pescadores, intermediarios); análisis de cómo interactúan los actores dentro del mercado (por ejemplo, organización de las cadenas de suministro); y evaluación de la dinámica general del mercado que resulta de estas interacciones (por ejemplo, factores que determinan el precio y la cantidad). Revisamos la bibliografía existente (108 artículos iniciales) y entrevistamos a actores clave del mercado, académicos y expertos de organizaciones no gubernamentales (14) para obtener datos para este marco. Nuestras conclusiones ofrecen una visión general del funcionamiento del mercado ilegal de totoaba y destacan los puntos de intervención (por ejemplo, los agentes aduanales) y las áreas en las que se requiere información adicional para reducir los vacíos informativos (por ejemplo, el mercado local estadunidense). Describimos la estructura y complejidad de este mercado, destacando el influyente papel de la delincuencia organizada en la configuración de su dinámica (por ejemplo, controlando los precios pagados a los pescadores y el almacenamiento). Al proporcionar una comprensión sistemática y en profundidad del funcionamiento del mercado, pretendemos establecer un punto de referencia para intervenciones eficaces y futuras investigaciones encaminadas a reducir las incertidumbres. Nuestros resultados suponen un paso crucial para abordar esta cuestión crítica y pueden ayudar a facilitar el desarrollo de estrategias eficaces para combatir el comercio ilegal de totoaba y promover la conservación de la biodiversidad de forma más amplia.

'I've got no PPE to protect my mind': understanding the needs and experiences of first responders exposed to trauma in the workplace.

ABSTRACTBackground: First responders (FRs) are at high risk of being exposed to traumatic events in their occupational roles. Responding to critical incidents often involves exposure to life-threatening circumstances, dealing with fatalities and encountering highly stressful situations that may trigger traumatic responses. These experiences can lead to poor physical and mental health (MH) outcomes including post-traumatic stress disorder, co-morbid conditions such as depression, anxiety, substance abuse, insomnia, and suicidality. Little research has explored the perspectives and experiences of FRs in dealing with occupational trauma(s) and how best to meet their health needs.Objective: This study aimed to explore FRs' experiences of exposure to occupational trauma and its impact on their mental wellbeing. The wider objective was to investigate how FRs can be supported to access appropriate and relevant help, addressing barriers like stigma.Method: A qualitative research design using in-depth semi-structured interviews with FRs (n = 54) was adopted. Interviews were audio-recorded, transcribed and analysed using an inductive thematic approach.Results: Themes developed were: (1) the pervasive, cumulative and salient impact of occupational trauma on MH (micro-traumas, nightmares, flashbacks and reliving experiences); (2) the demands of the job exacerbating the adverse effects of trauma (self and others); (3) insufficient support and unhelpful ways of coping following exposure to trauma (lack of psychological safety); (4) stigma and fear of judgement as barriers to MH help-seeking; and (5) need for specific, accessible and credible trauma-focused interventions and workplace support.Conclusions: The implications of these findings are discussed at the individual, service provider and organisational level, emphasising the importance of implementing a strengths-based, non-pathologising and de-stigmatising approach to trauma in the workplace as experienced by FRs. Emphasis is placed on the importance of overcoming barriers to accessing MH support and improving access to evidence-based, trauma-focused psychological interventions and workplace support.

First responders regularly experience traumatic events in their workplace which can bring about traumatic stress, which is further exacerbated by the demands and pressures of their jobs.First responders' coping needs are not being met to a sufficient extent, especially in terms of psychological/MH input.There is need for evidenced-based, easily accessible, occupation-specific trauma-focused interventions to support first responders with their MH needs from occupational trauma-related stressors.

Siniestralidad y apnea obstructiva del sueño. Revisión de la literatura y evaluación de la situación en 3 países latinoamericanos / Accident Rate and Obstructive Sleep Apnea: Literature Review and Assessment of the Situation in Three Latin American Countries

La apnea obstructiva del sueño (AOS) es una condición común en adultos en edad laboral. Incluso, en la actualidad, vemos cómo la edad de retiro se ha ido prolongando de tal manera que adultos mayores, quienes tienen mayor prevalencia de AOS, continúan trabajando incluso en situaciones de alto riesgo de siniestralidad. Uno de los principales síntomas de la AOS es la somnolencia diurna que puede contri- buir de manera directa al riesgo de accidentabilidad, compromiso cognitivo y desem- peño laboral. También se ha demostrado cómo la reducción de la materia gris a nivel cerebral y cerebelar provoca alteraciones en coordinación y capacidad de conducción. El tratamiento con dispositivos de presión positiva mejora el desempeño laboral y redu- ce la incidencia de accidentes de tránsito, pero algunos déficits cognitivos pueden per- sistir incluso después de meses de tratamiento. La evaluación del riesgo de accidentabilidad en conductores es un desafío y los cues- tionarios actuales no son adecuados para el cribado. Los simuladores de conducción y las pruebas de alerta son más prometedores. El futuro de la investigación se centra en estandarizar los resultados de los simulado- res, determinar los mejores predictores de eventos reales y utilizar la inteligencia arti- ficial y los automóviles autónomos para reducir los riesgos relacionados con la somno - lencia al volante. Es necesario que la posición de los entes gubernamentales de nuestros países latinoa- mericanos sea proactiva y orientada a la protección de la salud y la seguridad de la po- blación.

Obstructive sleep apnea (OSA) is a common condition among working-age adults. In today's context, we observe that the retirement age has been extended, with older adults, who have a higher prevalence of OSA, continuing to work even in high-risk situations. One of the main symptoms of OSA is daytime sleepiness, which can directly contribu- te to the risk of accidents, cognitive impairment and reduced work performance. It has also been demonstrated that the reduction of gray matter in the brain, especially in the cerebellum, can lead to coordination and driving capacity impairments. Treatment with positive pressure devices improves work performance and reduces the incidence of traffic accidents, but some cognitive deficits may persist even after months of treatment. Assessing the risk of accidents in drivers is a challenge, and current questionnaires are not suitable for screening. Driving simulators and alertness tests show more promise. The future of research is focused on standardizing simulator outcomes, identifying the best predictors of real-world events, and utilizing artificial intelligence and autonomous vehicles to mitigate risks associated with driver drowsiness. It is imperative that the stance of government entities in our Latin American countries is proactive and aimed at safeguarding the health and safety of the population.

El Trabajo Colaborativo como una Competencia Deseable en el Contexto del Aprendizaje de Anatomía Humana: Su Desarrollo Mediante Aula Invertida / Collaborative Work as a Desirable Competence in the Context of Learning Human Anatomy: Development Through a Flipped Classroom

El estudio de la anatomía humana como asignatura básica tiene el desafío de promover el desarrollo de competencias genéricas en los estudiantes. Tal es el caso del trabajo colaborativo, trascendental en el trabajo en salud. Así, aparece aula invertida cuyo esquema desarrolla actividades de trabajo en equipo. Por ello, el objetivo de este trabajo es analizar el impacto de aula invertida sobre el trabajo colaborativo en la enseñanza de la anatomía. Estudio cuantitativo, transversal, no experimental que involucró la implementación de aula invertida en un curso de Terapia Ocupacional de 2023. A partir de 5 sesiones planificadas se desarrollaron trabajos en 6 grupos; incluyeron síntesis de contenido y casos clínicos. Al cerrar el semestre se determinó un promedio de calificaciones (PC), junto a una autoevaluación (AE) y coevaluación (CE) que midió trabajo colaborativo mediante 3 subcompetencias (SC1-SC3) (escala 1,0 a 7,0). Se aplicaron pruebas estadísticas para determinar diferencias entre de SC1-SC3 según AE y CE, por grupos y si existe relación con PC. La prueba de U de Mann Whitney no arrojó diferencias entre AE y CE. La prueba de Friedman no evidenció diferencias entre SC1-SC3. La prueba H de Kruskal-Wallis halló diferencias de las subcompetencias según grupos; SC1 podrían influir en el PC, SC2 registra diferencias en el grupo G1 y G5, y "gestión de conflictos" (SC3) no difiere de forma destacada entre los grupos. La correlación de Spearman presenta una asociación positiva débil entre las subcompetencias y PC, aunque el valor-p no fue significativo. Es sumamente necesario potenciar el trabajo colaborativo en el inicio del pregrado. Anatomía humana, en este contexto, tiene la oportunidad de promover su desarrollo. Ello puede generarse en el marco de aula invertida, cuyo esquema promueve actividades de trabajo colaborativo, y como es sabido, en el rendimiento académico.

SUMMARY: As a basic subject, the study of human anatomy challenges the development of generic skills in students. Such is the case of collaborative work which is transcendental in the areas of healthcare work. Consequently, an inverted classroom is developed wherein teamwork activities are developed. The objective of this work is to analyze the impact of the flipped classroom on collaborative work in teaching anatomy. A quantitative, cross-sectional, non-experimental study that involved the implementation of a flipped classroom in an Occupational Therapy course in 2023 was applied. From 5 planned sessions, work was developed in 6 groups; they included content synthesis and clinical cases. At the end of the semester, a grade average (GA) was determined, along with a self-assessment (SA) and co-assessment (CA) measuring collaborative work through 3 sub competences (SC1-SC3) (scale 1.0 to 7.0). Statistical tests were applied to determine differences between SC1-SC3 according to SA and CA, by groups and if there is a relationship with GA. The Mann Whitney U test did not show differences between SA and CA. The Friedman test did not show differences between SC1-SC3. The Kruskal-Wallis H test found differences in sub competences according to groups; SC1 could influence GA, SC2 records differences in group G1 and G5, and "conflict management" (SC3) does not differ significantly between the groups. The Spearman correlation presented a weak positive association between the sub competences and GA, although the p-value was not significant. It is extremely necessary to promote collaborative work at the beginning of the undergraduate degree. In this context, human anatomy is an opportunity to promote its development. This can be generated within the framework of the inverted classroom promoting collaborative work activities, and academic performance as well.

Volvamos al parto humanizado / Let's go back to humanized childbirth

Actualmente, en la mayoría de los países, el parto se ha transformado en una práctica patológica requiriendo un seguimiento institucionalizado y conllevando acciones de violencia obstétrica sobre la mujer. El parto humanizado es un modelo de atención que considera las opiniones, necesidades y valoraciones emocionales de las mujeres y sus familias en los procesos de atención del embarazo, parto y puerperio. En el presente se describe el parto humanizado, historia, importancia, recomendaciones y beneficios para la familia gestante, así como la violencia obstétrica, priorizando la humanización y creando condiciones para que se cumplan las dimensiones espirituales, psicológicas y biológicas del ser humano. Se seleccionaron 12 artículos de investigación, siendo el español el idioma de mayor publicación. El modelo de parto humanizado incluye todo el proceso, desde el embarazo hasta el puerperio tardío, genera un impacto muy importante en el recién nacido y su desarrollo futuro(AU)

Currently, in most countries, childbirth has become a pathological practice, requiring institutionalized followup and leading to actions of obstetric violence against women. Humanized childbirth is a model of care that considers the opinions, needs and emotional evaluations of women and their families in the processes of pregnancy, childbirth and puerperium care. This paper describes humanized childbirth, history, importance, recommendations and benefits for the pregnant family, as well as obstetric violence, prioritizing humanization and creating conditions for the spiritual, psychological and biological dimensions of the human being to be fulfilled. 12 research articles were selected, with Spanish being the language with the most publications. The humanized birth model includes the entire process, from pregnancy to the late puerperium, it generates a very important impact on the newborn and its future development(AU)

[Translated article] Temporary work disability following trapezial resection and suspension arthroplasty for thumb carpometacarpal osteoarthritis.

PURPOSE: The aim of this study is to assess the time to return to work (TRW) in patients undergoing trapezial resection using the Mini TightRope® system at our centre and to investigate factors that might delay return to work following this surgery. MATERIAL AND METHODS: A retrospective study was conducted on patients who underwent Trapezial resection and suspensionplasty using the Mini TightRope® system between 2015 and 2016, with a minimum one-year follow-up. Telephone interviews were conducted along with a review of medical records and radiology reports, as well as temporary work disability documents, collecting epidemiological and occupational data. Groups were compared based on age, gender, dominant hand, biomechanical occupational requirements of the patients, and whether they had experienced prior temporary work disability. RESULTS: A total of 36 patients (29 women and 7 men) with an average age of 55.7 years were included. The median time to return to work was 126 days. Self-employed workers re-entered the workforce 72 days earlier on average; workers who had experienced prior temporary work disability had a greater total temporary work disability duration and took 91 days longer to return to work compared to those who had not. CONCLUSIONS: Patients employed by others and those who had experienced prior temporary work disability before the surgery had longer temporary work disability periods. In our study, no differences were observed based on gender, dominant hand, or biomechanical work demands of the intervened patients.

Impact of high-flow oxygen therapy via high velocity nasal insufflation on diaphragmatic thickening fraction in healthy subjects.

OBJECTIVE: The primary objective of this study was to evaluate the impact of high-flow nasal cannula oxygen therapy [HFNC] on the diaphragm thickening fraction. DESIGN: Prospective, descriptive, cohort study SETTING: The study was conducted in the Physiology and Respiratory Care Laboratory, Intensive Care Unit, Hospital Británico de Buenos Aires. PARTICIPANTS: Thirteen healthy subjects >18 years old INTERVENTIONS: High-flow nasal cannula oxygen therapy MAIN VARIABLES OF INTEREST: Demographic data (age and gender), anthropometric data (weight, height, and body mass index), and clinical and respiratory variables (Diaphragm thickening fraction [DTf], esophageal pressure swing, respiratory rate [RR], esophageal pressure-time product per minute [PTPes/min]). RESULTS: Median DTf decreased significantly as flow increased (p < 0.05). The baseline DTf measurement was 21.4 %, 18.3 % with 20 L/m, and 16.4 % with 40 L/m. We also observed a significant decrease in RR as flow increased in HFNC (p < 0.05). In the 8 subjects with recordings, the PTPes/min was 81.3 (±30.8) cmH2O/sec/min and 64.4 (±25.3) cmH2O/sec/min at baseline and 40 L/m respectively (p = 0.044). CONCLUSIONS: The use of high-flow oxygen therapy through nasal cannula of HFNC in healthy subjects decreases the DTf and RR in association with increased flow. In addition, the use of 40 L/m flow may reduce the muscular work associated with respiration.

Female ophthalmologists' perception of occupational hazards during pregnancy.

OBJECTIVE: Woman ophthalmologists of childbearing age are exposed to different types of occupational risks which can be harmful to pregnancy and to the development of the fetus. The objective of this paper is to analyze the perception of these risks during pregnancy. METHODS: We designed a survey which was answered by 42 ophthalmologists who had been working during pregnancy. We report the perception of global and specific risk according to the type of agent. RESULTS: 38.1% of the ophthalmologists perceive that the overall risk of working during pregnancy is high, and 35.7% consider it moderate. Regarding specific risk, the most relevant agents are the ergonomic and psychosocial ones. Physical agents are considered the least important. CONCLUSIONS: Although most of the surveyed ophthalmologists perceived the occupational risk as high or moderate, only 19% of them took time off work due to this reason. The most important agents were ergonomic and psychosocial.

Diseño y validación de contenido, por juicio de expertos, de un instrumento para la caracterización laboral y productiva de población con discapacidad visual / Design and content validation by expert judgment of an instrument for the labor and productive characterization of the visually impaired population / Desenho e validação de conteúdo, pela avaliação de especialistas, de um instrumento para a caracterização laboral e produtiva da população com deficiência visual

En Colombia, las tasas de empleo de la población con discapacidad visual están por debajo de las de la población general; sus ingresos también tienden a ser más bajos. Orientar los procesos de inclusión laboral se dificulta por la ausencia de instrumentos adecuados que permitan caracterizar e identificar sus necesidades. Se presenta un estudio dirigido a diseñar y validar el contenido de un instrumento para la caracterización laboral y productiva de esta población. A partir de la experiencia del Instituto Nacional para Ciegos, se diseñó una primera versión que fue sometida a validación de contenido con tres expertos que evaluaron su claridad, coherencia, relevancia y suficiencia, además de aportar observaciones y sugerencias. Se realizaron dos rondas de evaluación. Se estimó el grado de concordancia de las evaluaciones con el Coeficiente Kappa de Fleiss y se consideraron los aportes para ajustar el instrumento. Se obtuvo una versión final con 47 ítems en tres dimensiones: información general, académica y laboral, y productiva. El diseño, validación e implementación del instrumento reúne esfuerzos de la academia y el Estado para caracterizar a la población con discapacidad visual en diferentes ciudades del país y aportar a la reducción de las brechas de empleo e ingresos.

In Colombia, employment rates of the visually impaired population are below those of the general population, and their income also tends to be lower. The absence of adequate instruments to characterize and identify their needs makes orienting labor inclusion processes difficult. A study aimed at designing and validating the content of an instrument for the labor and productive characterization of this population is presented. Based on the experience of the Instituto Nacional para Ciegos (National Institute for the Blind), a first version was designed and submitted for content validation by three experts who assessed its clarity, coherence, relevance, and completeness and provided comments and suggestions. Two rounds of evaluation were carried out. The degree of consistency of the evaluations was estimated with the Fleiss Kappa Coefficient. Contributions were considered to adjust the instrument. A final version was obtained with 47 items in three dimensions: general, academic and employment, and productive information. The instrument's design, validation and implementation combine the efforts of academia and the State to characterize the visually impaired population in different cities of the country and contribute to the reduction of employment and income gaps.

Na Colômbia, as taxas de emprego da população com deficiência visual são inferiores às taxas da população em geral; sua renda também tende a ser menor. A orientação dos processos de inclusão laboral é dificultada pela ausência de instrumentos adequados para caracterizar e identificar suas necessidades. Apresentamos um estudo com o objetivo de elaborar e validar o conteúdo de um instrumento para a caracterização laboral e produtiva dessa população. Com base na experiência do Instituto Nacional para Cegos, uma primeira versão foi elaborada e submetida à validação de conteúdo com três especialistas que avaliaram sua clareza, coerência, relevância e suficiência, além de fornecerem comentários e sugestões. Foram realizadas duas roda-das de avaliação. O grau de concordância das avaliações foi estimado por meio do Coeficiente Kappa de Fleiss e as contribuições foram consideradas para ajustar o instrumento. Foi obtida uma versão final com 47 itens em três dimensões: informações gerais; acadêmicas e ocupacionais; e produtivas. O desenho, a validação e a implementação do instrumento reúnem os esforços do meio acadêmico, bem como do Estado, para caracterizar a população com deficiência visual em diferentes cidades do país e contribuir para a redução das lacunas de emprego e renda

Análisis de la carga laboral en tiempo médico en función del grado de complejidad de las muestras y propuesta de algoritmo para la distribución equitativa del trabajo asistencial en un servicio de anatomía patológica / Analysis of the workload in medical time according to the degree of complexity of the samples and proposal of an algorithm for the equitable distribution of the workload in an anatomic pathology department

Introducción: En un servicio de anatomía patológica se analiza la carga laboral en tiempo médico en función de la complejidad de las muestras recibidas, y se valora su distribución entre los patólogos, presentado un nuevo algoritmo informático que favorece una distribución equitativa. Métodos: Siguiendo las directrices para la «Estimación de la carga de trabajo en citopatología e histopatología (tiempo médico) atendiendo al catálogo de muestras y procedimientos de la SEAP-IAP (2.ª edición)» se determinan las unidades de carga laboral (UCL) por patólogo y UCL global del servicio, la carga media laboral que soporta el servicio (factor MU), el tiempo de dedicación de cada patólogo a la actividad asistencial y el número de patólogos óptimo según la carga laboral del servicio. Resultados: Determinamos 12.197 UCL totales anuales para el patólogo jefe de servicio, así como 14.702 y 13.842 para los patólogos adjuntos, con una UCL global del servicio de 40.742. El factor MU calculado es 4,97. El jefe ha dedicado el 72,25% de su jornada a la asistencia y los adjuntos el 87,09 y 82,01%. El número de patólogos óptimo para el servicio es de 3,55. Conclusiones: Todos los resultados obtenidos demuestran la sobrecarga laboral médica, y la distribución de las UCL entre los patólogos no resulta equitativa. Se propone un algoritmo informático capaz de distribuir la carga laboral de manera equitativa, asociado al sistema de información del laboratorio, y que tenga en cuenta el tipo de muestra, su complejidad y la dedicación asistencial de cada patólogo.(AU)

Introduction: In a pathological anatomy service, the workload in medical time is analyzed based on the complexity of the samples received and its distribution among pathologists is assessed, presenting a new computer algorithm that favors an equitable distribution. Methods: Following the second edition of the Spanish guidelines for the estimation of workload in cytopathology and histopathology (medical time) according to the Spanish Pathology Society-International Academy of Pathology (SEAP-IAP) catalog of samples and procedures, we determined the workload units (UCL) per pathologist and the overall UCL of the service, the average workload of the service (MU factor), the time dedicated by each pathologist to healthcare activity and the optimal number of pathologists according to the workload of the service. Results: We determined 12 197 total annual UCL for the chief pathologist, as well as 14 702 and 13 842 UCL for associate pathologists, with an overall of 40 742 UCL for the whole service. The calculated MU factor is 4.97. The chief pathologist devoted 72.25% of his working day to healthcare activity while associate pathologists dedicated 87.09% and 82.01% of their working hours. The optimal number of pathologists for the service is found to be 3.55. Conclusions: The results demonstrate medical work overload and a non-equitable distribution of UCLs among pathologists. We propose a computer algorithm capable of distributing the workload in an equitable manner. It would be associated with the laboratory information system and take into account the type of specimen, its complexity and the dedication of each pathologist to healthcare activity.(AU)

End-of-degree projects in radiology in Spanish universities.

The End-of-Degree Project (TFG) is a supervised research project that medical students must carry out before graduating. This study aims to make radiology teaching staff aware of the importance of getting involved in tutoring radiology TFGs. We provide recommendations to help encourage students choose our area and carry it out. We describe the TFG regulations for the subject of medicine as well as data on TFGs carried out both in medicine in general, and more specifically in radiology between 2018 and 2022. The total number of radiology TFGs was 181, accounting for 3.3% of the 5349 TFGs carried out in medicine. There was a discrepancy between the results found on the websites, those expected according to the number of graduates and those provided by the teachers contacted. We would consider reasonable a percentage of TFGs in radiology proportional to the number of credits of this subject during the degree course and the number of lecturers in this subject.

Intensity of Interprofessional Collaboration and related factors in Intensive Care Units. A descriptive cross-sectional study with an analytical approach.

OBJECTIVE: To determine the Intensity of Collaboration between the intensive care professionals of a third level hospital. METHOD: Descriptive cross-sectional study with an analytical approach. SETTING: 6 intensive care units of a third level hospital. SAMPLE: nurses and doctors. Consecutive type non-probabilistic sampling. DATA COLLECTION: sociodemographic, economic, motivation and professional satisfaction variables, and the intensity of collaboration using the "Scale of Intensity of Interprofessional Collaboration in Health." RESULTS: A total of 102 health professionals (91 nurses and 11 doctors) were included. The mean overall Intensity of Collaboration (IoC) was moderate. Men showed higher scores in all factors (p<.05). The IoC global score was higher in the group of professionals with ≤10 years of experience (p=.043) and those who were highly satisfied with the profession (p=.037). Physicians presented higher scores in the global IdC (p=.037) and in the Collaboration mean (p=.020) independently in the multivariate models. A negative linear relationship (rho: -0,202, p=.042) was observed between age and the overall IoC score. Professionals aged ≤30years reported a higher perception of Shared Activities (p=.031). Negative linear relationships were observed between years of experience and total IoC score (rho: -0,202, p=.042) and patients' Perception score (rho: -0.241, p=0.015). The research activity also showed to be a variable related to a greater degree of Collaboration at a global level and in some of the factors (p<.05). The scale of IoC obtained a Cronbach's α of 0,9. CONCLUSIONS: The intensity of interprofessional collaboration in ICUs is moderate. Professionals with experience of ≤10 years, a higher level of satisfaction and participation in research activities show a greater intensity of collaboration. Doctors perceive collaboration more intensely than nurses. All factors contribute equally to the internal consistency of the questionnaire.

O Trabalho por Turnos e a Qualidade do Sono de Enfermeiros de um Serviço de Urgência / Shift Work and Sleep Quality Emergency Service Nurses / Trabajo por Turnos y Calidad del Sueño de las Enfermeras el Servicio de Emergencia

Resumo Introdução: O sono é uma das necessidades primordiais do ser humano, cujo papel fundamental é relaxar e restabelecer o organismo para um novo ciclo. A privação de sono e o trabalho por turnos podem agravar as condições de saúde física e mental dos enfermeiros que trabalham por turnos. Objetivo: Analisar a qualidade do sono de enfermeiros de um serviço de urgência de um hospital da região norte de Portugal e a sua relação com o trabalho por turnos. Metodologia: Estudo descritivo-correlacional, transversal e quantitativo. Aplicou-se o Índice de Qualidade de Sono de Pittsburgh, amostra constituída por 60 enfermeiros. Tratamento de dados foi elaborado com recurso à estatística descritiva e inferencial. Resultados: A maioria dos participantes foram enfermeiras (68,3%), idade entre 31 e 40 anos (61,7%). Verificámos, quer os enfermeiros do sexo feminino quer os com a categoria profissional de enfermeiros de cuidados gerais percecionaram uma má qualidade de sono. Os participantes com horário fixo, que trabalham em turnos noturnos e que têm até dois turnos noturnos por semana apresentaram uma qualidade de sono mais baixa, (80%) dos enfermeiros evidenciaram dificuldade em adormecer e percecionaram má qualidade de sono. Conclusão: É necessário intervir a nível individual e organizacional, para adoção de medidas que visem melhorar a qualidade de sono de enfermeiros que trabalham por turnos. Importa sensibilizar a adoção de estratégias de higiene do sono, promovendo hábitos de vida saudáveis, tendo em vista melhorar a qualidade do sono dos enfermeiros, o que se traduzirá numa melhoria dos cuidados saúde prestados.

Abstract Introduction: Sleep is one of the primordial needs of human beings, and plays a fundamental role in relaxing and reestablishing the body for a new cycle. Sleep deprivation and shift work can have negative consequences for the physical and mental health of nurses working shifts. Objective: To analyze the sleep quality of nurses in an emergency department at a hospital in the north of Portugal and its relationship with shift work. Methodology: Descriptive-correlational, cross-sectional and quantitative study. The Pittsburgh Sleep Quality Index was applied to a sample of 60 nurses. Data processing was performed using descriptive and inferential statistics. Results: The majority of participants were nurses (68.3%), aged between 31 and 40 years old (61.7%). We found that both female nurses and those with the professional category of general care nurses perceived poor sleep quality. Participants with a fixed schedule, who work night shifts and who work up to two-night shifts per week had a lower quality of sleep, (80%) of nurses had difficulty falling asleep and perceived poor quality of sleep. Conclusion: It is necessary to intervene at an individual and organizational level to promote the adoption of measures to improve the quality of sleep of nurses who work shifts. It is important to raise awareness about the adoption of sleep hygiene strategies, promoting healthy lifestyle habits, with the aim of improving the quality of sleep of nurses, which will translate into an improvement in the health care provided.

Resumen Introducción: El sueño es una de las necesidades primordiales del ser humano, cuyo papel fundamental es relajar y restablecer el organismo para un nuevo ciclo. La falta de sueño y el trabajo por turnos pueden empeorar las condiciones de salud física y mental de las enfermeras que trabajan por turnos. Objetivo: Analizar la calidad del sueño de las enfermeras que trabajan en urgencias de un hospital del norte de Portugal y su relación con el trabajo por turnos. Metodología: Estudio descriptivo-correlacional, transversal y cuantitativo. Se aplicó el Índice de Calidad del Sueño de Pittsburgh, muestra compuesta por 60 enfermeras. El tratamiento de los datos se elaboró mediante estadística descriptiva e inferencial. Resultados: La mayoría de los participantes eran enfermeras (68,3%), con edades entre los 31 y 40 años (61,7%). Observamos que tanto las enfermeras como las que tienen la categoría profesional de enfermeras de cuidados generales perciben uma mala calidad del sueño. Los participantes con horario fijo, que trabajan en turnos nocturnos y que tienen hasta dos turnos nocturnos por semana tuvieron una menor calidad de sueño, (80%) dos enfermeras tuvieron dificultad para conciliar el sueño y percibieron mala calidad del sueño. Conclusión: Es necesario intervenir a nivel individual y organizacional de forma a adoptar medidas que mejoren la calidad del sueño de los enfermeros que trabajan por turnos. Del mismo modo es importante generar conciencia sobre la adopción de estrategias de higiene del sueño, para que se puedan promover hábitos de vida saludables, y así mejorar la calidad del sueño de las enfermeras, lo que se traducirá en una mejora de la atención médica brindada.

O mar que habita em mim: estratégias de comunicação sobre o trabalho da pesca artesanal de mulheres das águas / The sea that lives in me: communication strategies about the artisanal fishing work of women from the Waters / El mar que habita en mí: estrategias de comunicación sobre el trabajo pesquero artesanal de las mujeres de las aguas

As pescadoras artesanais do litoral de Pernambuco enfrentam os impactos das indústrias, do derramamento de petróleo e da pandemia de covid-19, conformando uma sindemia que agrava as vulnerabilidades socioe-conômicas, ambientais e sanitárias. Objetivou-se demonstrar que estratégias de comunicação e divulgação científica, como a cartilha "Saúde das mulheres das águas" e o documentário O mar que habita em mim, são importantes por promoverem a democratização do conhecimento. Trata-se de pesquisa-ação do tipo etnográfica para identificar aspectos do trabalho e da vida. Participaram 34 pescadoras, mediante grupos focais, oficina de fluxograma laboral, vivência do trabalho da pesca, análise e produção de estratégias. Esses materiais demonstram a relação saúde doença no trabalho da pesca enfatizando narrativas sobre deter-minação social da saúde. As estratégias comunicativas provocaram interesse da sociedade, promoveram debate e contribuíram para a consciência de profissionais/gestores de saúde sobre os povos das águas e as situações nos territórios.

Artisanal fisherwomen of Pernambuco face the impacts of the industries, of an oil spill and of the covid-19 pandemic, forming a syndemic that aggravates socioeconomic, environmental and health vulnerabilities. The objective was to demonstrate that scientific communication and dissemination strategies, such as the booklet "Saúde das mulheres das águas" and the documentary O mar que habita em mim, promote knowledge. This is an ethnographic type of action research to identify aspects of work and life. A total of 34 artisanal fisherwomen participated, in focus groups, labor flowchart workshop, experience of fishing work, analysis and production of strategies. These materials demonstrate the health disease relationship in fishing work, emphasizing the narratives of the fisherwomen about the social determination of their health. The communicative strategies provoked society's interests, promoted the debate and contributed to the awareness of professionals and health managers about the health of water's people and situations in the territories.

Pescadoras artesanales de pernambucano enfrentan impactos de industrias, derrame de petróleo y la pandemia de covid-19, formando una sindemia que agrava vulnerabilidades socioeconómicas, ambientales y de salud. El objetivo fue demostrar que las estrategias de comunicación y divulgación científica, como el folleto "'Salud das mujeres das aguas" y el documentario El mar que habita en mí, democratizan el conocimiento. Tiene abordaje de investigación-acción, etnográfica, para identificar aspectos del trabajo y la vida. Participaron 34 pescadoras en grupos focales, taller del flujo de trabajo, vivencia del trabajo en la pesca, análisis y elaboración de estrategias. Estos materiales demuestran la relación salud enfermedad en el trabajo pesquero, enfatizando narrativas sobre la determinación social de la salud. Las estrategias comu-nicativas despertaron el interés de la sociedad, promovieron el debate y contribuyeron a la sensibilización de los profesionales/gestores de la salud sobre los pueblos de las aguas y las situaciones de los territorios.

Reconfiguração identitária do enfermeiro na prática da saúde mental / Nurse identity reconfiguration in mental health practiceReconfiguración de la identidad del enfermero en la práctica de la salud mental / Reconfiguración de la identidad del enfermero en la práctica de la salud mental

Objetivo: Analisar as práticas de enfermeiros e suas implicações na (re)construção de sua identidade no contexto da saúde mental. Métodos: Trata-se de um estudo de caso, de abordagem qualitativa, alicerçado no referencial teórico de Claude Dubar. Participaram sete enfermeiros que atuam em Centros de Atenção Psicossocial de uma cidade do norte de Minas Gerais, Brasil. Os dados foram analisados à luz do referencial teórico sobre identidade de Claude Dubar, e por meio da Análise de Conteúdo. Resultados: Os dados foram analisados e discutidos por meio das categorias "As práticas do enfermeiro no contexto da saúde mental" e "Competências profissionais do enfermeiro em saúde mental e Identidade Real". Conclusão: O estudo sinaliza a reconfiguração identitária do enfermeiro no campo da saúde mental expressa pelas práticas, competências profissionais e identidade real construída na percepção de si como agente terapêutico.

Objective: To analyze the practices of nurses and their implications in the (re)construction of their identity in the context of mental health. Methods: This is a case study with a qualitative approach, based on the theoretical framework of Claude Dubar. Participants included seven nurses who work in Mental Health Services in a northern city of Minas Gerais, Brazil. The data were analyzed in the light of Claude Dubar's theoretical framework on identity and with Content Analysis. Results:The data were analyzed and discussed using the categories: "Nurses' practices in the context of mental health" and "Nurses' professional competencies in mental health and Real Identity." Conclusion: The study shows the nurses' identity reconfiguration in the field of mental health expressed by the practices, professional competencies, and real identity constructed in their perception of themselves as therapeutic agents.

Objetivo: Analizar las prácticas de la enfermería y sus implicaciones en la (re)construcción de su identidad en el contexto de la salud mental. Métodos: Se trata de un estudio de caso, con enfoque cualitativo, basado en el marco teórico de Claude Dubar. Siete enfermeros que actúan en Centros de Atención Psicosocial en una ciudad del norte de Minas Gerais, Brasil, participaron en el estudio. Los datos fueron analizados a la luz de la identidad del marco teórico de Claude Dubar y del análisis de contenido. Resultados:Los datos se analizaron y discutieron desde las siguientes categorías: "Las prácticas de enfermería en el contexto de la salud mental"; y "Competencias profesionales de las enfermeras en salud mental e identidad real". Conclusión: Este estudio destaca la reconfiguración de la identidad de los enfermeros en el campo de la salud mental que se manifiesta desde prácticas, competencias profesionales e identidad real construida en la percepción de sí mismos como agente terapéutico.

Análisis psicométrico de la escala de evaluación de la percepción del teletrabajo femenino durante situaciones de confinamiento familiar: el caso del COVID-19 / Psychometric analysis of the female teleworking perception scale during situations of family confinement: the case of COVID-19 / Análise psicométrico e validade da escala de percepção do teletrabalho feminino em situações de confinamento familiar: o caso da COVID-19

El estudio examina las características psicométricas de una escala que mide la percepción sobre el teletrabajo femenino en la población chilena en situación de confinamiento familiar, construida durante la pandemia por COVID-19. El cuestionario explora la interacción entre los ámbitos del trabajo y la familia, centrándose específicamente en la salud mental, las actitudes hacia el teletrabajo femenino, las dinámicas familiares relacionadas con el teletrabajo femenino y las dinámicas laborales en el contexto del teletrabajo femenino durante la pandemia. Los resultados indican una fuerte coherencia interna tanto para la escala global como para sus cuatro dimensiones diferenciadas: Salud Mental, ámbito laboral, teletrabajo femenino y ámbito familiar. El análisis factorial exploratorio (AFE) revela índices de ajuste favorables gl = 17; p<0.183; x 2 /gl = 22.211; CFI = 0.995; NNFI = 0.983; RMSEA = 0.052 para los 12 ítems en las cuatro dimensiones, alineándose bien con la estructura teórica respaldando los fundamentos del constructo balance trabajo/familia.

The study examines the psychometric characteristics of a scale that measures the perception of female teleworking in the Chilean population in a situation of family confinement, built during the COVID-19 pandemic. The questionnaire explores the interaction between the spheres of work and family, specifically focusing on mental health, attitudes towards female teleworking, family dynamics related to female teleworking, and work dynamics in the context of female teleworking during the pandemic. The results indicate strong internal coherence both for the global scale and for its four differentiated dimensions: Mental Health, work environment, female teleworking and family environment. The exploratory factor analysis (EFA) reveals favorable adjustment indices df = 17; p<0.183; χ 2 /df = 22.211; CFI = 0.995; NNFI = 0.983; RMSEA = 0.052 for the 12 items in the four dimensions, aligning well with the theoretical structure supporting the foundations of the work/family balance construct.

O estudo examina as características psicométricas de uma escala que mede as percepções do teletrabalho feminino na população chilena em confinamento familiar, construída durante a pandemia da COVID-19. O questionário explora a interação entre os domínios do trabalho e da família, concentrando-se especificamente na saúde mental, nas atitudes em relação ao teletrabalho feminino, na dinâmica familiar relacionada ao teletrabalho feminino e na dinâmica do trabalho no contexto do teletrabalho feminino durante a pandemia. Os resultados indicam uma forte consistência interna tanto para a escala geral quanto para suas quatro dimensões distintas: saúde mental, ambiente de trabalho, teletrabalho feminino e ambiente familiar. A análise fatorial exploratória (AFE) revela índices de ajuste favoráveis gl = 17; p<0,183; χ 2 /gl = 22,211; CFI = 0,995; NNFI = 0,983; RMSEA = 0,052 para os 12 itens nas quatro dimensões, alinhando-se bem com a estrutura teórica que sustenta os fundamentos do conceito de equilíbrio entre trabalho e família.

Patient safety, what does clinical simulation and teaching innovation contribute?

Clinical simulation in Intensive Care Medicine is a crucial tool to strengthen patient safety. It focuses on the complexity of the Intensive Care Unit, where challenging clinical situations require rapid decision making and the use of invasive techniques that can increase the risk of errors and compromise safety. Clinical simulation, by mimicking clinical contexts, is presented as essential for developing technical and non-technical skills and enhancing teamwork in a safe environment, without harm to the patient. in situ simulation is a valuable approach to practice in realistic environments and to address latent security threats. Other simulation methods as virtual reality and tele-simulation are gaining more and more acceptance. Herein, we provide current data on the clinical utility of clinical simulation related to improved safety in the practice of techniques and procedures, as well as improvements of teamwork performance and outcomes. Finally, we propose the needs for future research.

[Sistematic review on the influence of leadership style on job satisfaction of health professionals]. / Revisión sistemática sobre la influencia del estilo de liderazgo en la satisfacción laboral de los profesionales de la salud.

INTRODUCTION AND OBJECTIVES: Healthcare organisations are highly complex entities that live with a high risk of instability. In order to minimise this instability, interactions and personal relationships play a major role and accordingly the figure of the leader gains full significance. The leadership style used can produce different reactions and lead to multiple outcomes, including job satisfaction. The aim of the present review is to correlate leadership style with job satisfaction in healthcare professionals. MATERIAL AND METHODS: A systematic review was carried out in BVS, Cochrane plus, CINAHL, ApaPsycinfo and Pubmed, selecting publications that mentioned leadership styles and job satisfaction in healthcare professionals. Publications search strategy were limited for the 5-10last years, full text availability and language of writing: English, French and Spanish. Review-type publications were excluded. Of the 1566 initial titles, 15 were selected for analysis. RESULTS AND CONCLUSIONS: The transformational style showed the highest number of positive correlations, followed by the authentic and transactional styles. On the other hand, the passive and laissez-faire styles showed a negative correlation regardless of the professional category to which they belonged. The results of this study provide a starting point for adopting effective leadership styles to optimise the recruitment and training processes of staff in management and coordination roles.