Drivers of international variation in prevalence of disabling low back pain: Findings from the Cultural and Psychosocial Influences on Disability study.

BACKGROUND: Wide international variation in the prevalence of disabling low back pain (LBP) among working populations is not explained by known risk factors. It would be useful to know whether the drivers of this variation are specific to the spine or factors that predispose to musculoskeletal pain more generally. METHODS: Baseline information about musculoskeletal pain and risk factors was elicited from 11 710 participants aged 20-59 years, who were sampled from 45 occupational groups in 18 countries. Wider propensity to pain was characterized by the number of anatomical sites outside the low back that had been painful in the 12 months before baseline ('pain propensity index'). After a mean interval of 14 months, 9055 participants (77.3%) provided follow-up data on disabling LBP in the past month. Baseline risk factors for disabling LBP at follow-up were assessed by random intercept Poisson regression. RESULTS: After allowance for other known and suspected risk factors, pain propensity showed the strongest association with disabling LBP (prevalence rate ratios up to 2.6, 95% CI: 2.2-3.1; population attributable fraction 39.8%). Across the 45 occupational groups, the prevalence of disabling LBP varied sevenfold (much more than within-country differences between nurses and office workers), and correlated with mean pain propensity index (r = 0.58). CONCLUSIONS: Within our study, major international variation in the prevalence of disabling LBP appeared to be driven largely by factors predisposing to musculoskeletal pain at multiple anatomical sites rather than by risk factors specific to the spine. SIGNIFICANCE: Our findings indicate that differences in general propensity to musculoskeletal pain are a major driver of large international variation in the prevalence of disabling low back pain among people of working age.

[Teaching staff, student, and performance evaluation in nursing administration at nursing schools in Brazil]. / Avaliação de desempenho docente, discente e de resultados na disciplina administração em enfermagem nas escolas de enfermagem no Brasil.

The objective of this study was to analyze the theoretical references related to the performance evaluation process, establishing their correlation to different pedagogical lines. These references constitute the foundation for the analysis of data being collected and studied. This study is part of a broader project, currently in progress, whose objective is to determine how to evaluate teachers, students and achievement in courses dealing with content related to Nursing Administration at the graduate and undergraduate levels in Brazil. We hope to be contributing to a clearer and better understanding of this concrete reality, and of the performance evaluation process in light of the changes in the teaching of such courses.

[Nursing research projects in CNPQ (National Council for Scientific and Technologic Development): their trajectory, themes and adherences--1998/2000]. / Os projetos de pesquisa de enfermagem no CNPq: seu percurso, suas temáticas, suas aderências--1998/2000.

The present study analyses the themes proposed by research projects in nursing. It focuses on the projects that were sent to a Brazilian governmental research fomentation agency--CNPq--in the period of time between November 1998 and November 2000. The objective of this work is to identify the recurrent themes proposed in nursing research projects, and discuss its adherence to lines of research under study by nursing professionals which have the support of CAPES. It also relates these themes to the priorities of research established by CNPq. In order to achieve the objectives mentioned, an exploratory and descriptive study was carried out. The primary sources were evaluation grids of research projects. The secondary sources were studies, written and statistics reports from CNPq. Results show that most of the scholarships awarded by CNPq are in the southeast region of Brazil, where a larger number of researchers and post-graduation programs are concentrated. It also reveals that there is a diversity of themes being explored and that there is a relation between the themes and the parameters adopted for the studies.

[Use of individual protection equipment among nursing workers injured by puncture-cutting tools]. / O uso dos equipamentos de proteção individual entre os trabalhadores de enfermagem acidentados com instrumentos perfurocortantes.

The present study analyzed work related accidents involving nursing personnel from a public hospital in the state of São Paulo. The study population comprised the entire nursing staff. The results obtained showed a high incidence of accidents with puncture-cutting instruments, particularly among the auxilliary nursing staff, which indicates that these workers don't often use individual protection equipment, even when it is made available at the work place. Due to the manipulation of sharp instruments, nursing personnel are especially vulnerable to suffer biological risks and serious diseases. These results indicate the need to prevent the occurrence of such accidents.