Changes in the diagnosis of depression among nursing professionals during the COVID-19 pandemic: A longitudinal study.

AIMS: To identify changes in mental health status among nursing professionals in a Brazilian municipality during the COVID-19 pandemic. DESIGN: An observational and longitudinal study. METHODS: Using the Patient Health Questionnaire-9, the presence of depressive symptoms was evaluated among 690 nursing professionals in the city of Pelotas, Brazil, at two moments: June/July 2020 and June/July 2021. RESULTS: 13.0% incidence of depressive symptoms was identified; as well as 12.2% remission; 24.1% persistence and 50.7% absence. Among the factors associated with the worst prognoses we can mention female gender, greater workload, feeling of overload, illness of family members or friends due to COVID-19 and use of psychotropic drugs CONCLUSIONS: There was significant mobility in the diagnosis of depression among the professionals studied during the period analysed, with incidence of new cases of significant depression and greater than the number of remissions. In addition to sociodemographic aspects, traumatic experiences and exposure to continuous overload were associated with persistence and incidence of new cases. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: With the advent of the COVID-19 pandemic, several studies have shown an increase in depressive symptoms among nursing professionals; however, understanding the long-term effects of this scenario is still a challenge. IMPACT: What problem did the study address? This study investigates changes in the mental health status of nursing professionals working at different care levels, taking the prevalence of screening for depression as a proxy, during a period of a year during the COVID-19 pandemic. What were the main findings? Between both data collection moments, 2020 e 2021, there was a significant percentage of professionals with persistent depression, in addition to a significant proportion of incident cases that slightly exceeded the number of remissions and the factors associated with the worst prognoses were sociodemographic aspects such as gender and emotional stressors like illness of family members or close friends due to COVID-19, in addition to those related to the organisation and support provided by the services, such as workload and feeling of overload. Where and on whom will the research have an impact? This study will impact the nursing professionals and in role of the health services in order to establishing actions that contribute to minimising the deleterious effects of the pandemic on the mental health of their Nursing teams. REPORTING METHOD: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Cross-cultural adaptation of the Recovery Self-Assessment RSA-R Family/Brazil: Validity evidence based on test content. / Adaptação transcultural do Recovery Self-Assessment RSA-R família/Brasil: evidências de validade baseada no conteúdo.

In the cross-cultural adaptation of instruments, the qualitative component of adaptation is generally poorly reported, sometimes being superficially addressed. In this study we aimed to describe the qualitative component of the cross-cultural adaptation process and to demonstrate validity evidence based on test content of the Recovery Self-Assessment-RSA-R Family/Brazil. We conducted a qualitative study that included the steps of preparation, translation, back-translation, expert's assessment, workshop with a researcher from Yale University, and two pilot studies involving family members of patients attended at mental health services. Among the results, we found considerable validity evidence based on test content with a percentage of agreement above 80%. Pilot studies contributed to accentuating this evidence, assisting in the cultural adequacy of the statements and in the operational equivalence of the instrument. The adaptation process of the RSA-R Family/Brazil proved to be complex. From this experience, we concluded that presenting validity evidence based on test content is important to ensure the applicability tools to the target culture. The instrument will still be evaluated as for psychometric characteristics through statistical techniques.

Na adaptação transcultural de instrumentos o componente qualitativo da adaptação é geralmente pouco relatado, às vezes tratado de maneira superficial. Este estudo objetivou descrever o componente qualitativo do processo de adaptação transcultural e demonstrar evidências de validade baseadas no conteúdo do Recovery Self Assessment-RSA-R família/Brasil. Foi realizado um estudo qualitativo que incluiu as fases de preparação, tradução, retrotradução, avaliação por especialistas, workshop com pesquisadora da Universidade de Yale e dois estudos pilotos com familiares de usuários atendidos nos serviços de saúde mental. Dentre os resultados encontrou-se boa evidência de validade baseada no conteúdo com uma porcentagem de concordância acima de 80% entre especialistas. Os estudos pilotos contribuíram para acentuar essa evidência, na adequação das frases e na equivalência operacional do instrumento. O processo da adaptação do RSA-R família/Brasil demonstrou-se complexo, sendo que, a partir dessa experiência, conclui-se que apresentar evidência de validade baseadas no conteúdo é essencial para garantir aplicabilidade dos instrumentos à cultura alvo. O instrumento ainda será avaliado quanto às características psicométricas por meio de técnicas estatísticas.

Knowledge and compliance as factors associated with needlestick injuries contaminated with biological material: Brazil and Colombia. / Conhecimento e adesão como fatores associados a acidentes com agulhas contaminadas com material biológico: Brasil e Colômbia.

This was a cross-sectional study to start a cohort in two University Hospitals of two countries - Brazil and Colombia - for assessing the prevalence of needlestick and sharps injuries (NSI), the level of compliance with standard precautions (SPs), and knowledge on blood borne pathogens and associated factors among health students and professionals, within the framework of the implementation of the NR-32 standard. We created compliance scales based on 12 and 10 questions, for assessing knowledge. We used the Multinomial Poisson-Tweedie Regression to evaluate the relationship between knowledge and compliance with SPs within NSI. We evaluated 965 individuals (348 students and 614 professionals). The mean score points for level of knowledge was 10.98, with a median of 11 (10; 12) and α-Cr of 0,625. Compliance with SP had a mean of 30.74 and median of 31 (28; 34), with a α-Cr coefficient of 0.745, associated with country, group (student) and risk perception. Among the factors associated with the report of NSI, we singled out knowledge and compliance, country of origin, and full vaccination scheme against the Hepatitis B virus. We concluded that the level of knowledge and compliance were adequate among participants, but better among Brazilian participants, and it was associated with NSI reporting.

Fizemos estudo transversal para iniciar coorte em dois Hospitais Universitários de dois países - Brasil e Colômbia - para avaliar a prevalência de acidentes com material biológico (AT-MB), o nível de adesão às Precauções Padrão (PP) e o conhecimento sobre patógenos transmissíveis pelo sangue e fatores associados entre trabalhadores e estudantes da saúde, no marco da implementação da norma NR-32. Criamos escalas para estimar conhecimento e adesão baseadas em 12 e 11 perguntas respectivamente. Utilizamos Regressão de Poisson-Tweedie para avaliar a associação do conhecimento e da adesão às PP com sofrer AT-MB. Avaliamos 965 indivíduos (348 estudantes e 617 profissionais). O conhecimento teve média de 10,98 com mediana de 11 (10, 12) e α-Cr de 0,625. A média de adesão foi de 30,74 com mediana de 31 (28, 34) e α-Cr de 0,745, associando-se a País, grupo (estudantes) e percepção de risco. Entre os fatores associadas ao relato de AT-MB encontraram-se o conhecimento, a adesão às PP, País de origem e ter tomado o esquema completo de vacinação contra Hepatites B. Concluímos que o nível de conhecimento e adesão foram adequados, ainda melhores entre os participantes do Brasil e associaram-se ao relato AT-MB.

Hicimos estudio transversal como punto de partida de estudio de cohorte en dos Hospitales Universitarios en dos países - Brasil y Colombia - para evaluar la prevalencia de accidentes con material biológico (AT-MB), el nivel de adhesión a las Precauciones Estándares (PUs) y el conocimiento sobre patógenos transmisibles y factores asociados entre trabajadores y estudiantes de la Salud en el marco de la implementación de la norma NR-32. Creamos escalas para evaluar el conocimiento y la adhesión con base en 12 e 11 preguntas respectivamente. Utilizamos Regresión de Poisson-Tweedie para evaluar asociación entre el conocimiento y la adhesión a las PUs con sufrir AT-MB. Evaluamos 965 individuos (348 estudiantes e 617 profesionales). El puntaje medio de conocimiento fue 10,98 con mediana de 11 (10, 12) y α-Cr de 0,625. La media de adhesión fue de 30,74 con mediana de 31 (28, 34) e α-Cr de 0,745, asociándose a país, grupo (estudiantes) e percepción de riesgo. Entre los factores asociados al relato de AT-MB encontramos conocimiento, adhesión a las PUs, país de origen y tener el esquema completo de vacunación contra Virus da Hepatitis B. Concluimos que el nivel de conocimiento y adhesión fueron adecuados, aunque mejores entre los participantes del Brasil y se asociaron a los AT-MB.

Conhecimento e adesão como fatores associados a acidentes com agulhas contaminadas com material biológico: Brasil e Colômbia / Knowledge and compliance as factors associated with needlestick injuries contaminated with biological material: Brazil and Colombia / Conocimiento y adhesión como factores asociados a los accidentes con agujas contaminadas con material biológico: Brasil y Colombia

Resumo Fizemos estudo transversal para iniciar coorte em dois Hospitais Universitários de dois países - Brasil e Colômbia - para avaliar a prevalência de acidentes com material biológico (AT-MB), o nível de adesão às Precauções Padrão (PP) e o conhecimento sobre patógenos transmissíveis pelo sangue e fatores associados entre trabalhadores e estudantes da saúde, no marco da implementação da norma NR-32. Criamos escalas para estimar conhecimento e adesão baseadas em 12 e 11 perguntas respectivamente. Utilizamos Regressão de Poisson-Tweedie para avaliar a associação do conhecimento e da adesão às PP com sofrer AT-MB. Avaliamos 965 indivíduos (348 estudantes e 617 profissionais). O conhecimento teve média de 10,98 com mediana de 11 (10, 12) e α-Cr de 0,625. A média de adesão foi de 30,74 com mediana de 31 (28, 34) e α-Cr de 0,745, associando-se a País, grupo (estudantes) e percepção de risco. Entre os fatores associadas ao relato de AT-MB encontraram-se o conhecimento, a adesão às PP, País de origem e ter tomado o esquema completo de vacinação contra Hepatites B. Concluímos que o nível de conhecimento e adesão foram adequados, ainda melhores entre os participantes do Brasil e associaram-se ao relato AT-MB.

Abstract This was a cross-sectional study to start a cohort in two University Hospitals of two countries - Brazil and Colombia - for assessing the prevalence of needlestick and sharps injuries (NSI), the level of compliance with standard precautions (SPs), and knowledge on blood borne pathogens and associated factors among health students and professionals, within the framework of the implementation of the NR-32 standard. We created compliance scales based on 12 and 10 questions, for assessing knowledge. We used the Multinomial Poisson-Tweedie Regression to evaluate the relationship between knowledge and compliance with SPs within NSI. We evaluated 965 individuals (348 students and 614 professionals). The mean score points for level of knowledge was 10.98, with a median of 11 (10; 12) and α-Cr of 0,625. Compliance with SP had a mean of 30.74 and median of 31 (28; 34), with a α-Cr coefficient of 0.745, associated with country, group (student) and risk perception. Among the factors associated with the report of NSI, we singled out knowledge and compliance, country of origin, and full vaccination scheme against the Hepatitis B virus. We concluded that the level of knowledge and compliance were adequate among participants, but better among Brazilian participants, and it was associated with NSI reporting.

Resumen Hicimos estudio transversal como punto de partida de estudio de cohorte en dos Hospitales Universitarios en dos países - Brasil y Colombia - para evaluar la prevalencia de accidentes con material biológico (AT-MB), el nivel de adhesión a las Precauciones Estándares (PUs) y el conocimiento sobre patógenos transmisibles y factores asociados entre trabajadores y estudiantes de la Salud en el marco de la implementación de la norma NR-32. Creamos escalas para evaluar el conocimiento y la adhesión con base en 12 e 11 preguntas respectivamente. Utilizamos Regresión de Poisson-Tweedie para evaluar asociación entre el conocimiento y la adhesión a las PUs con sufrir AT-MB. Evaluamos 965 individuos (348 estudiantes e 617 profesionales). El puntaje medio de conocimiento fue 10,98 con mediana de 11 (10, 12) y α-Cr de 0,625. La media de adhesión fue de 30,74 con mediana de 31 (28, 34) e α-Cr de 0,745, asociándose a país, grupo (estudiantes) e percepción de riesgo. Entre los factores asociados al relato de AT-MB encontramos conocimiento, adhesión a las PUs, país de origen y tener el esquema completo de vacunación contra Virus da Hepatitis B. Concluimos que el nivel de conocimiento y adhesión fueron adecuados, aunque mejores entre los participantes del Brasil y se asociaron a los AT-MB.

Survival of patients with AIDS and association with level of education level and race/skin color in South and Southeast Brazil: a cohort study, 1998-1999. / Sobrevida de pacientes com aids e associação com escolaridade e raça/cor da pele no Sul e Sudeste do Brasil: estudo de coorte, 1998-1999.

OBJECTIVE: to analyze the survival of people with AIDS and association with schooling and race/skin color. METHODS: this was a retrospective cohort study of people diagnosed with AIDS between 1998 and 1999, in the South and Southeast regions of Brazil. We used survival analysis (Kaplan-Meier method), stratified by schooling and race/skin color and multivariate analysis was performed using Cox regression. RESULTS: the study included 2,091 people who had survived at 60 months, with 65% survival among White participants and 62% among Black/brown participants. Irregular use of antiretroviral (HR=11.2 - 95%CI8.8;14.2), and age ≥60 years (HR=2.5 - 95%CI1.4;4.4) were related to lower survival; schooling >8 years (HR=0.4 - 95%CI0.3;0.6) and being female (HR=0.6 - 95%CI0.5;0.8) were positively related to survival; those with less schooling had lower survival. CONCLUSION: lower schooling levels overlap race/skin color differences in relation to survival; these inequalities explain the differences found, despite the policies on universal access to antiretroviral.

Sobrevida de pacientes com aids e associação com escolaridade e raça/cor da pele no Sul e Sudeste do Brasil: estudo de coorte, 1998-1999 / Sobrevida de pacientes con sida y asociación con escolaridad y raza/color de la piel en el Sur y Sudeste de Brasil: estudio de cohorte de 1998-1999 / Survival of patients with AIDS and association with level of education level and race/skin color in South and Southeast Brazil: a cohort study, 1998-1999

Objetivo: analisar a sobrevida de pessoas com aids e sua associação com escolaridade e raça/cor da pele. Métodos: coorte de diagnosticados entre 1998 e 1999, nas regiões Sul e Sudeste do Brasil, com análise de sobrevida (método de Kaplan--Meier), estratificada por escolaridade e raça/cor da pele; a análise multivariada foi realizada mediante regressão de Cox. Resultados: foram incluídas 2.091 pessoas com sobrevida em 60 meses, a percentuais de 65% entre brancos e 62% entre pretos/pardos; o uso irregular de antirretrovirais (HR=11,2 - IC95%8,8;14,2) e a idade ≥60 anos (HR=2,5 - IC95%1,4;4,4) foram relacionados com menor sobrevida; escolaridade >8 anos (HR=0,4 - IC95%0,3;0,6) e sexo feminino (HR=0,6 - IC95%0,5;0,8) relacionaram-se positivamente com sobrevida; os menos escolarizados tiveram sobrevida menor. Conclusão: menor escolaridade sobrepôs-se às diferenças de raça/cor da pele, quando relacionada à sobrevida; tais desigualdades explicaram as diferenças observadas, mesmo com políticas de acesso universal aos antirretrovirais.

Objetivo: analizar la sobrevida de personas con sida y su asociación con escolaridad y raza/color de la piel. Métodos: cohorte de diagnosticados entre 1998 y 1999, en las regiones Sur y Sudeste de Brasil, con análisis de supervivencia (Kaplan-Meier), estratificados por educación y raza/color de la piel; el análisis multivariante se realizó con regresión de Cox. Resultados: fueron incluidas 2.091 personas con sobrevida de 60 meses, a porcentuales de 65% entre blancos y 62% entre negros/pardos; el uso irregular de antirretrovirales (HR=11,2 - IC95%8,8;14,2) y la edad ≥60 años (HR=2,5 - IC95%1,4;4,4) se relacionaron con una menor sobrevida; escolaridad >8 años (HR=0,4 - IC95%0,3;0,6) y sexo femenino (HR=0,6 - IC95%0,5;0,8) se relacionaron positivamente con sobrevida; los menos escolarizados tuvieron sobrevida menor. Conclusión: menor escolaridad se superpuso a las diferencias de raza/color de la piel referida, cuando relacionada a la supervivencia; tales desigualdades explicaron las diferencias observadas, aún con políticas de acceso universal a antirretrovirales.

Objective: to analyze the survival of people with AIDS and association with schooling and race/skin color. Methods: this was a retrospective cohort study of people diagnosed with AIDS between 1998 and 1999, in the South and Southeast regions of Brazil. We used survival analysis (Kaplan-Meier method), stratified by schooling and race/skin color and multivariate analysis was performed using Cox regression. Results: the study included 2,091 people who had survived at 60 months, with 65% survival among White participants and 62% among Black/brown participants. Irregular use of antiretroviral (HR=11.2 - 95%CI8.8;14.2), and age ≥60 years (HR=2.5 - 95%CI1.4;4.4) were related to lower survival; schooling >8 years (HR=0.4 - 95%CI0.3;0.6) and being female (HR=0.6 - 95%CI0.5;0.8) were positively related to survival; those with less schooling had lower survival. Conclusion: lower schooling levels overlap race/skin color differences in relation to survival; these inequalities explain the differences found, despite the policies on universal access to antiretroviral.

Nomeação e institucionalização da saúde do trabalhador: um campo em disputa / Naming and institutionalization of the health of the worker: a disputed field / Designación e institucionalización de la salud del trabajador: un campo en disputa

Resumo Considerando a dispersão de sentidos que constitui a nomeação da área 'Saúde do Trabalhador', buscou-se compreender o que está em jogo nas constantes mudanças da nomenclatura nesse campo. Essas alterações ocorrem em uma linha do tempo, mas concomitantemente. Seu marco inaugural foi encontrado na estabilidade do nome 'medicina do trabalho', nome institucionalizado pela Organização Internacional do Trabalho, no início da segunda metade do século XX. Desse primeiro gesto de nomeação, seguem outros, estabelecidos em relações tensas e contraditórias de substituição, recobrimento e concorrência como: saúde ocupacional, saúde e segurança no trabalho, e, mais contemporaneamente, em meio a estas variações, encontrou-se o acréscimo do termo 'Saúde do Trabalhador'. O penúltimo nome é o mais estável e acionado pelas instâncias internacionais e empresariais.

Abstract Based on the dispersal of meanings that constitutes the naming of the 'Health of the Worker' field, we sought to comprehend what is at stake in the constant changes in nomenclature in this field. These changes occur within a timeline, but they happen concomitantly. Its inaugural landmark was found in the stability of the name 'occupational medicine,' a name institutionalized by the International Labour Organization in the beginning of the second half of the 20th century. This first gesture of naming was followed by other gestures, established in tense and contradictory relationships of replacement, recovering and concurrence, such as: occupational health, health and safety at work, and, more recently, among these variations, we found the addition of the term 'Health of the Worker.' The second-to-last name is the most stable one, and it is used by international and entrepreneurial organizations.

Resumen Partiendo de la dispersión de sentidos que constituye la designación del área 'Salud del Trabajador', se buscó comprender lo que está en juego en los constantes cambios de la nomenclatura en este campo. Estos cambios se producen en una línea de tiempo, pero de forma concomitante. Su marco inaugural se encuentra en la estabilidad del nombre 'medicina del trabajo', institucionalizado por la Organización Internacional del Trabajo a comienzos de la segunda mitad del siglo XX. A este primer gesto de designación le siguen otros, establecidos en relaciones tensas y contradictorias de sustitución, enmascaramiento y competencia, tales como: salud ocupacional, salud y seguridad en el trabajo, y más recientemente, en medio de estas variaciones, se encontró el agregado del término 'Salud del Trabajador'. El penúltimo nombre es el más estable y utilizado por las instancias internacionales y empresariales.

Social support for patients undergoing liver transplantation in a Public University Hospital.

BACKGROUND: Several diseases may lead to the need for liver transplantation due to progressive organ damage until the onset of cirrhosis, resulting in changes in interpersonal relationships. Social Support for transplant candidates is an important variable, providing them with psychological and social well-being. This study aims to assess social support in chronic hepatic patients, waiting for liver transplantation. METHODS: A cross-sectional study was conducted with 119 patients, for convenience sampling, from the liver transplant waiting list at a Brazilian University Hospital Outpatients. The information was collected through semistructured questionnaires, in four stages: 1) socioeconomic and demographic information 2) clinical aspects 3) feelings 4) Social Support Network Inventory (SSNI), to Brazilian Portuguese. The statistical analysis was conducted using ANOVA and multivariate linear regression analysis to evaluate the relationship between the scales of social support and the collected co-variables. RESULTS: Average age was 50.2 ± 11.6, and 87 (73.1%) were men. Patients with alcohol and virus liver disease etiology had the same frequency of 28%. The MELD, without extrapoints, was 16.7 ± 4.9. Global social support family score was 3.72 ± 0.39, and Cronbach's alpha = 0.79. The multivariate analysis presented the following associations, age = [- 0.010 (95% CI = - 0.010 - -0.010); P = 0.001], etiology of hepatic disease = [- 0.212 (95% CI = - 0.37 - -0.05); P = 0.009], happiness = [- 0.214(95% CI = - 0.33 - -0.09) P = 0.001) and aggressiveness = [0.172 (95% CI = 0.040-0.030); P = 0.010). CONCLUSIONS: The social support was greater when the patients were younger (18 to 30 years). Patients with alcoholic cirrhosis, regardless of whether or not they were associated with virus, had less social support. As for feelings, the absence of happiness and the presence of aggressiveness showed a negative effect on social support.

[Demographic, socioeconomic, and health profile of working and non-working Brazilian children and adolescents: an analysis of inequalities]. / Perfil demográfico, socioeconômico e de saúde de crianças e adolescentes trabalhadores e não trabalhadores, Brasil: análise das desigualdades.

The objectives of this study were to describe the work done by Brazilian children and adolescents and compare the socioeconomic and health profile of those that worked (or were looking for work) versus non-working youngsters. Based on the 2008 Brazilian National Sample Household Survey (PNAD/2008), we selected children and adolescents 5 to 17 years of age, divided into two analytical categories: "workers" (working or looking for employment) and "non-workers". We calculated prevalence rates for the characteristics of their main work, as well as socioeconomic and health variables comparing the two categories. Poisson regression was used to estimate prevalence ratios, adjusted by health characteristics, with "non-workers" as the reference category. Compared to "non-workers", the "workers" category was associated with a higher proportion of boys; age 14 to 17 years; black or brown skin color; lower school attendance; and worse housing conditions. Child labor was associated with worse self-rated health; chronic backache; arthritis or rheumatism; and depression. Effective policies to support families need to be strengthened to effectively fight child labor.

Perfil demográfico, socioeconômico e de saúde de crianças e adolescentes trabalhadores e não trabalhadores, Brasil: análise das desigualdades / Demographic, socioeconomic, and health profile of working and non-working Brazilian children and adolescents: an analysis of inequalities / Perfil demográfico, socioeconómico y salud de los niños y adolescentes trabajadores y no trabajadores, Brasil: análisis de las desigualdades

Os objetivos do estudo foram descrever o trabalho de crianças e adolescentes brasileiros e comparar o perfil socioeconômico e de saúde dos que trabalhavam ou buscavam emprego com os não trabalhadores. A partir da Pesquisa Nacional por Amostra de Domicílios (PNAD/2008), selecionamos crianças e adolescentes de 5 a 17 anos divididos em duas categorias de análise: “trabalhadores” (trabalhavam ou buscavam emprego) e “não trabalhadores”. Calculamos prevalências das características do trabalho principal, bem como das variáveis socioeconômicas e de saúde entre as categorias de análise. Razões de prevalência ajustadas das características de saúde foram estimadas utilizando-se a regressão de Poisson, sendo “não trabalhadores” a categoria de referência. Comparados aos “não trabalhadores”, os “trabalhadores” tiveram maior proporção de meninos; idade entre 14 e 17 anos; pretos e pardos; menor frequência escolar e piores condições de moradia. O trabalho infantil esteve associado à pior saúde referida; doença de coluna ou costas; artrite ou reumatismo e depressão. Políticas eficazes de apoio às famílias devem ser fortalecidas para o efetivo combate ao trabalho infantil.

The objectives of this study were to describe the work done by Brazilian children and adolescents and compare the socioeconomic and health profile of those that worked (or were looking for work) versus non-working youngsters. Based on the 2008 Brazilian National Sample Household Survey (PNAD/2008), we selected children and adolescents 5 to 17 years of age, divided into two analytical categories: “workers” (working or looking for employment) and “non-workers”. We calculated prevalence rates for the characteristics of their main work, as well as socioeconomic and health variables comparing the two categories. Poisson regression was used to estimate prevalence ratios, adjusted by health characteristics, with “non-workers” as the reference category. Compared to “non-workers”, the “workers” category was associated with a higher proportion of boys; age 14 to 17 years; black or brown skin color; lower school attendance; and worse housing conditions. Child labor was associated with worse self-rated health; chronic backache; arthritis or rheumatism; and depression. Effective policies to support families need to be strengthened to effectively fight child labor.

Los objetivos del estudio fueron describir el trabajo de niños y adolescentes brasileños y analizar la situación socioeconómica y la salud de los niños que trabajan y que no trabajan. De la Encuesta Nacional por Muestra de Domicilios (PNAD/2008) seleccionamos niños y adolescentes de 5 a 17 años y los dividimos en dos categorías de análisis: “trabajadores” (trabajando o buscando trabajo) y “no-trabajadores”. Se calculó la prevalencia de las características del trabajo, así como las variables socioeconómicas y de salud en las categorías de análisis. Las razones de prevalencia ajustadas de las características de salud se estimaron mediante regresión de Poisson, los ‘no trabajadores eran categoría de referencia. En comparación con los “no trabajadores”, los “trabajadores” tenían mayor proporción de niños; 14 a 17 años; no caucásica; menor asistencia escolar y peores condiciones de vivienda. El trabajo infantil se asoció con una percepción de salud peor; enfermedades de columna o espalda; artritis o reumatismo y depresión. Las políticas eficaces de apoyo a las familias deben reforzarse para combatir eficazmente el trabajo infantil.

Evaluation of the level of knowledge and compliance with standart precautions and the safety standard (NR-32) amongst physicians from a public university hospital, Brazil / Avaliacao do nivel de conhecimento e adesao as precaucoes-padrao e da Norma Regulamentadora (NR-32) entre os medicos de um hospital publico universitario, Brasil

Brazil is the first country in the world to have broad coverage standard (NR-32) focused on protecting health workers exposed to biological risks. This study evaluated the degree of knowledge of the NR-32 Standard and the level of knowledge and compliance with the standard precautions. A cross-sectional study was conducted with 208 randomly selected health professionals; 93 of them were residents and 115 were physicians at a Brazilian Clinical Hospital. To collect information, the participants were interviewed and/or they completed semi-structured questionnaires divided into three domains: knowledge of the standard, knowledge of biosafety, and compliance with standard precautions. Cronbach's alpha was used to assess internal consistency of the scales of knowledge and compliance with values above +0.75 indicating excellent agreement. Multivariate linear regression was used to evaluate the predictors for compliance with NR-32, biosafety, and standard precautions. Mean knowledge of the NR-32 Standard was 2.2 (± 2.02) points (minimum 0 and maximum 7 points). The minimum expected mean was 5.25 points. The mean knowledge of biosafety was 12.31 (± 2.10) points (minimum 4 and maximum16 points). The minimum expected mean was 12.75 points. The mean compliance with standard precautions was 12.79 (± 2.6) points (minimum 6 and maximum 18 points). The minimum expected mean was 13.5 points. The individual means for using gloves, masks and goggles during procedures and for not recapping needles were 2.69, 2.27, 1.20 and 2.14, respectively. The factors associated with knowledge of the NR-32 were: greater knowledge amongst those who studied at a public university and who had knowledge of biosafety. The knowledge of the NR-32 Standard was low, but there was a good level of knowledge of biosafety issues. The compliance with standard precautions was acceptable in general, but was low for some of the evaluated precautions.

O Brasil é o primeiro país do mundo a ter uma norma de ampla abrangência (NR-32) que enfatiza a proteção dos trabalhadores de saúde expostos a riscos biológicos. Este estudo avaliou o grau de conhecimento da Norma NR-32, o nível de conhecimento e adesão às precauções padrão. Estudo transversal foi realizado com 208 profissionais selecionados aleatoriamente, sendo 93 médicos residentes e 115 médicos, em um Hospital Universitario brasileiro. As informações foram coletadas mediante entrevista e/ou preenchimento de questionário semiestruturado dividido em três domínios: conhecimentos da norma, conhecimentos em biossegurança e adesão às precauções padrão. Para avaliar a consistência interna das escalas de conhecimento e adesão, utilizou-se o alfa de Cronbach, considerando-se concordância excelente para valores maiores que +0,75. Regressão linear multivariada foi utilizada para avaliar os fatores preditores da adesão à NR-32, biossegurança e precauções padrão. A média de conhecimento sobre a Norma NR-32 foi 2,2 (± 2,02) pontos (mínimo 0 e máximo 7 pontos,). A média mínima esperada foi de 5,25 pontos. A média de conhecimento em biossegurança foi de 12,31 (± 2,10) (mínimo 4 e máximo 16 pontos). Foi esperada uma média mínima de 12,75 pontos. A média de adesão às precauções padrão foi de 12,79 (± 2,6) pontos (mínimo 6 e máximo 18). A média mínima esperada foi de 13,5 pontos. A média individual para o uso de luvas, máscara e óculos durante procedimentos e o não reecape de objetos perfurocortantes foi de 2,69, 2,27, 1,20 e 2,14, respectivamente. Os fatores associados ao conhecimento da NR-32 foram: maior conhecimento para quem estudou em universidade pública e quem tem conhecimento sobre biossegurança. O conhecimento da Norma NR-32 foi baixo, mas o nível de conhecimento em temas de biossegurança foi bom. A adesão às precauções-padrão em geral foi aceitável, mas foi baixa para algumas precauções avaliadas.

Evaluation of the level of knowledge and compliance with standart precautions and the safety standard (NR-32) amongst physicians from a public university hospital, Brazil.

Brazil is the first country in the world to have broad coverage standard (NR-32) focused on protecting health workers exposed to biological risks. This study evaluated the degree of knowledge of the NR-32 Standard and the level of knowledge and compliance with the standard precautions. A cross-sectional study was conducted with 208 randomly selected health professionals; 93 of them were residents and 115 were physicians at a Brazilian Clinical Hospital. To collect information, the participants were interviewed and/or they completed semi-structured questionnaires divided into three domains: knowledge of the standard, knowledge of biosafety, and compliance with standard precautions. Cronbach's alpha was used to assess internal consistency of the scales of knowledge and compliance with values above +0.75 indicating excellent agreement. Multivariate linear regression was used to evaluate the predictors for compliance with NR-32, biosafety, and standard precautions. Mean knowledge of the NR-32 Standard was 2.2 (± 2.02) points (minimum 0 and maximum 7 points). The minimum expected mean was 5.25 points. The mean knowledge of biosafety was 12.31 (± 2.10) points (minimum 4 and maximum 16 points). The minimum expected mean was 12.75 points. The mean compliance with standard precautions was 12.79 (± 2.6) points (minimum 6 and maximum 18 points). The minimum expected mean was 13.5 points. The individual means for using gloves, masks and goggles during procedures and for not recapping needles were 2.69, 2.27, 1.20 and 2.14, respectively. The factors associated with knowledge of the NR-32 were: greater knowledge amongst those who studied at a public university and who had knowledge of biosafety. The knowledge of the NR-32 Standard was low, but there was a good level of knowledge of biosafety issues. The compliance with standard precautions was acceptable in general, but was low for some of the evaluated precautions.