Supporting conservationists' mental health through better working conditions.

Biodiversity conservation work can be challenging but rewarding, and both aspects have potential consequences for conservationists' mental health. Yet, little is known about patterns of mental health among conservationists and its associated workplace protective and risk factors. A better understanding might help improve working conditions, supporting conservationists' job satisfaction, productivity, and engagement, while reducing costs from staff turnover, absenteeism, and presenteeism. We surveyed 2311 conservation professionals working in 122 countries through an internet survey shared via mailing lists, social media, and other channels. We asked them about experiences of psychological distress, working conditions, and personal characteristics. Over half were from and worked in Europe and North America, and most had a university-level education, were in desk-based academic and practitioner roles, and responded in English. Heavy workload, job demands, and organizational instability were linked to higher distress, but job stability and satisfaction with one's contributions to conservation were associated with lower distress. Respondents with low dispositional and conservation-specific optimism, poor physical health, and limited social support, women, and early-career professionals were most at risk of distress in our sample. Our results flag important risk factors that employers could consider, although further research is needed among groups underrepresented in our sample. Drawing on evidence-based occupational health interventions, we suggest measures that could promote better working conditions and thus may improve conservationists' mental health and abilities to protect nature.

Mejores condiciones de trabajo para apoyar la salud mental de los conservacionistas Resumen La conservación de la biodiversidad puede ser difícil pero gratificante y ambos aspectos pueden tener consecuencias en la salud mental de los conservacionistas. Sin embargo, sabemos poco sobre la salud mental de los conservacionistas, sus patrones y los factores de protección y riesgo asociados al lugar de trabajo. Un mayor conocimiento ayudaría a mejorar las condiciones de trabajo, pues impulsaría la satisfacción laboral, la productividad y el compromiso de los conservacionistas, mientras se reducen los costos derivados de la rotación de personal, el ausentismo y el presentismo. Encuestamos a 2,311 profesionales de la conservación de 122 países con una encuesta virtual compartida por listas de correo, redes sociales y otros medios. Les preguntamos a los profesionales sobre sus experiencias de estrés psicológico, condiciones de trabajo y características personales. Más de la mitad trabajaban y procedían de Europa y Norteamérica; la mayoría respondió en inglés, contaba con estudios universitarios y actualmente desempeña funciones académicas y profesionales. La carga de trabajo excesiva, las exigencias laborales y la inestabilidad organizacional se relacionaron con un mayor estrés, mientras la estabilidad laboral y la satisfacción con la contribución propia a la conservación se asociaron con un menor estrés. En nuestra muestra, los encuestados con baja disposición y un optimismo específico hacia la conservación, mala salud física, apoyo social limitado, las mujeres y los profesionales que inician su carrera son los que corren un mayor riesgo de sufrir estrés. Nuestros resultados señalan importantes factores de riesgo que los empresarios podrían considerar, aunque es necesario seguir investigando entre los grupos menos representados en nuestra muestra. Con base en las intervenciones de salud laboral respaldadas con pruebas, sugerimos medidas que podrían promover mejores condiciones de trabajo y, así mejorar la salud mental de los conservacionistas y su capacidad para proteger la naturaleza.

Balancing making a difference with making a living in the conservation sector.

Goals play important roles in people's lives because they focus attention, mobilize effort, and sustain motivation. Understanding conservationists' satisfaction with goal progress may provide insights into real-world environmental trends and flag risks to their well-being and motivation. We asked 2694 conservationists working globally how satisfied they were with progress toward goals important to them. We then explored how this satisfaction varied among groups, including demographic and occupational. Finally, we looked at respondents' experiences associated with goal-progress satisfaction. Many (94.0%) indicated that making a meaningful contribution to conservation was an important goal for them, and over half were satisfied or very satisfied in this area (52.5%). However, respondents were generally dissatisfied with progress on collective conservation goals (e.g., stopping species loss). Some groups were more likely to report dissatisfaction than others. For instance, those in conservation for longer tended to be less satisfied with collective goal progress (log odds -0.21, 95% credibility interval [CI] -0.32 to -0.10), but practitioners reported greater satisfaction (log odds 0.38, 95% CI 0.15-0.60). Likewise, those who were more optimistic in life (log odds 0.24, 95% CI 0.17-0.32), male (log odds 0.25, 95% CI 0.10-0.41), and working in conservation practice (log odds 0.25, 95% CI 0.08-0.43) reported greater satisfaction with individual goal progress. Free-text responses suggested widespread dissatisfaction with livelihood goals, particularly related to job security and adequate compensation. Although contributing to conservation appeared to be a source of satisfaction, slow goal progress in other areas--particularly around making a living--looked to be a source of distress and demotivation. Employers, funders, professional societies, and others should consider ways to help those in the sector make a difference while making a satisfactory living by, for example, prioritizing conservationists' well-being when allocating funding. This support could include avoiding exploitative practices, fostering supportive work environments, and celebrating positive outcomes.

El Balance entre Hacer una Diferencia y Ganarse la Vida en el Sector de la Conservación 21-323 Resumen Los objetivos juegan un papel importante en la vida de las personas porque enfocan la atención, movilizan esfuerzos y mantienen la motivación. El entendimiento de la satisfacción de los conservacionistas con el progreso de sus objetivos podría proporcionar información sobre las tendencias ambientales del mundo real y marcar los riesgos para su bienestar y motivaciones. Les preguntamos a 2694 conservacionistas trabajando alrededor del mundo cuán satisfechos están con el progreso hacia los objetivos que consideran más importantes. Después exploramos cómo esta satisfacción varió entre grupos, incluyendo grupos demográficos y laborales. Finalmente, observamos las experiencias de los respondientes asociadas con la satisfacción con el progreso de los objetivos. Muchos (94%) indicaron que contribuir significativamente a la conservación es un objetivo importante para ellos, y más de la mitad estuvieron satisfechos o muy satisfechos en este campo (52.5%). Sin embargo, los respondientes también mostraron una inconformidad generalizada con el progreso de los objetivos colectivos de conservación (p. ej.: detener la pérdida de especies). Algunos grupos tuvieron una mayor probabilidad de reportar inconformidades que otros grupos. Por ejemplo, aquellos con mayor tiempo en la conservación tendieron a estar menos satisfechos con el progreso de los objetivos colectivos (probabilidad log -0.21, 95% intervalo de credibilidad [IC] -0.32 a -0.10), pero los practicantes reportaron una mayor satisfacción (probabilidad log 0.38, 95% IC 0.15-0.60). De igual manera, quienes cuentan con mayor optimismo cotidiano (probabilidad log 0.24, 95% IC 0.17-0.32), son de sexo masculino (probabilidad log 0.25, 95% IC 0.10-0.41) y trabajan en la práctica de la conservación (probabilidad log 0.25, 95% IC 0.08-0.43) reportaron una mayor satisfacción con el progreso de los objetivos individuales. Las respuestas de texto libre sugirieron una inconformidad generalizada con los objetivos de sustento, particularmente los relacionados con la seguridad laboral y las compensaciones adecuadas. Aunque contribuir a la conservación parece ser una fuente de satisfacción, el progreso lento de los objetivos en otras áreas - particularmente las relacionadas con ganarse la vida - indicaba ser una fuente de angustia y desmotivación. Los empleadores, financiadores, las sociedades profesionales y demás deberían considerar maneras para ayudar a aquellos en el sector de la conservación a lograr una diferencia a la vez que se ganan la vida satisfactoriamente, por ejemplo, mediante la priorización del bienestar de los conservacionistas al momento de asignar financiamientos. Este apoyo podría incluir evitar prácticas explotadoras, fomentar ambientes de trabajo solidarios y celebrar los resultados positivos.

[Quality of life of health personnel during the COVID-19 pandemic: exploratory reviewQualidade de vida do pessoal de saúde durante a pandemia de COVID-19: revisão exploratória]. / Calidad de vida del personal de salud durante la pandemia de COVID-19: revisión exploratoria.

Objective: Describe the quality of life of health personnel, the work environment, and interactions between employees and their work environment during the pandemic. Methods: A scoping review was conducted. The electronic databases PubMed, Cumulative Index of Nursing and Allied Literature Complete, and Google Scholar were used, as well as the repositories of the World Health Organization and the Centers for Disease Control and Prevention. Primary, secondary, and grey literature studies published between December 2019 and March 2021 in Spanish, English, and Portuguese were included. Methodological quality was assessed using the Authority, Accuracy, Coverage, Objectivity, Date and Importance (AACODS) checklist; a tool for the measurement of multiple systematic reviews (AMSTAR); and the Critical Appraisal Checklist for Text and Opinion Papers. A thematic analysis was carried out based on the quality-of-life and well-being model. Results: Of a total of 208 articles, 11 were included. The quality of life of health personnel during the COVID-19 pandemic was affected by the characteristics of health personnel, the work environment, and interactions between employees and their work environment. Problems related to psychosocial and occupational factors were observed. Discussion: The quality of life of health personnel was characterized by stigmatization, stress, anxiety, and fatigue. Organizational management and the implementation of psychological interventions appear to affect interactions between employees and their work environment, and improve their quality of life.

Objetivo: Descrever a qualidade de vida do pessoal de saúde, o ambiente de trabalho e a interação entre o funcionário e o ambiente de trabalho durante a pandemia. Métodos: Foi realizada uma revisão exploratória. Foram utilizadas as bases de dados eletrônicas PubMed, Cumulative Index of Nursing and Allied Literature Complete, Google Scholar e os repositórios da Organização Mundial da Saúde e dos Centros de Controle e Prevenção de Doenças. Foram incluídos estudos primários, secundários e da literatura cinzenta, publicados entre dezembro de 2019 e março de 2021, em espanhol, inglês e português. A qualidade metodológica foi avaliada pelas checklists AACODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance), AMSTAR (A measurement tool to assess systematic reviews) e Critical Appraisal Checklist for Text and Opinion Papers. Foi realizada uma análise temática com base no modelo de qualidade de vida e bem-estar. Resultados: De um total de 208 artigos, 11 foram incluídos. A qualidade de vida do pessoal de saúde durante a pandemia de COVID-19 foi influenciada pelas características do pessoal de saúde, do ambiente de trabalho e da interação entre o funcionário e o ambiente de trabalho. Constataram-se deficiências relacionadas a fatores psicossociais e ocupacionais. Discussão: A qualidade do pessoal de saúde foi caracterizada por estigma, estresse, ansiedade e fadiga. A gestão organizacional e a aplicação de intervenções psicológicas evidenciam um efeito na interação entre o funcionário e o ambiente de trabalho, e influenciam sua qualidade de vida.

[Prevention of infections related to health care in primary care. Lessons from the pandemic]. / Prevención de infecciones relacionadas con la asistencia sanitaria en atención primaria. Lecciones de la pandemia.

The health system failed to guarantee the safety of both professionals and citizens who came to the centers at the beginning of the pandemic. The lack of materials and guidelines for the prevention of infections caused in Spain the worst catastrophe in the history of patient safety and occupational health in healthcare. It also happened in other countries but Spain had the highest rates of infected health workers in the world. It was a largely avoidable event. We review what measures have been taken to prevent infections in primary care centers, such as hand hygiene, masks and personal protection material or the maintenance of social distance, among others. We update the recommendations and raise the perspectives in a situation that requires flexibility and adaptability to maintain quality and safe care.

[Health worker safety as an essential condition for patient safety]. / La seguridad de los profesionales como condición indispensable para la seguridad de los pacientes.

The greatest asset of any health system is its professionals, and they must be cared for in order to take care. It is necessary to emphasize that they are key for the resilience of our health systems. This is particularly important in crisis times and especially important for primary health care.During the COVID-19 pandemic, working conditions have been the main common latent factor for patient safety incidents. Primary Care professionals have worked in unsafe working conditions, with lack of means of protection, great uncertainty, lack of scientific knowledge and rapidly changing work protocols for dealing with cases and contacts of COVID-19 infection, with a high care pressure, long working hours, suspension of vacations, and even changes in their jobs. All of this has contributed to their becoming, not only the first victims of the pandemic, but also the second victims of the adverse events that occurred during it.Therefore, in this article we analyze the main risks and damages suffered by professionals in Primary Care and provide keys to contribute to their protection in future similar situations.

[Risk factors and burnout levels in Primary Care nurses: A systematic review]. / Factores de riesgo y niveles de burnout en enfermeras de atención primaria: una revisión sistemática.

OBJECTIVE: To determine the risk factors and levels of burnout in Primary Care nurses. METHODS: A systematic review was performed. DATA SOURCES: CINAHL, CUIDEN, LILACS, PubMed, ProQuest, ScienceDirect and Scopus databases were consulted. Search equations were 'burnout AND community health nursing' and 'burnout AND primary care nursing'. The search was performed in October 2015. STUDY SELECTION: The final sample was n=12 studies. Quantitative primary studies that used Maslach Burnout Inventory for burnout assessment in Primary Care nurses were included without restriction by publication date. DATA EXTRACTION: The main variables were the mean and standard deviation of the three burnout dimensions, high, medium and low prevalence rates of each dimension, and socio-demographic, occupational and psychological variables that potentially influence burnout level. RESULTS: Studies show high prevalence rates, generally between 23% and 31%, of emotional exhaustion. The prevalence rates of high depersonalisation and low personal accomplishment show heterogeneity, varying between 8%-32% and 4%-92% of the sample, respectively. Studies show that older nurses with more seniority, anxiety and depression, among other variables, have higher burnout levels, while nurses with higher salary, high job satisfaction, organisational support, and good self-concept have less burnout. CONCLUSION: High emotional exhaustion is the main affected dimension of burnout in Primary Care nursing. There is heterogeneity in depersonalisation and personal accomplishment. Burnout must be prevented in these professionals, by increasing protective factors and monitoring its appearance in those with risk factors.

[Fibromyalgia patients' perceptions of the impact of the disease in the workplace]. / Percepciones de pacientes con fibromialgia sobre el impacto de la enfermedad en el ámbito laboral.

OBJECTIVE: To explore the perceptions of patients with fibromyalgia (FM) on the problems they experience in the workplace, to discuss how they face and adapt to the limitations imposed by the symptoms of this disease. DESIGN: An exploratory qualitative study conducted in 2009. LOCATION: Associations of patients of FM from Valencia (Spain). PARTICIPANTS: Sixteen patients (13 women and 3 men) diagnosed with FM by a rheumatologist, of different ages and occupations, selected from key informants and the snowball technique. METHOD: Pragmatic sample. Semi-structured interviews until saturation of information when no new information emerged. Qualitative content analysis using the software Atlas.ti-5, to generate and assign codes, forming categories and identifying a latent theme. RESULTS: We identified four categories: difficulties in meeting the work demands, need for social support in the workplace, strategies adopted to continue working, and resistance to leave the employment. A theme which crosscut these categories emerged: FM patients motivation to continue in the labour market. CONCLUSIONS: Addressing the specific needs of patients it is essential in order to helping them to stay in the labour market, according to their capabilities. Awareness programs about the consequences of FM in the workplace are needed to achieve the collaboration of managers, entrepreneurs, occupational health professionals and primary care physicians and nurses.

[Psychosocial stress environment and health workers in public health: Differences between primary and hospital care]. / Entorno psicosocial y estrés en trabajadores sanitarios de la sanidad pública: diferencias entre atención primaria y hospitalaria.

OBJECTIVE: To describe the psychosocial environment of health professionals in public health in primary and hospital care, and compare it with that of the general Spanish working population, as well as to evaluate the effect of psychosocial risk factors on symptoms related to perceived stress. DESIGN: Cross-sectional study with stratified random sampling. SETTING: Health care workers in the province of Granada, distributed in 5 hospitals and 4 health districts. PARTICIPANTS: A total of 738 employees (medical and nursing staff) of the Andalusian Health Service (SAS) were invited to take part. MAIN MEASUREMENTS: CopSoQ/Istas21 questionnaire developed for the multidimensional analysis of the psychosocial work environment. Stress symptoms were measured with the Stress Profile questionnaire. RESULTS: The response rate was 67.5%. Compared with the Spanish workforce, our sample showed high cognitive, emotional, and sensory psychological demands, possibilities for development and sense of direction in their work. Primary care physicians were the group with a worse psychosocial work environment. All the groups studied showed high levels of stress symptoms. Multivariate analysis showed that variables associated with high levels of stress symptom were younger and with possibilities for social relations, role conflict, and higher emotional demands, and insecurity at work. CONCLUSIONS: Our findings support that the psychosocial work environment of health workers differs from that of the Spanish working population, being more unfavorable in general practitioners.

Why do physicians go to work when they are sick? Presenteeism at different career stages.

INTRODUCTION AND OBJECTIVE: Physicians find it difficult to take on the role of the patient and they show unusual behaviors when ill. One of these behaviors is presenteeism, which is working while sick. The objective of this research is to analyze the factors that contribute to the phenomenon of presenteeism in Spanish physicians. MATERIAL AND METHODS: Mixed methodology study: one national survey through the General Council of Medical Associations website (quantitative part), 22 semistructured interviews with sick residents and practicing physicians, and three focus groups involving professionals from the occupational health services (qualitative). A bivariate analysis using parametric and non-parametric tests. The significance level was p<0.05 (95% confidence interval). Qualitative analysis using the comparative-constant method until saturation of information. RESULTS: Presenteeism is reported by 89.4% of doctors who responded to the survey, and it is more common among women. Contributing factors include fear of overburdening colleagues (the main reason and more common among women 58.14% vs 48.35%), self-perception of doing one's duty (the second reason and more common among men, 44.63% vs 33.14%) and economic impact and difficulty in accepting the role of a sick person. This behavior has an impact on patient safety, and is part of the hidden curriculum that also affects the training of medical professionals. CONCLUSIONS: Presenteeism is a widespread and accepted practice among medical professionals. Although normalized, and even appreciated as a way to avoid overburdening colleagues, presenteeism has important implications for clinical ethics and patient safety.

[Health and well-being of healthcare workers: employment and working conditions beyond the pandemic]. / Salud y bienestar del personal sanitario: condiciones de empleo y de trabajo más allá de la pandemia. Informe SESPAS 2024.

Healthcare workers are people who work in health activities, whether or not they have direct contact with citizens. Currently, around 1.3 million people (70% women) work in healthcare activities in Spain. This represents around 10% of the active population, having increased by 33% since 2008, especially the number of women, which has doubled. Healthcare organizations, especially hospitals, are extremely complex workplaces, with precarious working and employment conditions, especially in more hierarchical occupations, exposing healthcare workers to numerous occupational hazards, mainly from ergonomic and psychosocial conditions. These causes frequent musculoskeletal and mental disorders, highlighting burnout, which is estimated at 40% in some services such as intensive care units. This high morbidity is reflected in a high frequency of absences due to illness, around 9% after the pandemic. The pandemic, and its consequences in the last three years, has put extreme pressure on the health system and has clearly shown its deficiencies in relation to working and employment conditions. The hundreds of occupational health professionals, technicians and healthcare workers, who are part of the structures of health organizations, constitute very valuable resources to increase the resilience of the NHS. We recommend the strengthening in resources and institutionally of the occupational health services of health centers and the creation of an Observatory of working, employment and health conditions in the National Health Service, as an instrument for monitoring changes and proposing solutions.

[Effectiveness of a stretching program on anxiety levels of workers in a logistic platform: a randomized controlled study]. / Efectividad de un programa de estiramientos sobre los niveles de ansiedad de los trabajadores de una plataforma logística: un estudio controlado aleatorizado.

OBJECTIVE: To study the influence of a short programme of stretching exercises on anxiety levels of workers in a Spanish logistic company. METHOD: A controlled clinical trial was carried out by means of an inter-subject design of random homogeneous blocks. Participants were assigned to the experimental group (n=67), treated with a programme of stretching exercises of 10-minute duration after working hours for a period of 3 months, or to the untreated control group (n=67). The primary result variable was anxiety, and the secondary variables were burnout syndrome, quality of life and flexibility. An analysis of covariance (ANCOVA) by intention to treat was performed on each of the result variables by controlling the baseline scores, the age and the practice of introjective activities outside the program, with the size effect calculated by means of the partial eta-squared value (η(2)). RESULTS: The results of the ANCOVA showed a moderate effect of the stretching exercise programme on the levels of anxiety (η(2)=0,06; P=.004). Other effects found were substantial for flexibility (η(2)=0,13; P<.001); moderately high for bodily pain (η(2)=0,08; P=.001), and moderate for vitality (η(2)=0,05; P=.016); mental health (η(2)=0,05; P=.017); general health (η(2)=0,04; P=.028) and exhaustion (η(2)=0,04; P=.025). CONCLUSIONS: The implementation of a short programme of stretching exercises in the work place was effective for reducing levels of anxiety, bodily pain and exhaustion, and for raising levels of vitality, mental health, general health and flexibility. This type of intervention could be seen as a low-cost strategy for improving the well-being of workers.

Occupational safety and health in the agricultural sector: a bibliographic review.

In the labor context the agricultural sector has been a little neglected in terms of the implementation of policies and standards that allow maintaining low accident rates, and in the last year strategies have been established to improve this situation. The aim of this study was to conduct a bibliometric analysis of the scientific literature on the methodologies used to plan, verify, and maintain occupational safety and health in the agricultural sector. The methodology focused on the search for information in the Scopus and Web of Science databases through a search equation, and then through inclusion and exclusion criteria to evaluate the selected articles. It was found that the country with most studies on occupational safety and health was the United States, and that methodologies such as social participation, videos, and team learning are among the most successful processes. The year of publication with the largest amount of research published was 2021, the survey approach appears in 82% of the articles, the use of technology as a means of dissemination of improvement actions was evidenced, and the most innovative processes included: use of religion, checklists, fear, threats, and work organization processes.

En el contexto laboral el sector agrícola ha sido un poco relegado en cuanto a la implementación de políticas y normas que permitan mantener índices bajos de accidentabilidad, y en el último año se han establecido estrategias para que esto mejore. El objetivo de este estudio era realizar un análisis bibliométrico de la literatura científica sobre las metodologías empleadas para planear, verificar y mantener la seguridad y salud en el trabajo en el sector agrícola. La metodología se centró en la búsqueda de información en la base de datos Scopus y Web of Science a través de una ecuación de búsqueda, para luego a través de criterios de inclusión y exclusión trabajar con los artículos seleccionados. Se evidenció que el país que más ha trabajado con la seguridad y salud en el trabajo es los Estados Unidos, que han establecido metodologías como participación social, videos y dentro de los procesos más acertados está el aprendizaje en equipo. El año de publicación con la mayor cantidad de investigaciones establecidas fue durante el 2021; la encuesta aparece en el 82% de los artículos, y se evidenció el uso de la tecnología como medio de divulgación de acciones de mejoras y dentro de las más innovadoras estarían, el uso de la religión, lista de comprobación, el miedo y la amenazas y los procesos de organización del trabajo.

[COVID-19 epidemiology in health and social health workers in the health area of A Coruña and Cee]. / Epidemiología de la COVID-19 entre el personal de centros sanitarios y sociosanitarios del área sanitaria de A Coruña y Cee.

OBJECTIVE: Since the beginning of the pandemic, it has become necessary to know the epidemiological evolution of SARS-CoV-2. Therefore, this study aims to describe the characteristics of the casuistry of COVID-19 in health and social-health workers in the health area of A Coruña and Cee during the first epidemic wave, as well as to determine the association between the clinical profile and/or its duration and the condition of RT-PCR repositivization. MATERIALS AND METHODS: During the study period, 210 cases belonging to healthcare and social-healthcare workers from the healthcare area of A Coruña and Cee were diagnosed. A descriptive analysis of sociodemographic factors was carried out, as well as the search for association between the clinical picture and the duration of detection of a positive RT-PCR. RESULTS: The most affected categories were nursing (33.3%) and nursing assistants (16.2%). The mean time taken for cases to become RT-PCR negative was 18.3±9.1 days, with a median of 17. It was observed that 26 cases (13.8%) had a positive result in a subsequent RT-PCR, without meeting criteria for reinfection. The existence of skin manifestations and arthralgias was associated with repositivization after adjusting for age and sex (OR=4.6 and OR=6.5, respectively). CONCLUSIONS: In healthcare professionals diagnosed with COVID-19 during the first wave, symptoms such as dyspnea, skin manifestations and arthralgias led to RT-PCR repositivization after a previous negative result and without meeting criteria for reinfection.

Concern about COVID-19 infection and workload as predictors of psychological distress during the health emergency in Peruvian healthcare personnel.

INTRODUCTION: During the health emergency, there is concern about the mental health repercussions that Peruvian health workers, who represent the front line of care for COVID-19, may be experiencing. OBJECTIVE: To determine whether concern about COVID-19 and workloads predict psychological distress in healthcare workers. METHODS: Predictive study in which 367 workers (nurses, doctors, nursing assistants, obstetricians, dentists, psychologists, nutritionists, among others) from 12 health networks in the Puno region participated, selected through intentional non-probabilistic sampling. The data were collected via the Kessler Psychological Distress Scale, the COVID-19 Scale of Concern and the Workload Scale. RESULTS: It was found that there are no significant differences between men and women in psychological discomfort and concern about COVID-19 infection and workload. Furthermore, highly significant correlations were found between the study variables (P < .01). Multiple regression analysis showed an adequate adjustment for the model (F = 94.834; P < .001), where concern about COVID-19 (ß = -0.436; P < .01) and workload (ß = 0.239; P < .01) are variables that significantly predict psychological discomfort (adjusted R2 = 0.33). CONCLUSIONS: Concern about COVID-19 and work overload predict psychological distress in health personnel in the Puno region.

[Visceral adiposity index (VAI) and dysfunctional adiposity index (DAI). Relationship with obesity parameters]. / Relación de los índices de adiposidad visceral (VAI) y disfuncional (DAI) con parámetros de obesidad.

INTRODUCTION: Obesity is a global pandemic with a growing impact on morbidity and mortality. We assessed the associative strength of the Visceral Adiposity Index (VAI) and Dysfunctional Adiposity Index (DAI) in obesity and associated risk using different methods. MATERIAL AND METHODS: Cross-sectional study in 418 343 workers from different autonomous communities in Spain, estimating prevalence of obesity with: waist circumference, waist/height index, BMI, CUN-BAE, ECORE-BF, RFM, PALAFOLLS, IMG, METS-VF calculated according to their specific formulas. Descriptive analysis of categorical variables and associative strength of VAI and DAI for obesity was performed with ROC curves considering high risk when the AUC value.0.8 and moderate with AUC.0.7 and.0.8. SPSS 27.0 was used, considering statistical significance p.0.05. RESULTS: The prevalence of obesity varied according to the method used, being high with Palafolls (72.92% in women and 86.98% in men) and low with METS-VF (1.31% in women and 8.54% in men). The mean values of VAI and DAI are always higher in men. The AUC of the ROC curve for VAI was high with METS-VF: in women 0.836 (95%CI 0.829-0.843), in men 0.848 (95%CI 0.845-0.850) and with waist circumference in men: 0.819 (95%CI 0.816-0.822). DAI was high for METS-FV in women: 0.809 (95%CI 0.801-0.817). CONCLUSIONS: The prevalence of obesity and related risk differs according to the assessment method used. VAI shows high strength of association with obesity and fat mass for METS-VF in both sexes and with waist circumference in men; DAI for METS-VF in women.

Waiting time from identification to recognition an occupational disease in Spain.

OBJECTIVE: To estimate the waiting time since a suspected an occupational disease (OD) is identified, notified and recognized in Spain. METHOD: A series of 34 patients attended at Occupational Diseases Unit (ODU) of Hospital del Mar in Barcelona were follow up since their identification until final resolution by the National Institute of Social Security (INSS). Median, and 25 and 75 percentiles (interquartile range [IQR]) were calculated in weeks by total time (n=27), ODU time (n=34), patient time (n=31) and INSS time (n=27). RESULTS: Total time was 51 weeks (IQR: 33.6 and 122.6), of which 42 weeks (17.6-99.5) corresponded to the waiting period at the INSS. CONCLUSIONS: The disproportionately long waiting time since INSS receives a case could impact on the under-recognition of OD. Urgent improvement of the administrative process is needed to reduce the patient waiting time for the recognition of OD.

[Causality and responsibility in occupational health]. / Causalidad y responsabilidad en salud laboral.

The objective of this work is to review the imperfect relationship between causality and responsibility, from the perspective of occupational health, where this tension occurs so frequently when addressing the prevention of illnesses and occupational injuries. From epidemiology, we are very demanding in our observations, both in terms of internal and external validity, when establishing causal relationships. An essential rigor in the analysis of causality, which does not prevent us from myopia when a purely biomedical vision is adopted, forgetting the causes at different levels and of an economic and political nature. In turn, we need a governance (administrations, companies and governments) that assumes responsibility through the establishment of policies, many of them based on legal norms. Rules resulting from participatory processes, broad in democratic societies, in which conflicting interests intervene, and sometimes extends for years, which can lead to unacceptable situations of unrecognized suffering. So, helping us with some prosthesis, a glasses for science, to provide evidence that explains from macro to micro the process that takes us from health to disease, and a hearing aids for politics, to assume with all consequences their responsibility for taking preventive measures listening to the interests of the most vulnerable people, we could enjoy a long and healthy life.

[Permanent disability and premature mortality in a cohort of affiliates with the Spanish Social Security, 2004-2015]. / Incapacidad permanente y mortalidad prematura en una cohorte de afiliados a la Seguridad Social en España, 2004-2015.

OBJECTIVE: To describe a surveillance and monitoring system based on the analysis of the incidence rate of permanent disability (PD) and premature mortality (PM) in a sample of members of the Spanish Social Security. METHOD: Study of three birth cohorts (1950-1959, 1960-1969 and 1970-1979) of people affiliated to the general Social Security system, included in the Continuous Sample of Labour Lives, who has been active for at least one day between 2004 and 2015 (N = 753,341). For each cohort, the annual incidence rates of PD and MP were estimated according to occupation and economic activity in women and men. RESULTS: Between 2004 and 2015 the rates of PI and MP showed higher values in men with respect to women in practically all cohorts of births, occupations and economic activities groups. The trend throughout the observation period was increasing, both in the incidence of PD and PM in men and women, for the three birth cohorts and for all occupational categories. CONCLUSIONS: The results derived from this work allows the continuous monitoring of the temporal evolution of the incidence of permanent disability and premature mortality in a representative sample of social security affiliates.

Workplace violence on healthcare professionals and underreporting: Characterization and knowledge gaps for prevention.

Work-related violence against healthcare workers inflicted by healthcare users is a rising multidimensional phenomenon, a cause of concern among those who ensure the safety and health of these professionals. Although different studies indicate high percentages of attacks against healthcare workers, statistics from reports reveal much lower data. Underreporting of occupational violence against healthcare workers is a well-known fact reported in many studies. It is presented as a major obstacle when it comes to proposing adequate preventive measures, because the data on which to base these measures do not correspond to the true incidence of all the assaults that take place. Underreporting also makes it difficult to correctly assess the usefulness of preventive measures implemented. The following article looks at the latest studies carried out on the subject, presenting an overview of the factors accompanying these assaults, as well as the main reasons for this underreporting. It also highlights the lack in the literature of instruments designed to measure underreporting that have undergone a validation process. For all these reasons, this problem requires further study with validated tools to determine the reasons and circumstances that accompany and promote the underreporting of violence against healthcare workers. Knowing these reasons is a preliminary step in the fight against workplace violence and to measure the true magnitude of the problem, to provide the occupational health services with precise data and develop and assess the preventive measures implemented.

[Occupational exposures, diet and storing: Recommendations to reduce environmental pollutants in breastfeeding]. / Exposiciones laborales, dieta y envasado: recomendaciones para reducir los contaminantes medioambientales en la lactancia materna.

The pollution of the planet also reaches the breastfeeding ecosystem, one of the most intimate and inviolable that links us as an animal species to the rest of mammals. Nursing mothers may be concerned about whether the quality of their milk will be adequate for their baby and whether environmental pollutants through work, diet, and storing may adversely affect their child. Breast milk is a source of exposure to environmental pollutants, and at the same time it counteracts much of the effects of these exposures. An approach based on the principles of reality and precaution of environmental health to avoid, reduce or eliminate the production and use of harmful chemicals during pregnancy and lactation would improve the human and planetary health for the offspring.