Shiftwork related health problems among nurses: a cross sectional study in a tertiary care centre of Central India

Background: The nurses have an essential role to play in the provision of hospital healthcare services round the clock, which means that shifts are compulsory for them. Such work schedules have been related to numerous health problems including cardiovascular and gastrointestinal problems. This study has therefore been performed to assess the health problems associated with shift work among nurses. Methods: A cross?sectional study among 375 nurses conducted in a tertiary care centre of central India. Nurses working in a shift duties and had worked for more than a year were included. Data were collected with the help of a pre designed pre tested questionnaire. Health problems related to shift work were assessed by using standard shift work index questionnaire. Blood pressure and blood sugar levels were measured. Data analysis was done using IBM SPSS Statistics Version 23. Results: Mean age of the study participants was 38.36±8.69 (23-57) years. Most frequently reported gastrointestinal symptom was disturbed appetite (33%) whereas most frequently reported cardiovascular symptom was headache (32.80 %). Common health problems reported by nurses after engaging in shift work were anaemia, chronic back pain, hypertension, varicose veins, diabetes, haemorrhoids, arthritis. Conclusions: Due to high proportion of health problems among nurses as compared to general population institutions must pay attention on their health and take measures for their well being.

Tradução para a língua portuguesa da 11a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-11) / The translation into Portuguese of the 11th International Statistical Classification of Diseases and Related Health Problems (ICD-11)

RESUMO A 11a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde representa um avanço no enfoque do conhecimento e em novas abordagens das doenças. A Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde é utilizada para diferentes finalidades práticas, possibilitando avaliação do avanço da agenda de saúde global, alocação de recursos, segurança do paciente, qualificação da assistência à saúde e reembolso de seguros de saúde. É inteiramente digital, com recursos tecnológicos que permitem sua atualização periódica. No início de 2022, a 11a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde entrou em vigência oficial, tendo sido disponibilizada em vários de seus idiomas oficiais, como o árabe, chinês, espanhol, francês e inglês. Apresenta-se aqui o processo de tradução para a língua portuguesa em uso no Brasil, coordenado pela Universidade Federal de Minas Gerais, com apoio do Ministério da Saúde do Brasil e da Organização Pan-Americana da Saúde/Organização Mundial da Saúde. O trabalho foi realizado em três etapas entre agosto de 2021 e dezembro de 2022 por tradutores com diferentes formações: médicos especialistas (49), fisioterapeuta (1), farmacologista (1) e odontologista (1). Com este artigo metodológico, almeja-se ampliar a discussão de perspectivas para implementação da 11a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde no Brasil e construir uma oportunidade para sua adaptação e uso por outros países de língua oficial portuguesa.

ABSTRACT The 11th International Statistical Classification of Diseases and Related Health Problems (ICD-11) represents an advance in the focus on knowledge and new disease approaches. The ICD is used for different practical purposes, enabling assessment of progress in the global health agenda, resource allocation, patient safety, health care qualification, and health insurance reimbursement. It is entirely digital, with technological resources that allow periodic updating. In early 2022, ICD-11 entered into official force, having been made available in several official ICD languages such as Arabic, Chinese, Spanish, French, and English. The translation process into Brazilian Portuguese, coordinated by the Federal University of Minas Gerais (UFMG), with support from the Brazilian Ministry of Health (MS) and PAHO/WHO, is presented here. The work was carried out in three stages between August 2021 and December 2022 by translators with different backgrounds: medical specialists (49), physiotherapists (1), pharmacologists (1), and dentists (1). This methodological article aims to broaden the discussion of perspectives on implementing the ICD-11 in Brazil and build an opportunity for its adaptation and use by other Portuguese-speaking countries.

Factores asociados a las infecciones relacionadas con la asistencia sanitaria en la unidad de cuidados intensivos pediátricos

Introducción: Las infecciones asociadas con la asistencia sanitaria representan un grave problema de salud e impacto económico, elementos que conducen a un aumento en el número de días estancia, agrava el pronóstico del paciente grave y condiciona costo familiar y social. Objetivo: Determinar los principales factores de riesgo asociados a las infecciones relacionadas con la atención médica en la unidad de cuidados intensivos. Métodos: Estudio observacional, analítico, tipo casos y controles en la sala de cuidados intensivos del Hospital Pediátrico Universitario "Paquito González Cueto" en pacientes con infecciones relacionadas con los servicios sanitarios, desde enero 2018 a diciembre 2020. Resultados: Predominaron los menores de 4 años fundamentalmente el grupo de 1-4 años con riesgo 2,1 veces mayor para las infecciones con ligero predominio del sexo masculino, prevalecieron los normopesos 31,6 % que presentaron algún déficit nutricional por defecto, con un riesgo de infección de 7,2 veces para desnutridos; 48,3 % de los pacientes tenían un factor intrínseco asociado. Las enfermedades neurológicas crónicas, oncoproliferativas e inmunodeficiencias fueron las más representativas; el uso previo de antibióticos, cateterismo y estadía hospitalaria prolongada fueron los factores extrínsecos que predominaron, con riesgo significativo en casi la totalidad de los pacientes. Conclusiones: Existe asociación con riesgo elevado de infección en niños menores de 4 años, con déficit nutricional por defecto; factores intrínsecos como las enfermedades crónicas con predominio de las neurológicas y factores de riesgo extrínsecos significativos en su mayoría. Esto permite dirigir las estrategias de mejora para disminuir la morbilidad y mortalidad.

Introduction: Infections associated with healthcare represent a serious health problem and an economic impact, elements that lead to an increase in the number of days/stay, worsen the prognosis of the seriously ill patient and conditions family and social cost. Objective: To determine the main risk factors associated with healthcare-related infections in the intensive care unit. Methods: Observational, analytical, case-control type study in the intensive care unit of "Paquito González Cueto" University Pediatric Hospital in patients with infections related to health services, from January 2018 to December 2020. Results: Children under 4 years of age predominated, mainly the group of 1-4 years with a 2.1 times higher risk for infections, with a slight predominance of the male sex, the normal weight prevailed (31.6%) who presented some nutritional deficit by default, with a risk of infection of 7.2 times for malnourished; 48.3% of the patients had an associated intrinsic factor. Chronic neurological, onco-proliferative and immunodeficiencies diseases were the most representative; the previous use of antibiotics, catheterization and prolonged hospital stay were the extrinsic factors that predominated, with significant risk in almost all patients. Conclusions: There is an association with an elevated risk of infection in children under 4 years of age, with nutritional deficit by default; intrinsic factors such as chronic diseases with a predominance of neurological diseases and significant extrinsic risk factors. This makes it possible to direct improvement strategies to reduce morbidity and mortality.

Relación de los contenidos de las Ciencias Básicas Biomédicas con los problemas de salud: una necesidad de la Educación Médica

RESUMEN Aprender solucionando problemas constituye una estrategia educacional de elección cuando se persiguen la integración y contextualización curriculares, para formar un médico que deberá ser un comunicador, capaz de trabajar en equipos y de educar al individuo y a la comunidad a vivir con salud. A las Ciencias Básicas Biomédicas se le reconoce su contribución al desarrollo del pensamiento científico de los estudiantes, además de la aportación de contenidos esenciales que constituyen las bases biológicas de la profesión, que sirven de punto de partida para la ampliación, actualización y aplicación de los contenidos en el aprendizaje del método clínico-epidemiológico y para la autoeducación en este campo a lo largo de su vida profesional. Mediante la relación de los contenidos de esta disciplina con los problemas de salud, se fortalece el compromiso académico, el aprendizaje autodirigido, significativo y activo, así como el rendimiento académico, la motivación y la participación, lo que ofrece satisfacción y bienestar al estudiante en un contexto en el que las enfermedades crónicas no trasmisibles constituyen uno de los mayores retos que enfrentan los sistemas de salud a nivel mundial.

ABSTRACT Learning by solving problems constitutes an educational strategy of choice when curricular integration and contextualization are pursued, to train a doctor who must be a communicator, capable of working in teams and educating the individual and the community to live with health. Basic Biomedical Sciences are credited with their contribution to the development of students' scientific thinking, in addition to providing them with essential content that constitutes the biological bases of the profession and that serves as a starting point for the expansion, updating and application of the contents in learning the clinical-epidemiological method and for self-education in this field throughout their professional life. Through the relationship of the contents of this discipline with health problems, academic commitment, self-directed, meaningful and active learning are strengthened, as well as academic performance, motivation and participation, which offers satisfaction and well-being to the student in a context in the than chronic disease not transmissible they constitute one of the bigger challenges that confront the systems of worldwide health.

Prevalence and influencing factors of mental health problems among hypertensive patients in Ya'an city five years after Lushan earthquake / 四川精神卫生

ObjectiveTo analyze the prevalence and influencing factors of mental health problems among hypertensive patients in Ya'an city five years after the Lushan earthquake， so as to provide references for promoting the mental health of hypertensive patients in earthquake-stricken areas. MethodsStratified random cluster sampling method was adopted to select 800 hypertensive patients in Ya'an city in December 2018. The general information of patients were collected via a self-designed questionnaire， and their mental health problems were assessed via the 12-item General Health Questionnaire （GHQ-12）.Then Logistic regression analysis was applied to explore the influencing factors. ResultA total of 744 valid questionnaires （93.00%） were obtained， and mental health problems were detected in 79 cases （10.62%）. Univariate analysis denoted that the detection rate of mental health problems yielded statistical difference among patients of different marital status （P<0.01）， family per capita monthly income （P=0.012） and social assistance recipients （χ2=25.194， P<0.01）. Logistic regression analysis indicated that the unmarried/separated/divorced/widowed status （OR=3.879， P=0.015） and social assistance recipients （OR=4.705， P<0.01） were risk factors for mental health problems among hypertensive patients. ConclusionThe detection rate of mental health problems is low among hypertensive patients in Ya'an city， while the unmarried/separated/divorced/widowed and social assistance recipients may suffer more serious mental health problems.

Perception of menstrual hygiene and complications related to it among medical students.

Background: Menstrual hygiene is an issue that is insufficiently acknowledged. Menstruation and menstrual practices are still clouded by taboos and socio-cultural restrictions resulting into adverse health of females. The present study was designed to assess the knowledge, attitude, practice, and health related issues regarding menstruation among medical students, which will add up to the lacking data regarding menstrual hygiene among medical students. Objectives: To assess knowledge, attitude and practice of menstrual hygiene among medical students and prevalence of health-related issues related to menstruation. Methodology: A cross-sectional study was conducted in May-June 2020, online data is collected through questionnaire from 118 medical students studying in Karnataka Institute of Medical Sciences, Hubli, Karnataka, India. Results: From our analysis, we have found that there is adequate knowledge, good attitude, and practice of menstrual hygiene among medical students. There is also positive correlation between menstrual hygiene practice and its related health issues. Conclusion: This study highlights the need for more intensified methods to generate a population who are more aware and complaint to practice and participate in spreading hygiene menstrual practices

Conocimientos de la dimensión ambiental en estudiantes de medicina y residentes de medicina general integral / Knowledge about the Environmental Dimension in Medical Students and Family Medicine Residents

Introducción: El daño al medio ambiente es cada vez mayor, los problemas ambientales globales crecen por día, ya sea por causas naturales o antrópicas. Esto provoca la aparición y agravamiento de diversas enfermedades por lo que existe una relación entre los problemas ambientales y los problemas de salud. Por esta razón los médicos deben conocer profundamente dicha relación lo que permitirá desempeñar mejor sus variadas funciones y entre ellas las educativas. Objetivo: Evaluar el nivel de conocimientos sobre la dimensión ambiental en estudiantes de sexto año de la carrera de Medicina y residentes de primer año de Medicina General Integral. Métodos: Se aplicó una encuesta de conocimientos, a través de la plataforma Moodle, sobre conceptos, factores y problemas relacionados con el medio ambiente y sus vínculos con problemas de salud, a 32 estudiantes de sexto año terminado de la carrera de Medicina correspondiente al 35,55 por ciento del total de la matrícula, así como a 29 residentes de medicina general integral también con primer año de la residencia finalizado para un 55,76 por ciento de los matriculados. Las muestras pertenecientes a las facultades de ciencias médicas Manuel Fajardo y Salvador Allende se seleccionaron de forma aleatoria. Resultados: El resultado general de la encuesta fue de un 21,88 por ciento de aprobados para los estudiantes y de un 27,59 por ciento para los residentes. Estos concordaron con un bajo porciento de aciertos en diferentes preguntas, por ejemplo, las que exploraron conceptos importantes como medio ambiente y desarrollo sostenible, así como la de los problemas ambientales de Cuba y sus efectos, como el deterioro de la condición higiénico-sanitaria (ambientales) en los asentamientos humanos, entre otros. Conclusiones: El nivel de conocimiento mostrado por los estudiantes y los residentes, acerca de la dimensión ambiental, evidencia insuficiencias cognoscitivas en esta esfera y en su relación con la actividad profesional(AU)

Introduction: Environmental damage is increasing over time; global environmental problems are growing every day, whether due to natural or man-made causes. This brings about the appearance and worsening of various diseases, based on the relationship between environmental problems and health problems. For this reason, physicians must have deep understanding of this relationship, which will allow them to carry out their various functions better, including educational ones. Objective: To assess, in sixth-year medical students and in first-year residents of Family Medicine, their level of knowledge about the environmental dimension. Methods: A knowledge survey was applied, using the Moodle platform, about concepts, factors and problems related to the environment and their links with health problems. The respondents were 32 students in the sixth academic year of the Medicine major, a figure accounting for 35.55 percent of the total enrollment; as well as 29 Family Medicine residents also with the first academic year of their residency completed, which accounted for 55.76 percent of those enrolled. The samples belonging to Manuel Fajardo and Salvador Allende medical schools were randomly selected. Results: The general result of the survey was 21.88 percent of approved respondents for students and 27.59 percent for residents. These coincided with a low percentage of correct answers in different questions; for example, those that explored important concepts such as environment and sustainable development, as well as that of Cuba's environmental problems and their effects, such as the deterioration of the hygienic-sanitary condition (environmental) in human settlements, among others. Conclusions: The level of knowledge shown by students and residents about the environmental dimension shows cognitive deficiencies in this sphere and in its relationship with professional activity(AU)

Neck pain and associated factors in a sample of high school students in the city of Bauru, São Paulo, Brazil: cross-sectional study

ABSTRACT BACKGROUND: Neck pain is a major public health problem. OBJECTIVE: The aim of the present study was to determine the prevalence of neck pain among high school students and to analyze associations with sociodemographic variables, use of electronic devices, habitual physical activity practices and mental health problems. DESIGN AND SETTING: Cross-sectional epidemiological study on a sample of high school students in the city of Bauru, São Paulo, Brazil. METHOD: Participants were selected through cluster sampling in two stages and data were collected via face-to-face interviews. Data collection comprised the following steps: 1. sociodemographic characteristics; 2. use of electronic devices; 3. habitual physical activity levels; 3. mental health; and 4. neck pain. RESULTS: A total of 1,628 participants were interviewed. The prevalence of neck pain was 49.1% (95% confidence interval, CI 46.7 to 51.5), with 40.4% (95% CI 37.0 to 43.7) in men and 57.5% (95% CI 54.2 to 60.9) in women. The variables associated with in neck pain were: female (prevalence ratio, PR = 2.04), use of cell phone in standing posture (PR = 1.47), use of tablet in sitting posture (PR = 1.72), length of computer use greater than 3 hours/day (PR = 1.54), length of cell phone use greater than 3 hours/day (PR = 1.54), length of tablet use greater than 3 hours/ day (PR = 1.34) and mental health problems (PR = 1.56). CONCLUSION: There is high prevalence of neck pain among students and striking associations with female sex, use of electronic devices and mental health problems.

Understanding the Behavioral Problems and Oral Health Status of Children With Autism Spectrum Disorder: A Narrative Review

@#Autism Spectrum Disorder (ASD) is a neurodevelopment disorder with an unidentified etiology and wide-ranging functional impact. This narrative review aimed to identify various behaviours and oral health problems among children with ASD, recognize the barriers towards oral health care, and identify the strategies for oral health care management. Online databases (Scopus, PubMed and Google Scholar) were used by using various search terms. All types of articles with different level of evidence were included. Articles which were not in English and were not available in full text were excluded. Various behavioural problems among ASD contributed to various oral healthcare challenges that lead to compromise oral health status. Caregivers and dental professionals have to identify these problems towards strategizing an effective oral health management for them. Therefore, this narrative review provide an insight towards controlling the oral health problems faced through preventative and practical approach for the chidlren with ASD.

Necesidad de una formación ambiental en la carrera de medicina / The need for environment-related training in the medical major

El deterioro del medio ambiente es un hecho indiscutible. Se llama a la comunidad internacional, a los Gobiernos y pueblos a frenar el daño causado y a colaborar con la recuperación. No obstante, el perjuicio resulta cada vez mayor. Diversos problemas naturales destruyen la Tierra, también los causados por el ser humano, como el cambio climático y la contaminación, cuyas nefastas consecuencias generan y agravan los problemas de salud vegetal, animal y humana. El cambio climático influye en el comportamiento de enfermedades transmisibles y no transmisibles. La contaminación, a través de contaminantes ambientales, como los disruptores endocrinos, pueden conllevar a la aparición de enfermedades crónicas. A pesar de que estas condiciones afectan al medio ambiente y en particular al hombre, no existe una verdadera conciencia ambiental, por lo que cabe preguntarse: ¿por qué persiste esta situación a pesar de los esfuerzos realizados y de la divulgación de esta problemática no solo en Cuba sino también a nivel mundial? Los insuficientes conocimientos de la temática ambiental y su no interiorización influyen en la falta de conciencia, por eso es imprescindible impartirlos en la carrera de medicina para lograr una verdadera formación en esta esfera, que contribuya con el desarrollo de una conciencia ambiental en la población, pues una de las funciones del médico es educar. Cuba tiene potencialidades que le permiten enfrentar los problemas ambientales que atentan contra el desarrollo socioeconómico, en general, y contra la vida, en particular, para así poder lograr un desarrollo humano sostenible(AU)

Environmental degradation is an indisputable fact. The international community, governments and peoples are called upon to stop the damage caused and to collaborate with its recovery. However, the damage is increasing. Various natural problems destroy the Earth; also those caused by humans, such as climate change and pollution, whose dire consequences generate and aggravate plant health, animal health and human health problems. Climate change influences the behavior of communicable and non-communicable diseases. Pollution, through environmental pollutants, such as endocrine disruptors, can lead to the appearance of chronic diseases. Despite the fact that these conditions affect the environment and the human being in particular, there is no true environmental awareness, so it is worth asking: Why does this situation persist despite efforts made and the disclosure of this problem not only in Cuba but also worldwide? Insufficient knowledge about environmental issues and its lack of internalization influence the lack of awareness; that is why, it is essential to teach them in the medical major, in order to achieve real training in this area, which contributes to the development of environmental awareness among the population, because one of the functions of the physician is to educate. Cuba has potential resources that allows to face environmental problems that threaten socioeconomic development, in general, and against life, in particular, in order to achieve sustainable human development(AU)

Respuesta social ante las medidas tomadas para el enfrentamiento a la COVID-19 en Camagüey / The social response to the measures taken to confront COVID-19 in Camagüey

RESUMEN Introducción: La investigación persigue el objetivo de determinar la respuesta social ante las medidas tomadas para el enfrentamiento a la COVID-19 en la provincia de Camagüey. Clasificada como investigación-desarrollo del Centro de Desarrollo de las Ciencias Sociales y Humanísticas en Salud fue realizada en el período de abril - julio 2020. Material y Métodos: Se utilizó el cuestionario asistido para recolectar información sobre la respuesta social ante la enfermedad. Fue aplicado al unísono en el territorio en el período de 5 de mayo al 30 de junio, cuando aún Camagüey no había pasado a la primera fase de recuperación, se tuvo como criterio asignar cuotas para abarcar todos los municipios de la provincia y aplicar en la población de modo aleatorio. A partir de las medidas tomadas de aislamiento social se utilizó la pesquisa activa de los estudiantes y profesores de la Universidad de Ciencias Médicas para la recogida de información. La muestra final quedó conformada por 603 personas encuestadas. Resultados: La población encuestada valoró el esfuerzo y la voluntad política y consideró adecuada la respuesta al enfrentamiento de la enfermedad también se valoró adecuada las acciones de las diversas instituciones en el enfrentamiento a la COVID-19. Discusión: Resulta significativo que los sujetos que participaron en el estudio reconocieran problemas con el cumplimiento del aislamiento y la responsabilidad social, con la distribución equitativa de los recursos y la necesidad de fortalecer las medidas de control social ante las indisciplinas sociales.

ABSTRACT Introduction: The investigation pursues the objective of determining the social response to the measures taken to confront COVID-19 in the province of Camagüey. Classified as research-development of the Center for the Development of Social and Humanistic Sciences in Health, it was carried out in the period from April - July 2020. Material and methods: The assisted questionnaire was used to collect information on the social response to the disease. It was applied in unison in the territory in the period from May 5 to June 30, when Camagüey had not yet passed to the first recovery phase, the criterion was to assign quotas to cover all the municipalities of the province and apply in the population randomly. Based on the measures taken of social isolation, the active research of the students and professors of the University of Medical Sciences was used to collect information. The final sample was made up of 603 people surveyed. Results: The surveyed population valued the effort and political will and considered the response to the confrontation of the disease adequate, the actions of the various institutions in the confrontation with COVID-19 were also considered adequate. Discussion: It is significant that the subjects who participated in the study recognized problems with compliance with isolation and social responsibility, with the equitable distribution of resources and the need to strengthen social control measures in the face of social indiscipline.

Threatening Health Impacts and Challenging Life of Sanitary Workers

The term sanitation refers to adequate treatment and disposal of human excreta and sewage, and provide clean drinking water. The aim of sanitary system is protecting human health by providing safe and clean environment. It helps to prevent transmission of diseases which are spreading through faecal-oral route. Sanitary workers are protecting the society from diseases such as diarrhoea, ascariasis, cholera, hepatitis, poliomyelitis, schistosomiasis and trachoma with their effective services.Sanitary services are given by the sanitary workers for the betterment of human health. Sanitary workers are doing the work such as sweeping streets, collecting waste from house to house and streets, latrine or pit cleaning, cleaning school toilets, public toilets, toilets of municipalities, government and private offices, operating waste collecting trucks, management of faecal sludge, desludging the septic tank, cleaning sewer, cleaning manholes, cleaning sewage treatment plants and handling waste water and sludge at sewage treatment plants.Sanitary workers are the key persons responsible for cleanliness of the country. At the same time, they are facing many challenges such as (i) issues related to their health and safety: cuts, injuries, musculoskeletal problems, respiratory problems, gastro intestinal problems and infectious diseases like gastroenteritis, diarrhoea, cryptosporidiosis, giardiasis, hepatitis A, hepatitis B, leptospirosis, salmonellosis, typhoid fever and tetanus.; (ii) legal and institutional issues: poor enforcement of law, lack of standard operating procedures, poor legal protection and workers safety which is influenced by the availability of equipment and materials used for doing the work and also by customers and employers; (iii) insecurity in financial status and social issues; social stigma like intergenerational discrimination.Sanitary workers are not concentrating on their own health and nutritional status due to lake of awareness. There is a need to enrich the knowledge of workers regarding prevention of health problems, protection from health issues and promotion of their health. The employer has to ensure that workers have undergone training before placement in the job and also, they must be provided with proper guidelines. Workers must get adequate facilities in the working area. Sanitary workers must be provided with personal protective equipment and insisted to use it properly. Regular medical check-up, vaccination and follow up are very important to protect the sanitary workers.

Análisis de complejidad en la caracterización de episodios de morbilidad materno-infantil / Analysis of complexity in the characterization of maternal and child morbidity episodes

Introducción: La salud materno-infantil constituye una prioridad bien definida en el sistema sanitario de Cuba, por lo que el estudio de problemas sanitarios complejos resulta de incuestionable valor. Objetivo: Caracterizar a féminas con infecciones asociadas a la asistencia sanitaria o preeclampsia, desde el paradigma de la complejidad. Métodos: Se desarrolló una investigación compleja trietápica en el Hospital Provincial Ginecoobstétrico Mariana Grajales Coello de Santiago de Cuba, que incluyó un análisis de serie temporal y un estudio observacional, descriptivo y transversal, para lo cual se tomaron 1 896 pacientes diagnosticadas con infecciones asociadas a la asistencia sanitaria, desde el año 2004 al 2017, y 140 gestantes con preeclampsia, registradas en el quinquenio 2013-2017; además, se consideraron variables clínicas, epidemiológicas, humorales, ecográficas y anatomopatológicas. Se efectuaron análisis de series temporales (descomposición estacional, análisis espectral e identificación de componentes de la serie), de componentes principales y de redes neuronales; a la vez que se identificaron los patrones estacionales específicos y microbiológicos para las infecciones asociadas a la asistencia sanitaria. Resultados: La edad, la historia obstétrica y las fluctuaciones de la tensión arterial resultaron ser factores predictores de importancia relacionados con la preeclampsia, además de los fallos renal y hepático como agravamientos y/o complicaciones de dicha entidad clínica. Conclusiones: La utilización de métodos de análisis multinivel reveló el complejo entramado que se establece entre las variables clínicas, epidemiológicas, sociales y ambientales en relación con las infecciones asociadas a la asistencia sanitaria y la preeclampsia, lo que se evidenció con los hallazgos anatomopatológicos.

Introduction: The maternal and child health constitutes a very defined priority in the health system of Cuba, reason why the study of complex health problems is of unquestionable value. Objective: To characterize women with infections associated with the health assistance or pre-eclampsia, from the paradigm of complexity. Methods: A complex three phase investigation was carried out in Mariana Grajales Coello Provincial Gynecoobstetric Hospital in Santiago de Cuba that included a temporary series analysis and an observational, descriptive and cross-sectional study, for which 1 896 patients diagnosed with infections associated with the health assistance, from 2004 to 2017, and 140 pregnant women with pre-eclampsia, registered in the five year period 2013-2017 were selected, also, clinical, epidemiological, humoral, echographic and pathologic variables were considered. Temporary series analysis (seasonal factorization, spectral analysis and identification of the series components), of main components and neural network were carried out; at the same time that the specific seasonal and microbiological patterns were identified for the infections associated with health assistance. Results: The age, obstetric history and fluctuations of blood pressure were important prediction factors related to pre-eclampsia, besides renal and hepatic failure as worsenings and/or complications of this clinical entity. Conclusions: The use of multilevel analysis methods revealed the complex structure that is established between the clinical, epidemiological, social and environmental variables in connection with the infections associated with health assistance and pre-eclampsia, what was evidenced with the pathologic findings.

A cross-sectional study of health and psychosocial problems among elderly people living in old-age homes of Ahmedabad and Gandhinagar districts, Gujarat, India

Background: Old age is a big challenge to human life with respect to health needs as well as psychosocial needs. This study has explored the very important aspects of old age. Very few studies have been conducted in Ahmedabad and Gandhinagar districts on the same aspects. The present study was an attempt to fill the gap in knowledge about the existing health-related and psychosocial problems faced by elderly population. Objectives: To study the health profile, socio-demographic factors, and psychosocial aspects of the elderly in old-age homes. Materials and Methods: A cross-sectional study on the public health aspects and psychosocial problems of old-age persons (60 years and above) was carried out in old-age homes in Ahmedabad and Gandhinagar districts, Gujarat, India. Results: A total of 500 elderly people, living in nine old-age homes in Ahmedabad district, were interviewed and examined. In the study population, 42.20% were male and 57.80% were female. Majority of the elderly were residing in old-age home for 3–10 years (59.60%). Moreover, the most frequent reason of shifting to old-age home among them was family conflicts (45.60%). Majority of the elderly were having body mass index in normal and overweight ranges. And, more number of females had shown overweight pattern as compared to males. This study revealed the five common presenting symptoms of the elderly to be joint pain (47.40%), impaired vision (39.20%), insomnia (28.00%), weakness (23.20%), and impaired memory (23.20%). Health problems of elderly population are of much concern as per this study. The major health problems found in the elderly were cancer, anemia, diabetes, cataract, hypertension, coronary heart disease, asthma, and osteoarthritis. Conclusion: Majority of the elderly people felt neglected by their family members. Two-thirds of old-age homes were having facility for regular health checkup. Majority of the elderly were having hypertension and joint pain as the most common presenting complaints among all.

Occupational hazards and health problems among traffic personnel of Mangaluru city

Background: Occupational health risks and hazards due to the polluted environment have become a serious public health concern. Thus, the duty-bound personnel like traffic police who are continuously exposed, may be at high risk and badly suffer from related health problems. This study was conducted to determine the prevalence of occupational hazards and related health problems among traffic personnel in Mangaluru city. It also aimed to determine the association between occupational hazards and health problems. Methods: This cross-sectional study was conducted among traffic personnel of Mangaluru city. A semi-structured questionnaire with established reliability and validity was used to measure occupational hazards, protective measures, and health problems. Results: The prevalence of respiratory morbidity, eye symptoms, and auditory symptoms was found to be 51.2%, 61.6%, and 47.5% respectively. Respiratory morbidity and duration of use of protective measures against air pollution are found to be significantly associated. The duration of exposure to noise pollution was also significantly associated with the auditory symptoms. Conclusions: Police personnel suffer from significant occupational health problems, due to hazards like air pollution and noise. Necessary protective measures should be taken to ensure the safety of traffic personnel. This study showed an association between occupational hazards and related health problems.

Diagnóstico local de usos de drogas en el barrio Malvín Norte, Montevideo / Local diagnosis of drugs use in Malvín Norte neighborhood, Montevideo

RESUMEN Introducción: La complejidad social de los usos problemáticos de drogas ha generado la necesidad de desarrollar diagnósticos locales que nutran el diseño de nuevas estrategias y políticas de proximidad. Objetivo: Realizar un diagnóstico local de problemas sanitarios asociados al uso de drogas en el barrio Malvín Norte, Montevideo. Métodos: Se siguió la Guía metodológica para la elaboración de diagnósticos locales y se realizaron: análisis documental; reportes institucionales; observaciones en territorio; taller de sensibilización; grupo de discusión; registro de detenciones asociadas a usos de drogas; encuestas; taller de devolución de resultados preliminares. Para el análisis se desarrolló una triangulación intermétodo, combinando métodos cualitativos y cuantitativos. Resultados: Se logró un conjunto articulado de datos sociodemográficos, urbanísticos, culturales e institucionales que explican diversas dimensiones del complejo fenómeno de las drogas en ese barrio. Se observó que las preocupaciones de los actores sociales e institucionales del barrio están centrados en el consumo de pasta base de cocaína, hecho que invisibiliza otros problemas graves, como el consumo de alcohol y la creciente psiquiatrización de un porcentaje excesivamente alto de la población escolar de la zona. Conclusiones: Se alcanza una mejor comprensión de la génesis de los problemas locales relacionados con el uso de drogas, lo que permite sugerir líneas de acción y políticas locales más adecuadas para un afrontamiento efectivo a esa problemática en la zona.

ABSTRACT Introduction: The social complexity of problematic drug uses has generated the need to develop local diagnoses that foster the design of new strategies and proximity policies. Objective: To carry out a local diagnosis of health problems associated with drug use in Malvín Norte neighborhood, Montevideo. Methods: The Methodological Guide for the elaboration of local diagnoses was followed and there were carried out: documentary analysis, institutional reports, interviews, field observations, awareness workshops, a debate group, records of arrests related to drug use, surveys; and a workshop on preliminary results. For the analysis, an inter-method triangulation was performed, combining qualitative and quantitative methods. Results: An articulated set of socio-demographic, urbanistic, cultural and institutional data was obtained explaining various dimensions of the complex phenomenon of drugs in that neighborhood. It was also noted that the concerns of neighborhood´s social and institutional actors tend to focus on the problems associated with cocaine base paste´s consumption and that this fact neglects other serious problems such as problematic alcohol consumption and growing "psychiatrization" of an excessively high percentage of the school population in the area. Conclusions: A better understanding of the genesis of local problems related to drug use was achieved, thus suggesting lines of action and local policies that are more suitable for the effective coping with this problem in the area.

A study on health problems among government primary school children in rural area of Kadapa district, Andhra Pradesh

Background: “To learn effectively, children need good health” says the World Health Organization’s Expert committee on school health services. Inspite of the primary health care that exists in India, yet it is unable to cover the health needs of school children, especially the primary school children. To know their health status and influencing factors, a study is designed in the rural area of Kadapa district of Andhra Pradesh. Methods: A cross sectional study design was used to assess the health condition of the rural government primary school children at school and socio-demographic data at their home during the period July to December 2016. A sample of 683 children from 20 schools was included in the study. The data was analyzed and inferences were drawn. Results: 38.79% of the rural government primary school children had one or more health problem. Dental problems were found in 21.66% followed by skin problems in 8.05%, nutritional defects in 7.61%, eye disorders in 6.88% and ENT problems in 22.84%. Only 5.42% had good personal hygiene. Majority of the children were poor belonging to the socioeconomic status of class IV (19.62%) and class V (76.60%). 83.39% of the children with health problems had poor housing conditions. Conclusions: More than 2/3rd was found suffering from health problem which was almost equally distributed among boys and girls. The suffering children were almost 95% from lower socioeconomic status and 83% with poor housing conditions.

Child and Adolescent Psychosocial Care Center service use profile in Brazil: 2008 to 2012

Objective: To describe the service use profile of Child and Adolescent Psychosocial Care Centers (Centro de Atenção Psicossocial Infanto-Juvenil [CAPSi]) in Brazil regarding diagnostic categories, sociodemographic aspects, and care modalities between 2008 and 2012. Methods: A descriptive, ecological study was performed using data from the Unified Health System regarding high-complexity procedure authorizations (Autorização de Procedimentos de Alta Complexidade [APAC]) for the period from 2008-2012. The variables sex, age, diagnosis (F00-F99 of ICD-10), and type of care provided were examined. The data were processed using TabWin and STATA version 12. Results: A total of 837,068 records were examined, each representing one visit to CAPSi. Most visits were by male users (68.8%). The most common diagnoses were hyperkinetic disorders (13%), pervasive developmental disorders (12.4%), and conduct disorders (8.4%). Conclusions: Behavioral and emotional disorders that usually appear during childhood or adolescence and psychological development disorders were frequent, with more than 50% of the latter comprising autism spectrum disorders. Regional differences were observed, with a higher presence of this diagnosis in the Southeast, while the North and Northeast had a high percentage of visits due to mental retardation.

Early health issues in late pre-terms

Background: Rates of preterm birth are increasing worldwide, mostly due to late preterm births (i.e. 34-36 6/7 weeks). The objective of the study is to calculate incidence of early morbidity and mortality in late preterm neonates (within first 7 days of life) compared with term neonates.Methods: It was a prospective cohort study. All live inborn late preterm infants (34 0/7 to 36 6/7 weeks) and term infants (37 0/7 to 41 6/7 weeks) who were born between November 2010 to October 2011. Study was done to find out early morbidity and mortality in late preterm births.Results: Present study included 256 late preterm infants and 498 term infants, amongst whom 95 (37.10%) late preterm and 98 (19.67%) term infants required NICU care (p<0.001). Late preterm infants were at significantly higher risk for overall morbidity due to any cause (P<0.001; Odds Ratio (OR):2.4; 95% CI: 1.7-3.3), respiratory morbidity (P<0.001; OR:3.64; 95% CI:1.7-7.4), neonatal depression (p<0.001; OR:2.94; 95% CI:1.00-8.62), any resuscitation/ventilation (P<0.05; OR: 3.1; 95% CI:1.15-8.31), probable sepsis (P<0.001; OR:11.2; 95% CI:2.5-49.8), confirmed sepsis (p=0.05; OR:7.7; 95% CI:0.9-63.9), or other problems like jaundice, hypoglycemia, hypothermia and feeding difficulty. The incidence of morbidity increased as gestational age decreases from 19.67% in term infants (>37 weeks) to 27.8%, 43%, 54.5% at 36, 35 and 34 weeks, respectively (P<0.001).Conclusions: The morbidity risk in late preterm births is 1.3 times more at 36 weeks, 2 times more at 35 weeks and 2.7 times more at 34 weeks as compared with term neonates. The mean cost of stay increased 1.8 times in the late preterm neonates as compared to the term neonates.

Health problems among IT professionals in Chennai city, Tamil Nadu

Background: Increasing technological advantage lead to the higher health disadvantages to IT professionals who spent most of the time working in front of the computer. They are experiencing many neural, visual and musculoskeletal ailments. The present study was done with the aim to limelight the health issues among IT employees in IT Park, Chennai.Methods: This cross-sectional quantitative survey related to health issues among IT professionals was done on 417 employees of Chennai IT Park during the period from January 2018 to May 2018. The predesigned questionnaire included socio-demographic and health related issues. It was sent to the employees through various media including Facebook messenger, LinkedIn private messaging and email. The data was analyzed and presented in number and percentages and the related associations were analysed by Chi square test.Results: The prevalence of pain in eye was the major visual problem noticed in 157 (38%) patients and the rate of incidence was similar in both males and females. About 50% of the participants had pain/stiffness in lower back. Feeling nervous ness is the related stress condition experienced by the respondents (49%). Other health correlated issues noticed among the participants was headache (40%). The prevalence rate of these factors was higher in males compared to females.Conclusions: The study concluded that IT professionals face several health issues in terms of visual, musculoskeletal and stress problems in Chennai IT Park