Fracturas vertebrales causadas por reductores de velocidad o "lomos de burro" / Spinal fractures caused by speed bumps

Objetivo: Presentar una serie de casos de fracturas vertebrales en pasajeros de autobús asociadas al pasaje por reductores de velocidad. Materiales y métodos: Se realizó un estudio descriptivo y retrospectivo de una serie de casos de lesiones vertebrales torácicas y lumbosacras sufridas por pasajeros a causa del impacto del vehículo con reductores de velocidad. Se incluyó a pacientes tratados en dos instituciones, entre el 1 de enero de 2012 y el 1 de enero de 2023. Resultados: Se registraron 23 pacientes con lesiones vertebrales de la columna toraco-lumbosacra, 14 mujeres (60,9%) y 9 hombres (39,1%), promedio de la edad 43 años (DE ± 12; rango 25-62). Casi todos eran pasajeros (n = 22; 95,7%) que viajaban sentados en la última fila del autobús (n = 20; 86,5%). Un solo caso correspondía a un conductor del vehículo. Se documentaron 29 lesiones vertebrales, 28 fracturas toracolumbares (de T10 a L2; 96,6%) y una fractura de coxis (3,4%). La vértebra más comprometida fue L1 (n = 16; 55%). Las fracturas más graves (A3/A4) se asociaron con tratamiento quirúrgico (p = 0,007) y una mayor mediana de días de internación (p = 0,005). Conclusiones: Las lesiones vertebrales asociadas al impacto vehicular con reductores de velocidad son fracturas causadas por un mecanismo de compresión axial, más frecuentes en pasajeros ubicados en la última fila de asientos del autobús. Comprometen predominantemente la charnela toracolumbar y la vértebra fracturada con más frecuencia es L1 y exclusivamente uno de los platillos vertebrales. Nivel de Evidencia: IV

Objective: To present a case series of spinal fractures in bus passengers caused by passing over speed bumps. materials and methods: A descriptive and retrospective study of a case series of thoracic and lumbosacral spinal injuries suffered by passengers as a result of vehicle impacts with speed bumps was conducted. Patients treated at two institutions from January 1, 2012 to January 1, 2023 were included. Results: 23 patients with vertebral injuries of the thoracolumbosacral spine were recorded: 14 women (60.9%) and 9 men (39.1%), average age 43 years (SD±12; range=25-62). Almost all of the patients were passengers (n=22, 95.7%) sitting in the last row of seats on the bus (n=20, 86.5%). A single case was documented involving the vehicle's driver. 29 spinal injuries were recorded, 28 thoracolumbar fractures (from T10 to L2; 96.6%) and 1 coccyx fracture (3.4%). The most frequently involved vertebra was L1 (n=16; 55%). The most severe fractures (A3/A4) were associated with surgical treatment (p=0.007) and a longer median hospital stay (p=0.005). Conclusions: Spinal injuries during vehicular impact with speed bumps are caused by an axial compression mechanism, with greater involvement of passengers who are located in the last row of seats. They primarily affect the thoracolumbar joint, with the L1 vertebra and exclusively one of the vertebral endplates being fractured most frequently. Level of Evidence: IV

Wounding characteristics and treatment principles of ground anti-armored vehicle ammunition against armored crew / 中华创伤杂志(英文版)

The wound mechanism, injury characteristics and treatment principles of anti-armored vehicle ammunition against armored crew in the past 20 years are summarized in this paper. Shock vibration, metal jet, depleted uranium aerosol and post armor breaking effect are the main factors for wounding armored crew. Their prominent characteristics are severe injury, high incidence of bone fracture, high rate of depleted uranium injury, and high incidence of multiple/combined injuries. During the treatment, attention must be paid on that the space of armored vehicle is limited, and the casualties should be moved outside of the cabin for comprehensive treatment. Especially, the management of depleted uranium injury and burn/inhalation injury are more important than other injuries for the armored wounds.

Road traffic accident clinical pattern and management outcomes at JUMC Emergency Department; Ethiopia

Background: Road Traffic Accident is an incident on a way or street open to public traffic. It becomes one of the most significant public health problems in the world especially in developing countries. In Ethiopia, it represents a significant risk for morbidity and mortality. It is also the major public health problem even though studies done on this topic in the study area is limited. Objective: To assess clinical pattern, associated factors and management outcomes among road traffic accident Victims attending emergency department of Jimma University Medical Center. Methods: Hospital based cross sectional study design was employed to review patients' chart visited the hospital from March to April 2021. A systematic random sampling technique was applied. The data were collected using pretested checklist and analyzed using SPSS version 26. Descriptive statistics and multivariate logistic regression were computed. Variables with P<0.05 were considered statistically significant. Results: About 49.6%) were pedestrians injured of which motorcycle accounted 42.9%. More than half of victims never got any type of prehospital care. On arrival, 38.7% were classified as Red of which 71.4% of them were managed surgically. About 84.9% of victims were discharged with improvement whereas12.6% were died. Victims with head injury (AOR= 16.61: 95% CI; 3.85, 71.71), time elapsed to reach nearby health facility (AOR= 3.30; 95 CI (1.13, 9.60), condition of patient at Emergency Department (AOR= 7.78; 95% CI: 2.33, 26.06), GCS at admission (AOR= 20.12; 95% CI: 7.23, 55.96) and days spent in hospital (AOR= 6.85; 95% CI 5.81, 8.06) were independent predictors of unfavorable outcome. Conclusion: Road Traffic Accident represents a significant risk for morbidity and mortality in Ethiopia, of which head injury and multiple sites injury increase injury severity. Targeted approaches to improving care of the injured victims may improve outcomes. Thus, the clinician should take into consideration the clinical presentation and give due attention to the identified contributing factors in its management.

Fatores de risco e proteção para acidentes de transporte terrestre entre adolescentes brasileiros, pense 2015/2019 / Factores de riesgo y protección de los accidentes de transporte por carretera entre los adolescentes brasileños, pense 2015/2019 / Risk and protective factors for road transportation accidents among brazilian adolescents, pense 2015/2019

RESUMO Objetivo: descrever a prevalência de fatores de risco e proteção para acidentes de transporte terrestre (ATT) entre adolescentes brasileiros. Métodos: foram analisados dados da Pesquisa Nacional de Saúde do Escolar, de 2015 e 2019, referentes aos indicadores de risco e/ou proteção no trânsito. Foram estimadas as prevalências e respectivos intervalos de confiança de 95% (IC 95%), segundo sexo, faixa etária e tipo de escola. Resultados: dos escolares de 13 a 17 anos entrevistados, 33,3% (IC 95%:32,1;33,7) referiram ter dirigido veículo motorizado ou ter sido transportado em veículo conduzido por alguém que tinha consumido bebida alcoólica, 38,1% (IC 95%:37,4;38,7) afirmaram ter sido transportados por quem utilizava o celular enquanto dirigia, 17,5% (IC 95%:16,8;18,2) referiram não usar cinto de segurança no banco da frente e 30,2% (IC 95%:29,4;30,9) no banco de trás, e 27,1% (IC 95%:26,5;27,7) dos estudantes relataram ter sido transportado por condutor alcoolizado. Entre 2015 e 2019, o uso do cinto de segurança no banco de trás, reduziu de 33,7% para 30,2%, e o uso de capacete ao andar de moto aumentou de 84,6% para 88,9%. Conclusão: a prevalência de escolares que dirigiam ou andavam com pessoas sob efeito do álcool ou que usavam o celular enquanto dirigiam foi elevada. Além disso, o uso de cinto de segurança no banco de trás foi baixo. Entre 2015 e 2019, o uso de cinto de segurança no banco de trás reduziu e o uso de capacete aumentou. É necessário ampliar as estratégias de educação no trânsito para os adolescentes, seus familiares e responsáveis.

RESUMEN Objetivo: describir la prevalencia de los factores de riesgo y protección de los accidentes de tráfico (ATT) entre los adolescentes brasileños. Métodos: se analizaron los datos de la Encuesta Nacional de Salud Escolar de 2015 y 2019, referidos a los indicadores de riesgo y/o protección en el tráfico. Se estimó la prevalencia y los respectivos intervalos de confianza del 95% (IC 95%), según el sexo, el grupo de edad y el tipo de escuela. Resultados: de los estudiantes de 13 a 17 años entrevistados, el 33,3% (IC 95%:32,1;33,7) declaró haber conducido un vehículo de motor o haber sido transportado en un vehículo conducido por alguien que había consumido bebidas alcohólicas, el 38,1% (IC 95%: 37,4;38,7) declararon haber sido transportados por alguien que utilizaba el teléfono móvil mientras conducía, el 17,5% (IC 95%:16,8;18,2) declararon no llevar el cinturón de seguridad en el asiento delantero y el 30,2% (IC 95%:29,4;30,9) en el asiento trasero, y el 27,1% (IC 95%:26,5;27,7) de los estudiantes declararon haber sido transportados por un conductor alcoholizado. Entre 2015 y 2019, el uso del cinturón de seguridad en el asiento trasero, se redujo del 33,7% al 30,2%, y el uso del casco cuando se conduce una moto, aumentó del 84,6% al 88,9%. Conclusión: la prevalencia de escolares que conducían o viajaban con personas bajo los efectos del alcohol o que utilizaban el teléfono móvil mientras conducían era elevada. Además, el uso del cinturón de seguridad en el asiento trasero era escaso. Entre 2015 y 2019, se redujo el uso del cinturón de seguridad en el asiento trasero y aumentó el uso del casco. Es necesario ampliar las estrategias de educación vial para los adolescentes, sus familias y tutores.

ABSTRACT Objective: to describe the prevalence of risk and protection factors for road transportation accidents (RTAs) among Brazilian adolescents. Methods: data from the 2015 and 2019 National School Health Survey were analyzed, referring to the risk and/or protection risk indicators in terms of traffic. The prevalence values and respective 95% confidence intervals (95% CI) were estimated according to gender, age group and type of school. Results: of the students aged from 13 to 17 years old that were interviewed, 33.3% (95% CI: 32.1-33.7) reported having driven a motor vehicle or being a passenger in a vehicle driven by someone who had drunk alcohol, 38.1% (95% CI: 37.4-38.7) reported having been a passenger of someone who used a cell phone while driving, 17.5% (95% CI: 16.8-18.2) reported not wearing a seatbelt in the front seat and 30.2% (95% CI: 29.4-30.9) not doing so in the back seat, and 27.1% (95% CI: 26.5-27.7) of the students reported having been a passenger of a drunk driver. Between 2015 and 2019, back-seat seatbelt use dropped from 33.7% to 30.2%, and helmet use while riding a motorcycle increased from 84.6% to 88.9%. Conclusion: the prevalence of in-school adolescents who drove or were passengers in vehicles driven by motorists under the effect of alcohol or using cell phones while driving was high. In addition to that, back-seat seatbelt use was low. Between 2015 and 2019, back-seat seatbelt use was reduced and helmet u se while riding a motorcycle increased. It is necessary to expand the traffic education strategies aimed at adolescents, their family members and guardians.

Road traffic injuries among women brought to the largest tertiary hospital in the Philippines

Introduction@#Road traffic accidents are a growing public health burden, especially in the low- and middle-income countries (LMICs). With resource scarcity, road traffic injuries may lead to poor quality of life among survivors, or deaths at worst. Victims of crashes involving transportations are gendered; therefore, there may be differences in the trends and characteristics of injuries sustained by men and women related to road crash. @*Objectives@#This study aimed to determine the factors related to severity of road crashes among women road users in the Philippines from 2008 to 2017. @*Methods@#We conducted a retrospective review of clinical records of women patients involved in road crash at the Trauma Division, Department of Surgery of the Philippine General Hospital (PGH) for the ten-year period, January 1, 2008 to December 31, 2017. Data were extracted from the electronic patient records in Integrated Surgical Information System (ISIS). @*Results@#From 2008 to 2017, 926 of the road crash victims brought to PGH were women. There was an increasing trend, with the years 2015 to 2017 accounting for half of the total cases (55.62%). The highest cases of women patient admissions were also recorded during the months of June and July (5.61%). The CALABARZON region (11.23%) and National Capital Region (8.21%) had the highest admissions. The patients were most commonly pedestrians (12.20%) and involved in collisions (13.50%) or vehicle involvement (13.17%). The most common vehicle involved was a motorcycle (9.72%) followed by car and vans (1.62%). Only a small proportion of women patients used helmets (3.33%) and seatbelts (0.12%). The median length of hospital stay of women patients was 5 days. The most commonly sustained injuries among patients were multiple (83.65%), external (43.72%), extremity (33.15%), head and neck (23.47%), and face (21.58%) injuries. Among these, injuries to the extremity had the highest average length of hospital stay (16.04 ± 31.28 days) while external and head and neck injuries had the shortest (10.81 ± 33.42 days). Multinomial regression showed that women patients who suffered from head and neck, and abdominal injuries had increased odds of dying by 4.94 times (CI: 2.158-11.302, p < 0.05), and 3.33 times (CI:1.235-9.02, p < 0.05), respectively, compared to those who did not suffer said injuries. @*Conclusion@#There is a significant number of women involved in road crashes in the Philippines, and therefore, there is a need for directed policies on female road users as vulnerable road users.

Epidemiology of tobacco use and nicotine dependence in truck drivers

ABSTRACT OBJECTIVE To investigate the epidemiology of tobacco use and nicotine dependence in a sample of truck drivers in Brazil. METHODS Between 2015 and 2016, a cross-sectional study was conducted on 624 truck drivers who operate on the BR-050 highway in Brazil. Participants were interviewed about sociodemographic data, occupational characteristics, mental health, behavioral data, and tobacco use. Then, the Fagerstrom test for nicotine dependence (FTND) was used to verify nicotine dependence in smoking truck drivers. Logistic regression and linear regression were also used to verify factors associated with tobacco use in the previous 30 days and nicotine dependence scores, respectively. RESULTS The prevalence of tobacco use among truck drivers was 21.1% (n = 132;95%CI: 18.1-24.5). Of the total number of smokers who responded to the FTND (n = 118; 89.4%), most had high/very high nicotinic dependence (68.6%; 95%CI: 59.8-76.3). Tobacco use was associated with absence of religion (adjusted odds ratio [AOR]: 2.60; 95%CI: 1.35-5.01), employment relationship of the contract (AOR = 1.98; 95%CI: 1.26-3.13); > 12 hours daily working time (AOR = 1.80; 95%CI: 1.09-2.98) and alcohol use in the previous 30 days (AOR = 2.92; 95%CI: 1.86-4.57). Irregular physical activity was associated with higher scores of nicotine dependence (β = 1.87; 95%CI: 0.55-3.19). CONCLUSION The results showed a high prevalence of tobacco use and high/very high nicotine dependence among the truck drivers.

Epidemiological progression of COVID-19 positive cases among transnational truck drivers in the East African Region

COVID-19 triggered a range of border controls to curb the spread of the disease. Containment measures and restrictions were put in place to mitigate cross border transmission while maintaining the flow of essential goods and services in the East and Horn of Africa Region. The first cases of COVID-19 detection among truck drivers, triggered and strengthened cross-border collaboration for detecting and responding to COVID-19 pandemic. Infection was significantly common among truck drivers in the region. As at 13 January 2021, there were 3,457 reported cumulative cases among truck drivers in the EHoA region. About 2,879 (83.3%) of the cases were reported in Uganda, 374 (10.8%) cases reported in Kenya, 190 (5.5%) cases reported in Rwanda and 14 (0.4%) cases reported in South Sudan. The reduction in the number of documented new COVID-19 cases among truck drivers declined with collaborative, timely and cooperative border point screening, and so preventing COVID-19 spread in the region. With most East African countries setting the stage for reopening borders and air spaces, sustained comprehensive surveillance is crucial for maintaining the gains from the collaborative response.

Prevalence and correlates of erectile dysfunction among long-distance commercial vehicle drivers and commercial motorcycle riders in Ibadan Nigeria: a comparative cross-sectional study

Background: Erectile dysfunction (ED) is a global public health problem that affects the quality of life, interpersonal, occupational, and social functioning of sufferers. Despite being high-risk groups, there is a paucity of data on erectile dysfunction among commercial vehicle drivers and motorcycle riders. Objectives: We aimed to determine and compare the prevalence and factors associated with ED among long-distance commercial vehicle drivers (CVDs) and commercial motorcycle riders (CMRs) in Ibadan, Nigeria. Methods: We used a comparative cross-sectional study design to enroll eligible male respondents in selected motor/motorcycle parks within Ibadan metropolis. Interviewer administered questionnaires were used to elicit sociodemographic/health-related characteristics, and ED status among participants. Data was analyzed using STATA version 12. Chi-square and Binary logistic regression were conducted to explore the association between ED and other covariates. Analyses were performed at 5% significance level. Results: The prevalence of ED was significantly higher among motorcycle riders than vehicle drivers (71.4% vs 47.4%, p = 0.001). Predictors of ED among CMRs were monogamous marriage type and history of perineal injury; while among CVRs were aged above 40-years, history of perineal injury, and current use of alcohol. Conclusion: There is a need for public education and awareness programmes on ED to reduce the burden and improve well-being in these populations

Potencial da utilização de sensoriamento remoto para complementar inspeções de veículos do ciclo diesel no Estado de São Paulo / Potential of the use of remote sensing to complement inspections of diesel vehicles in the State of São Paulo

As emissões de poluentes atmosféricos causam um grande problema à saúde. A maior parte da poluição gerada no Estado de São Paulo é proveniente de veículos automotores, que são responsáveis pela emissão de 96% do CO, 73% de HC, 62% de NOX e 40% de MP10, sendo os veículos diesel os maiores responsáveis pelas emissões de MP e NOX no Estado. No Brasil, as medidas tomadas pelo PROCONVE, que visam a mitigação da poluição causada por veículos, se mostram eficazes para homologação de veículos novos, porém requerem que a continuidade do trabalho seja realizada com inspeções dos veículos em uso. A tecnologia de sensoriamento remoto, desenvolvida no final dos anos 1980, tem sido amplamente utilizada para de monitoramento de frotas, assim como em programas de Inspeção e Manutenção em diversos locais do mundo. Os resultados alcançados são satisfatórios e, de forma geral, indicam grandes reduções nos níveis de emissão de poluentes. Estudos apontam que as emissões de NOX foram as que tiveram menores reduções reais entre fases das regulamentações. O Estado de São Paulo possui controle de poluentes de veículos do ciclo diesel em uso através de fiscalizações por opacidade, Escala de Ringelmann e sistema SCR. O sistema de sensoriamento remoto mostra-se como um bom complemento ao que é realizado atualmente. Foram propostos dois sistemas de legislação de inspeções veiculares que contemplam o SR como ferramenta de seleção dos veículos diesel. Além disso, foi mostrado como poderiam ser escolhidos limites para high e low emitters, assim como procedimentos para escolha dos pontos de instalação do sistema.

Emissions of air pollutants cause a big health problem. Most of the pollution generated in the State of São Paulo comes from motor vehicles, which are responsible for the emission of 96% of CO, 73% of HC, 62% of NOX, and 40% of PM10, with diesel vehicles being the biggest responsible for the emissions of PM and NOX in the state. In Brazil, the actions taken by PROCONVE, aimed at mitigating pollution caused by vehicles, prove to be effective for the approval of new vehicles but require that the continuity of the work be carried out by inspections of in-use vehicles. Remote sensing technology, developed in the late 1980s, has been widely used for fleet monitoring, as well as in Inspection and Maintenance programs in many locations around the world. The results achieved are satisfactory and, in general, indicate large reductions in pollutant emission levels. Studies show that NOX emissions were the ones that had the smallest real reductions between phases of regulations. The State of São Paulo controls in-use diesel vehicles pollutants by inspections of opacity, Ringelmann Scale, and SCR system. The remote sensing system proves to be a good complement to what is currently performed. Two systems of procedures for diesel vehicle inspections were proposed, which include the SR as a tool for the selection of diesel vehicles. In addition, it was shown how limits for high and low emitters could be chosen, as well as procedures for selecting the system installation points.

Tendência temporal das internações por acidentes de trânsito na cidade de São Paulo, Brasil, 2000-2019 / Time trend in hospitalizations from motor vehicle accidents in the city of São Paulo, Brazil, 2000-2019 / Tendencia temporal de los internamientos por accidentes de tráfico en la ciudad de São Paulo, Brasil, 2000-2019

Este estudo avaliou a tendência das taxas de internação por acidentes de trânsito no Sistema Único de Saúde (SUS), de residentes no Município de São Paulo, Brasil, entre 2000 e 2019, segundo sexo, faixa etária e meio de transporte (pedestres, ciclistas, motociclistas e ocupantes de veículo). Foi ajustado um modelo de regressão segmentada com resposta binomial negativa, com pontos de inflexão para acomodar possíveis mudanças de tendência. Foram registradas 189.765 internações durante o período de estudo, a maioria de homens (80,5%) com idade entre 20 e 49 anos (71,2%). O tipo de acidente mais frequente foi com motocicleta (42,8%), seguido dos atropelamentos de pedestres (33,7%). De um modo geral, o período de 2000 a 2007 foi marcado pelo crescimento das taxas de hospitalização por acidentes de trânsito para todos os meios de transporte, em ambos os sexos e na maioria das faixas etárias. O momento em que as taxas pararam de crescer ou que eventualmente passaram a cair foi diferente para os diferentes meios de transporte. Para ocupantes de veículos e ciclistas, a tendência na maioria das faixas etárias inverteu-se para uma de queda em 2008, mas para pedestres e motociclistas, isto só ocorreu em 2012. A partir de 2015, a queda cessou em pedestres e as taxas em ciclistas voltaram a subir, na maioria das faixas etárias. Para motociclistas, as taxas voltaram a crescer em homens de 20 a 59 anos (7,2% ao ano, atingindo valores superiores a 140 por 100 mil habitantes em 2019) e em mulheres, de 15 a 39 anos (4,9% ao ano). É possível que os benefícios das medidas de segurança implementadas até agora tenham atingido seu limite, de modo que as atuais medidas de controle e prevenção devem ser revistas.

This study assessed the hospitalization rates from motor vehicle accidents in the Brazilian Unified National Health System (SUS) in residents of the city of São Paulo, Brazil, from 2000 to 2019, according to sex, age bracket, and means of transportation (pedestrians, cyclists, motorcyclists, and motor vehicle occupants). A segmented regression model with negative binomial response was adjusted with inflection points to accommodate possible changes in trends. 189,765 hospitalizations were recorded during the study period, mostly males (80.5%) and from 20 to 49 years of age (71.2%). The most frequent type of accident involved motorcyclists (42.8%), followed by run-over pedestrians (33.7%). In general, the period from 2000 to 2007 was marked by increasing hospitalization rates from motor vehicle accidents involving all means of transportation, in both sexes, and in most age brackets. The year when the rates stopped increasing (or in some cases began to drop) differed according to the means of transportation. For vehicle occupants and cyclists, the trend in most age brackets turned downward in 2008, but the same did not happen with pedestrians and motorcyclists until 2012. Starting in 2015, the decline stopped in pedestrians, and the rates in cyclists turned upward again in most age brackets. For motorcyclists, the rates turned upward again in men 20 to 59 years of age (7.2% per year, exceeding 140 per 100,000 inhabitants in 2019) and in women 15 to 39 years of age (4.9% per year). The benefits of traffic safety measures implemented thus far in Brazil may have reached their limit, so that the current control and prevention measures need to be revised.

Este estudio evaluó la tendencia de las tasas de internamiento por accidentes de tránsito en el Sistema Único de Salud, de residentes en el Municipio de São Paulo, Brasil, entre 2000 y 2019, según sexo, franja de edad y medio de transporte (peatones, ciclistas, motociclistas y ocupantes de vehículo). Fue ajustado a un modelo de regresión segmentada con respuesta binomial negativa, con puntos de inflexión para acomodar posibles cambios de tendencia. Se registraron 189.765 internamientos durante el período de estudio, la mayoría de hombres (80,5%) con edad entre 20 y 49 años (71,2%). El tipo de accidente más frecuente fue con motocicleta (42,8%), seguido de atropellamientos de peatones (33,7%). De modo general, el período de 2000 a 2007 estuvo marcado por el crecimiento de las tasas de hospitalización por accidentes de tránsito para todos los medios de transporte, en ambos sexos, y en la mayoría de las franjas de edad. El momento en el que las tasas pararon de crecer, o que eventualmente pasaron a caer, fue diferente para los diferentes medios de transporte. En el caso de ocupantes de vehículos y ciclistas, la tendencia en la mayoría de las franjas de edad se invirtió hacia una caída en 2008, pero en peatones y motociclistas, esto solo ocurrió en 2012. A partir de 2015, la caída cesó en peatones y las tasas en ciclistas volvieron a subir, en la mayoría de las franjas de edad. Para los motociclistas, las tasas volvieron a crecer en hombres de 20 a 59 años (7,2% al año, alcanzando valores superiores a 140 por 100 mil habitantes en 2019) y en mujeres, de 15 a 39 años (4,9% al año). Es posible que los beneficios de las medidas de seguridad implementadas hasta ahora hayan alcanzado su límite, de modo que las actuales medidas de control y prevención deben ser revisadas.

Optimal Dispatch and Technical and Economic Feasibility Analysis of Residential Microgrids Considering Demand Side Management

Abstract The electrical system is becoming more robust with the insertion of distributed energy resources (DERs) and the need for energy autonomy by consumers, given that the current scenario is a growth in demand for electric energy. This paper aims to apply a computational model capable of determining the optimal hourly allocation of controllable loads in residence, as well as studying the optimal dispatch of residential microgrids considering management on the demand side. In addition, this paper presents an economic feasibility analysis of residential microgrids considering distributed generation from wind and solar sources, distributed storage, electric vehicles, and residential controllable loads. Thus, it was possible to conclude that in residence, the insertion of distributed energy generation and storage elements can present a significant reduction in electric energy costs, which can be even greater if these elements are associated with optimized controllable load management.

Preditores da intenção de abandono profissional em caminhoneiros / Predictors of intention to leave profession in truck drivers

Apesar da importância da retenção de caminhoneiros, há pouca compreensão acerca das variáveis e suas interações para explicar a intenção do abandono profissional. O objetivo deste estudo foi avaliar as variáveis sociodemográficas, laborais, psicossociais, estressores ocupacionais e a satisfação no trabalho como possíveis preditores da intenção de abandono em uma amostra de 565 caminhoneiros brasileiros. Como instrumentos de avaliação, foram utilizadas as Subescalas de Tendência ao Abandono, Satisfação no Trabalho e Riscos Psicossociais, questionários de variáveis sociodemográficas, laborais e estressores ocupacionais. Os resultados obtidos por meio da análise de regressão linear múltipla apontaram um modelo explicativo para a tendência ao abandono composto por sete variáveis que conjuntamente explicaram 29,2% da variância, sendo a satisfação no trabalho a variável de maior poder preditivo (13,2%). O estudo sugere ações de retenção desses profissionais aos gestores do transporte, com o objetivo de evitar a rotatividade dessa categoria.

Despite the importance of truck driver's retention, there is not enough understanding about the variables that interact to explain the intention to leave the profession. The objective of this study was to evaluate variables such as, sociodemographic, labor, psychosocial, occupational stressors and satisfaction with work, as possible predictors of abandonment, in a sample of 565 Brazilian truck drivers. For data capture purposes, a set of assessment tools was used. It was composed by: Subscales of Tendency to Abandonment, Job Satisfaction and Psychosocial risks, sociodemographic, labor and occupational stressors questionnaire. The results obtained by multiple linear regression analysis, have indicated seven variables to explain the model variance of 29,2%, with job satisfaction having the most significant prediction capacity (13,2%). The study suggests some retention actions by the management level on truckload carriers, in order to avoid the turnover of this job category.

Tecnologias da informação e comunicação na educação em saúde acerca do Coronavírus: relato de experiência / Tecnologías de la información y comunicación en educación sanitaria relacionadas con Coronavirus: reporte de experiencia / Information and communication technologies applied to health education related to Coronavirus: experience report

Objetivo: relatar a experiência de docentes da Universidade Federal de Pelotas quanto ao uso de tecnologias de informação e comunicação no desenvolvimento de atividades de educação em saúde para trabalhadores do transporte individual de passageiros e entregadores, quanto à prevenção do coronavírus. Método: relato de experiência sobre ação de educação em saúde, realizada entre abril e maio de 2020, utilizando-se infográficos e podcasts como material educativo que foram disseminados por intermédio de redes sociais e aplicativos de mensagens instantâneas de texto para celulares. Resultados: os materiais educativos sobre as medidas de prevenção ao coronavírus foram produzidos pelos docentes e disponibilizados online para as associações e sindicatos de motoristas de Pelotas e outras regiões do Brasil. Conclusões: a ação foi considerada bem-sucedida, em virtude da ampla difusão do material produzido para diferentes regiões do Brasil.(AU)

Objective: to report the experience of teachers at the Federal University of Pelotas regarding the use of information technologies and communication in the development health education activities for workers in the individual transport passengers and delivery personnel, regarding the prevention of Coronavirus. Method: experience report on health education action, carried out between April and May 2020, using infographics and podcasts as educational material that were disseminated through social networks and instant messaging applications for mobile phones. Results: the educational materials on Coronavirus prevention measures were produced by teachers and made available online for drivers' associations and unions in Pelotas and other regions of Brazil. Conclusions: the action was considered successful, due to the wide dissemination of the material produced to different regions of Brazil.(AU)

Objetivo: informar sobre la experiencia de profesores de la Universidad Federal de Pelotas con respecto al uso de las tecnologías de la información y la comunicación en el desarrollo de actividades de educación sanitaria para los trabajadores en el transporte individual de pasajeros y el personal de entrega, en relación con la prevención del Coronavirus. Método: informe de experiencia sobre acciones de educación para la salud, realizado entre abril y mayo de 2020, utilizando material educativo que se difundió por medio de redes sociales y aplicaciones de mensajería instantánea para teléfonos celulares. Resultados: los materiales educativos sobre las medidas de prevención del Coronavirus fueron producidos por profesores y puestos a disposición en línea para las asociaciones y sindicatos de conductores en Pelotas y otras regiones de Brasil. Conclusiones: la acción se consideró exitosa debido a la amplia difusión del material producido a diferentes regiones de Brasil.(AU)

Comportamentos alimentares de risco à saúde e fatores associados entre motoristas de caminhão / Unhealthy eating habits and associated risk factors among truck drivers

Resumo O objetivo deste artigo é identificar fatores associados aos comportamentos alimentares de risco à saúde entre motoristas de caminhão. Trata-se de um estudo transversal realizado com motoristas de caminhão entrevistados no Porto de Paranaguá. Foram obtidas informações sobre o consumo de frutas, verduras e legumes, salgados fritos, bebidas açucaradas industrializadas e doces, e retirada de gordura visível de carne vermelha e da pele de carne de frango. Modelos hierarquizados foram construídos para identificar fatores associados aos comportamentos alimentares de risco à saúde. Dos entrevistados (n = 670), 53,1% apresentaram quatro ou mais comportamentos alimentares de risco à saúde. Tal condição associou-se com idade inferior a 40 anos (RP = 1,49; IC95% = 1,28-1,73), capacidade para exercer a profissão referida como moderada/baixa/muito baixa (RP 1,28; IC 95% 1,08-1,52), não praticar atividade física no tempo livre (RP = 1,66; IC95% = 1,38-2,00), qualidade da alimentação referida como ruim/muito ruim (RP = 1,25; IC95% = 1,05-1,49) e índice de massa corporal (IMC) < 25 Kg/m2 (RP = 1,22; IC95% = 1,05-1,43). Mais da metade dos motoristas de caminhão apresentaram comportamentos alimentares de risco à saúde, reforçando a necessidade de estratégias de incentivo à redução desses hábitos.

Abstract The scope of this article is to identify risk factors associated with unhealthy eating habits among truck drivers. It involved a cross-sectional study carried out with truck drivers individually interviewed at the Port of Paranaguá in the State of Paraná, Brazil. Information was obtained on the consumption of fruit, vegetables, fried salted food, sweetened beverages, and the removal of visible fat from red meat and of skin from chicken meat. Hierarchical Poisson regression models were applied to identify factors associated with unhealthy eating habits. Of those interviewed (n = 670), 53.1% had four or more unhealthy eating habits. This condition was associated with age less than 40 years (prevalence ratio, PR = 1.49; 95% confidence interval, CI = 1.28-1.73), moderate, low or very low ability to exercise the profession (PR 1.28; 95% CI 1.08-1.52), not taking physical exercise in free time (PR = 1.66; 95%CI = 1.38- 2.00), overall self-reported eating habits as poor or very poor (RP = 1.25; IC95% = 1.05-1.49) and body mass index < 25 Kg/m2 (PR = 1.22; 95% CI = 1.05-1.43). More than half of the truck drivers revealed unhealthy eating habits, highlighting the need for strategies to rectify these habits.

Nota informativa nº 01/2020-GST/DVAST/SVS/SES: nota técnica recomendações aos caminhoneiros ­ prevenção ao Covid-19 / Informative note nº 01/2020-GST / DVAST / SVS / SES: technical note recommendations to truck drivers - prevention to Covid-19

Recomendações para assegurar a proteção dos caminhoneiros em período de pandemia no enfrentamento a Covid-19.

Recommendations to ensure the protection of truck drivers in a pandemic period when facing Covid-19.

Recomendaciones para garantizar la protección de los camioneros en un período pandémico frente al Covid-19.

Accidentalidad vial: efectos de la calidaddel sueño en el funcionamiento ejecutivo deconductores de transporte público urbano / Road accident: effects of sleep quality on the executiveFunctioning of urban public transport drivers

El propósito de este estudio fue comprender cómo la calidad del sueño, los cam-bios de las funciones ejecutivas y su posible asociación con la accidentalidad vial en los conductores de servicio de transporte público urbano son temas fundamentales para los escenarios de prevención de accidentes en las ciudades. Esta investigación se desarrolló con un diseño cuantitativo-analítico, observacional, prospectivo y re-trospectivo, para evaluar estos tres puntos, a saber: la calidad de sueño, el funciona-miento ejecutivo y su relación con la siniestralidad de tránsito. A partir de un sondeo preliminar, realizado en trabajadores de servicio público y urbano en el 2010, se hizo una segunda evaluación en 2016 para examinar la trazabilidad de los cambios observables en los tres factores delimitados. Nuestro estudio pudo determinar que la perturbación del sueño sugiere una tendencia al deterioro en la ejecución de tareas que exigen flexibilidad y planificación, lo cual contribuye a aumentar la accidentali-dad vial entre los conductores de servicio público.

The objective of this study is to understand how sleep quality, changes in executive functions and the possible association with the presence of traffic accidents in ur-ban public transport service drivers is fundamental in accident prevention context in cities. This research developed a quantitative-analytical, observational, prospective and retrospective design, to evaluate three essential points: sleep quality, executive function and their relationship with the traffic accident rate of drivers. From a pre-liminary observation of public service and urban drivers made in 2010, a second evaluation was made up to 2016, to examine the three chosen factors. Our study was able to determine that the effect on sleep quality suggests a trend towards a de-terioration in flexibility and planning tasks, which contributes to an increase in road accidents among public service drivers

Concurrent Posterolateral Corner Injury Associated with a Schatzker Type 2 Tibial Plateau Fracture: A Case Report

Isolated posterolateral corner (PLC) injury associated with a Schatzker type 2 fracture is a very rare combination of injuries. A male who was driving a motor vehicle was injured after a collision accident. The plain radiographs and computed tomography scans of the knee showed a Schatzker type 2 fracture of the tibial plateau, mostly in the anterolateral portion of tibial plateau, and an avulsion fragment on the fibular tip. Magnetic resonance imaging showed no injury to cruciate ligaments, medial collateral ligament, or any meniscal injury. We performed an open reduction operation and internal fixation for treating the fracture. Six months later, he complained of instability. At 11 months later after initial operation, we performed the second operation for stabilizing the PLC. We present here a rare case of an isolated PLC injury associated with a Schatzker type 2 fracture. We discuss the mechanism of injury and review similar cases.

A percepção de caminhoneiros sobre o uso de substâncias psicoativas no trabalho: um estudo etnográfico / The perception of truck drivers on the use of psychoactive substances at work: an ethnographic study / La percepción de camioneros sobre el uso de sustancias psicoactivas en el trabajo: un estudio etnográfico

OBJETIVO: compreender a experiência subjetiva de caminhoneiros em relação ao uso de substâncias psicoativas. MÉTODO: utilizou-se método qualitativo de caráter etnográfico. RESULTADOS: os elementos encontrados, tais como elevado índice de consumo de substâncias, corroboram estudos epidemiológicos acerca da temática, acrescentando, todavia, sentidos subjetivos e depoimentos. CONCLUSÃO: há uma divergência de opiniões que enfraquece a categoria em relação à negociação por melhores condições de trabalho, ao mesmo tempo que o uso de substâncias ilícitas é considerado normal e não é questionado por parte dos participantes.

OBJECTIVE: to understand the subjective experience of truck drivers regarding the use of psychoactive substances. METHOD: an ethnographic approach to qualitative research was employed. RESULTS: the discovered elements, such as high levels of substance abuse, corroborate epidemiological research about the theme including, however, subjective feelings and testimonials. CONCLUSIONS: there is a divergence of opinions that weakens the category regarding negotiation for better working conditions, while the use of illicit substances is considered normal and is unquestioned by the subjects.

OBJECTIVOS: comprender la experiencia subjetiva de camioneros con respecto al uso de sustancias psicoactivas. MÉTODO: se utilizó el método cualitativo de carácter etnográfico. RESULTADOS: los elementos encontrados, como el alto índice de uso de sustancias, corroboran los estudios epidemiológicos sobre el tema, agregando, sin embargo, sentimientos subjetivos y testimonios. CONCLUSIONES: existe una divergencia de opiniones que debilita la categoría en relación con la negociación para mejorar las condiciones de trabajo, mientras que el uso de sustancias ilícitas se considera normal y no se cuestiona por los sujetos.

Circulação e cidadania: modos de comunicar na cidade / Circulation and citizenship: ways of communicating in the city / Circulación y ciudadanía: formas de comunicación en la ciudad

Este texto pretende discutir, a partir de uma perspectiva comunicacional, a relação entre circulação urbana e cidadania. Em um primeiro momento introdutório, nos deteremos principalmente nos conceitos de sistemas comunicacionais, comum e comunicação. Em seguida, pensaremos como o paradigma moderno de circulação, histórica e contemporaneamente, interfere na organização do comum e nos espaços da cidade de modo a privilegiar circuitos domésticos e de consumo em detrimento de usos e ocupações mais livres do espaço público. Por fim, discutiremos sobre a ideia de cidadania no Brasil para pensar com há uma relação explícita no modo como se circula na cidade, se constitui o comum urbano e se dispõe de certos direitos, especificamente o de liberdade de locomoção, ou, se quisermos, o direito de ir e vir.

This text intends to discuss, from a communicational perspective, the relationship between urban circulation and citizenship. In the first introductory moment, we will focus mainly on the concepts of communication, common and communication systems. Next, we will think about how the modern paradigm of circulation, historically and contemporarily, interferes with the organization of the commons and the city spaces in order to privilege domestic and consumption circuits over the freer uses and occupations of public space. Finally, we will discuss about the idea of citizenship in Brazil to think with there is an explicit relation in the way it circulates in the city, if it constitutes the urban common and if it has certain rights, specifically freedom of movement, or, if we wish, the right to come and go.

Este texto pretende discutir, desde una perspectiva comunicacional, la relación entre la circulación urbana y la ciudadanía. En el primer momento introductorio, nos centraremos principalmente en los conceptos de comunicación, sistemas comunes y de comunicación. A continuación, pensaremos cómo el paradigma moderno de la circulación, histórica y contemporáneamente, interfiere con la organización de los espacios comunes y municipales para privilegiar los circuitos domésticos y de consumo sobre los usos y ocupaciones más libres del espacio público. Finalmente, discutiremos sobre la idea de ciudadanía en Brasil para pensar que existe una relación explícita en la forma en que circula en la ciudad, si constituye el común urbano y si tiene ciertos derechos, específicamente la libertad de movimiento o, si lo deseamos, El derecho a ir y venir.