Efecto de la deuda económica sobre el bienestar psicológico de los residentes de cirugía: Resultados de un estudio nacional en Colombia / Effect of financial debt on the psychological well-being of surgery residents: Results of a national study in Colombia

Introducción. La deuda económica durante la residencia en cirugía general puede afectar el desempeño profesional, las decisiones de vida y el bienestar psicológico. La información disponible en Colombia es limitada. El objetivo de este estudio fue cuantificar la deuda económica del residente de cirugía general, identificar los factores asociados y evaluar su efecto en el bienestar psicológico. Métodos. Estudio de corte transversal analítico. Se invitó a 380 residentes a diligenciar una encuesta sobre los aspectos relacionados con su deuda económica y se utilizó el WHO-index para evaluar su bienestar psicológico. Resultados. Un total de 259 residentes participaron en el estudio (67,6 %). El 56 % posee una deuda económica promedio de COP $88.000.000 ((US$21.826)). Un alto nivel de endeudamiento se relacionó con el año de residencia, el tipo de institución (privada) y la solicitud de préstamos. Se identificó algún trastorno mental en 14,7 % y un bajo nivel de bienestar psicológico en 56,4 % de los participantes. No se identificó ninguna asociación entre una elevada deuda económica y el bajo bienestar psicológico. Conclusiones. La deuda económica tiene un efecto sobre los residentes. El endeudamiento de los residentes de cirugía en Colombia es altamente prevalente, y no se correlaciona con un pobre bienestar psicológico. La autodeterminación favorece el bienestar psicológico en el posgrado en cirugía general. Existe la necesidad de educación financiera en los residentes. Se requieren nuevos estudios que evalúen las causas del pobre bienestar psicológico.

Introduction. Financial debt during surgery residency can affect professional performance, life decisions, and psychological well-being. The information available in Colombia is limited. The objective of this study is to quantify the financial debt of the general surgery resident, identify the associated factors and evaluate their effect on psychological well-being. Methods. A cross-sectional study was carried out. A total of 380 residents were invited to complete a survey on aspects related to their financial debt, and the WHO-index to evaluate their psychological well-being. Results. A total of 259 residents participated in the study (67.6%). 56% have an average economic debt of $88,000,000 COP (US$21,826). High debt was related to level of residence, type of institution (private), and loan application. Some mental disorder was identified in 14.7% and a low level of psychological well-being in 56.4% of the participants. No association was identified between high financial debt and low psychological well-being. Conclusions. Economic debt has an effect on residents. Financial debt among surgical residents in Colombia is highly prevalent; however, it does not correlate with poor psychological well-being. Self-determination favors psychological well-being in the postgraduate course in general surgery. Likewise, the need for financial education in residents is imminent. New studies are required that thoroughly evaluate the causes of poor well-being.

Calidad de vida y toxicidad financiera de los receptores de trasplantes de células madre hematopoyéticas en COVID-19 / Quality of life and financial toxicity of hematopoietic stem cell transplant recipients in COVID-19 / Qualidade de vida e toxicidade financeira dos transplantados de células-tronco hematopoéticas na COVID-19

Objetivo: evaluar y correlacionar la calidad de vida y la toxicidad financiera de pacientes adultos sometidos a trasplante de células madre hematopoyéticas durante el período de la pandemia de COVID-19. Método: estudio observacional, analítico, realizado con 35 pacientes en un hospital de referencia para trasplante en Latinoamérica. Para la recolección de datos, se utilizaron los cuestionarios Functional Assessment Cancer Therapy Bone Marrow Transplantation y el COmprehensive Score for financial Toxicity. Para el análisis de los datos se utilizaron las pruebas de correlación de Spearman y Mann-Whitney. Resultados: la calidad de vida general durante la COVID-19 mostró un puntaje bajo (67,09/108) con mayor deterioro en el bienestar funcional (14,47/28), bienestar social (16,76/28) y preocupaciones adicionales (23,41/40). Los promedios del grupo alogénico fueron inferiores a los del grupo autólogo en todos los dominios, presentando diferencia significativa en relación a preocupaciones adicionales (p=0,01) y en el índice de evaluación del tratamiento (p=0,04). Se consideró que la toxicidad financiera tenía un impacto leve (22.11/44). Se observó una relación, aunque no significativa, entre la calidad de vida y la toxicidad financiera (p=0,051). Conclusión: la calidad de vida de la muestra fue baja; existe una correlación entre la calidad de vida y la toxicidad financiera, aunque no significativa. Cuanto mayor es la toxicidad financiera, menor es la calidad de vida.

Objective: to evaluate and correlate the quality of life and financial toxicity of adult patients undergoing hematopoietic stem cell transplantation during the COVID-19 pandemic. Method: observational, analytical study, carried out with 35 patients in a reference hospital for transplantation in Latin America. For data collection, the Functional Assessment Cancer Therapy Bone Marrow Transplantation and COmprehensive Score for Financial Toxicity questionnaires were used. Spearman and Mann-Whitney correlation tests were used for data analysis. Results: general quality of life during COVID-19 had a low score (67.09/108) with greater impairment in functional well-being (14.47/28), social well-being (16.76/28) and additional concerns (23.41/40). The means of the allogeneic group were lower than those of the autologous group in all domains, showing a significant difference in relation to additional concerns (p=0.01) and in the treatment evaluation index (p=0.04). Financial toxicity was considered to have a slight impact (22.11/44). There was a relationship, albeit not significant, between quality of life and financial toxicity (p=0.051). Conclusion: the quality of life of the sample was low; there is a correlation between quality of life and financial toxicity, although not significant. The higher the financial toxicity, the lower the quality of life.

Objetivo: avaliar e correlacionar a qualidade de vida e a toxicidade financeira dos pacientes adultos submetidos ao transplante de células-tronco hematopoéticas no período da pandemia de COVID-19. Método: estudo observacional, analítico, realizado com 35 pacientes em um hospital de referência para o transplante na América Latina. Para coleta de dados, utilizaram-se os questionários Functional Assessment Cancer Therapy Bone Marrow Transplantation e COmprehensive Score for financial Toxicity. Na análise dos dados empregaram-se os testes de correlação de Spearman e Mann-Whitney. Resultados: a qualidade de vida geral, durante a COVID-19, apresentou baixo escore (67,09/108), com maior comprometimento nas funções bem-estar funcional (14,47/28), social (16,76/28) e preocupações adicionais (23,41/40). As médias do grupo alogênico foram inferiores às do autólogo em todos os domínios, apresentando diferença significativa em relação às preocupações adicionais (p=0,01) e ao índice de avaliação do tratamento (p=0,04). A toxicidade financeira foi considerada de impacto leve (22,11/44). Observou-se relação, ainda que não significativa, entre a qualidade de vida e a toxicidade financeira (p=0,051). Conclusão: a qualidade de vida da amostra foi baixa, logo há uma correlação entre qualidade de vida e a toxicidade financeira, embora não significativa. Quanto maior a toxicidade financeira, menor a qualidade de vida.

Rentabilidad contable y EVA de la empresa colombiana constructora de otras obras de ingeniería civil

El objetivo de la investigación es evaluar la rentabilidad contable y el valor económico agregado de la constructora colombiana de otras obras de ingeniería civil en el período 2016-2021, mediante un método de análisis estático y de tendencias de indicadores contables y de gestión de valor Se encuentra que las ventas, activos y utilidad neta de la constructora fluctúan; logra rentabilidades sobre el patrimonio en cuatro años y en promedio, donde sobresale la eficacia en el control de costos y gastos como factor determinante en su comportamiento. No obstante, esta rentabilidad es menor que la constructora de mayores ventas en Colombia y aún más baja que la de su homóloga en países emergentes. Pese a las rentabilidades contables positivas de la constructora colombiana de otras obras de ingeniería civil, esta destruye valor económico agregado en cinco años y el valor de mercado agregado en el sexenio es negativo. Este resultado difiere al de la constructora afín en economías emergentes que crea valor económico agregado en cuatro años y el valor de mercado agregado es positivo en el sexenio. CLASIFICACIÓN JEL G30, L74, M4I

The objective of the research is to evaluate the accounting profitability and added economic value of the Colombian construction company of other civil engineering works in the period 2016-2021, through a method of static analysis and trends of accounting indicators and value management. The construction company's sales, assets, and net income are found to fluctuate; It achieves returns on equity in four years and on average, where efficiency in cost and expense control stands out as a determining factor in its behavior However this profitability is lower than that of the construction company with the highest sales in Colombia and even lower than that of its counterpart in emerging countries. Despite the positive accounting returns of the Colombian construction company of other civil engineering works, it destroys added economic value in five years and the added market value in the six years is negative. This result differs from that of the similar construction company in emerging economies, which creates added economic value in four years and the added market value is positive in six years. JEL CLASSIFICATION G30, L74, M4I

O objetivo da pesquisa é avaliar a rentabilidade contabilística e o valor econômico agregado da construtora colombiana de outras obras de engenharia civil no período 2016-2021, através de um método de análise estática e tendências de indicadores contábeis e gestão de valor. As vendas, os ativos e o lucro líquido da construtora flutuam; Obtém rentabilidade sobre o patrimônio em quatro anos e em média, onde a eficiencia no controle de custos e despesas se destaca como fator determinante em seu comportamento. No entanto, essa rentabilidade é inferior à da construtora com maior faturamento na Colômbia e ainda inferior à de sua congênere nos países emergentes. Apesar dos retornos contábeis positivos da construtora colombiana de outras obras de engenharia civil, ela destrói valor econômico agregado em cinco anos e o valor agregado de mercado em seis anos é negativo. Esse resultado difere do da construtora similar nas economias emergentes, que cria valor econômico agregado em quatro anos e o valor agregado de mercado é positivo em seis anos. CLASSIFICAÇÃO JEL G30, L74, M41

Presupuesto público en salud y sus efectos en la desnutrición crónica infantil. El caso peruano / Public health budget and its effects on chronic child malnutrition. The Peruvian case / Orçamento da saúde pública e seus efeitos sobre a desnutrição infantil crônica. O caso peruano

En la actualidad, aunque las tasas de malnutrición que afectan a los pueblos indígenas y a las zonas de bajos ingresos han disminuido en un 33,8%, América Latina sigue registrando niveles alarmantes de malnutrición, especialmente a nivel infantil. En el caso de Perú en particular, urge estudiar el impacto del presupuesto sanitario en la dinámica de la desnutrición infantil. Objetivo. Analizar la incidencia del presupuesto de salud pública en la reducción de la desnutrición infantil en Perú durante las dos últimas décadas. Metodología. Revisión narrativa acerca del impacto de los presupuestos de salud pública en la desnutrición. Dentro de busqueda se consideraron bases de datos como Scopus, Web of Science, Scielo, Redalyc, Latindex y Google Scholar desde el 2019 a 2023. Considerando con ecuación health budget" OR "chronic child malnutrition", "government spending" con la función booleana AND como parámetros de búsqueda para el campo "topic" para encontrar documentos que también trataran sobre "malnutrition" OR "chronic child malnutrition" OR "child malnutrition". Resultados. Se identificaron 57 fuente, se excluyeron 4 artículos por duplicidad y 37 por falta de información, dando como resultando un total de 16 artículos a considerar en este análisis. Conclusión. Se puede concluir que existe una relación significativa entre el aumento del presupuesto público en salud y la disminución de la desnutrición infantil a nivel nacional. La literatura existente destaca que a medida que se incrementa la asignación presupuestaria en el ámbito de la salud, se observa una reducción correspondiente en las tasas de desnutrición.

Currently, although malnutrition rates affecting indigenous peoples and low-income areas have decreased by 33.8%, Latin America continues to register alarming levels of malnutrition, especially at the child level. In the case of Peru in particular, there is an urgent need to study the impact of the health budget on the dynamics of child malnutrition. Objective. To analyze the impact of the public health budget on the reduction of child malnutrition in Peru during the last two decades. Methodology. Narrative review of the impact of public health budgets on malnutrition. Within the search, databases such as Scopus, Web of Science, Scielo, Redalyc, Latindex and Google Scholar from 2019 to 2023 were considered. Considering with equation health budget" OR "chronic child malnutrition", "government spending" with the Boolean function AND as search parameters for the field "topic" to find documents that also dealt with "malnutrition" OR "chronic child malnutrition" OR "child malnutrition". Results. Fifty-seven sources were identified, 4 articles were excluded due to duplicity and 37 due to lack of information, resulting in a total of 16 articles to be considered in this analysis. Conclusion. It can be concluded that there is a significant relationship between the increase in the public health budget and the decrease in child malnutrition at the national level. The existing literature highlights that as the health budget allocation increases, a corresponding reduction in malnutrition rates is observed.

Atualmente, embora as taxas de desnutrição que afetam os povos indígenas e as áreas de baixa renda tenham diminuído em 33,8%, a América Latina continua a registrar níveis alarmantes de desnutrição, especialmente no nível infantil. No caso do Peru, em particular, há uma necessidade urgente de estudar o impacto do orçamento da saúde na dinâmica da desnutrição infantil. Objetivo. Analisar o impacto do orçamento da saúde pública na redução da desnutrição infantil no Peru nas últimas duas décadas. Metodologia. Revisão narrativa do impacto dos orçamentos públicos de saúde sobre a desnutrição. Bases de dados como Scopus, Web of Science, Scielo, Redalyc, Latindex e Google Scholar de 2019 a 2023 foram consideradas na pesquisa. Considerando com equação "health budget" OR "chronic child malnutrition", "government spending" com a função booleana AND como parâmetros de pesquisa para o campo "topic" para encontrar documentos que também tratassem de "malnutrition" OR "chronic child malnutrition" OR "child malnutrition". Resultados. Foram identificadas 57 fontes, 4 artigos foram excluídos devido à duplicação e 37 devido à falta de informações, resultando em um total de 16 artigos a serem considerados nesta análise. Conclusão. Pode-se concluir que existe uma relação significativa entre o aumento do orçamento da saúde pública e a redução da desnutrição infantil em nível nacional. A literatura existente destaca que, à medida que a alocação do orçamento de saúde aumenta, observa-se uma redução correspondente nas taxas de desnutrição.

Combatting the financing of terrorism in conflict (war) conditions / Lucha contra la financiación del terrorismo en situaciones de conflicto (guerra) / Combate ao financiamento do terrorismo em condições de conflito (guerra)

The scientific article analyses modern terrorist threats in the territory of Ukraine, associated with the active use of financial assets, the latest technologies and innovative financial instruments, in particular cryptocurrencies. The positive experience of legislative initiatives and advanced practices of several foreign countries in combatting the legalisation of funds by illegal means and the financing of terrorism is highlighted. The problems of implementation of state policy in this sphere are revealed. Based on this, ways of improving the system of fighting terrorism in Ukraine on the international and national levels have been determined. It was concluded that the basis of the state policy in the field of combatting terrorism during the period of martial law and in the post-war period in Ukraine should be the development of the Strategy for Combatting Terrorism in Ukraine, which should take into account both the best world practices and the modern realities of waging war in the conditions of supporting terrorism with financial infusions.

El artículo científico analiza las amenazas terroristas modernas en el territorio de Ucrania, asociadas al uso activo de activos financieros, las últimas tecnologías e instrumentos financieros innovadores, en particular las criptodivisas. Se destaca la experiencia positiva de las iniciativas legislativas y las prácticas avanzadas de varios países extranjeros en la lucha contra la legalización de fondos por medios ilegales y la financiación del terrorismo. Se ponen de manifiesto los problemas de aplicación de la política estatal en este ámbito. Se concluye que la base de la política estatal en el ámbito de la lucha contra el terrorismo durante el período de la ley marcial y en el período de posguerra en Ucrania debe ser el desarrollo de la Estrategia de Lucha contra el Terrorismo en Ucrania, que debe tener en cuenta tanto las mejores prácticas mundiales y las realidades modernas de hacer la guerra en las condiciones de apoyo al terrorismo con infusiones financieras.

O artigo científico analisa as ameaças terroristas modernas no território da Ucrânia, associadas ao uso ativo de ativos financeiros, às tecnologias mais recentes e aos instrumentos financeiros inovadores, em especial as criptomoedas. A experiência positiva de iniciativas legislativas e práticas avançadas de vários países estrangeiros no combate à legalização de fundos por meios ilegais e ao financiamento do terrorismo é destacada. Os problemas de implementação da política estatal nessa esfera são revelados. Com base nisso, foram determinadas formas de aprimorar o sistema de combate ao terrorismo na Ucrânia em nível internacional e nacional. Concluiu-se que a base da política do Estado no campo do combate ao terrorismo durante o período da lei marcial e no período pós-guerra na Ucrânia deve ser o desenvolvimento da Estratégia de Combate ao Terrorismo na Ucrânia, que deve levar em conta tanto as melhores práticas mundiais quanto as realidades modernas de guerra nas condições de apoio ao terrorismo com infusões financeiras.

A STUDY ON FINANCIAL MODELING USING 3 STATEMENT MODEL AND DCF VALUATION: AN INSIGHT FOR NEW ENTREPRENEURS

Financial statements reect the position of a company in respect of its wealth and protability in its short- term and long-term existence. The company's result in terms of protability is reected in the Prot and Loss statement for a nancial year. The Long term nancial health of the company in terms of its wealth creation will be reected in its Financial Position Statement, termed as a Balance sheet reecting its assets and liability position throughout its existence. Various nancial modelling techniques are used to predict the future of a company. The 3-statement model predicts the company's nancial strength for the future regarding the Balance sheet, prot and Loss Account and Cash ow statement. The study aims to predict the nancial statements for a future period of 5 years based on the company's past performance. The study was based on the nancial performance of Siemens AG for the past ve years, and it attempts to predict the future 5 years of the company under study.

Global financial crisis and musculoskeletal pain: systematic review / Crise financeira mundial e dores musculoesqueléticas: revisão sistemática

ABSTRACT BACKGROUND AND OBJECTIVES: In recent history, major catastrophes are followed by economic crisis, which are commonly succeeded by high levels of psychological stress related to financial hardships. The relationship between this financial stress (FS) and musculoskeletal pain (MP) is not elucidated. The aim of this systematic review was to critically evaluate the evidence of the relationship between these financial difficulties and MP. METHODS: A comprehensive search was conducted on the following databases: Medline, LILACS, Scielo and PsycINFO. Studies included were observational, among adults, measuring FS and its association with MP worsening or development, recruiting participants or data from any setting, and providing outcome data for at least one pain outcome measure. RESULTS: 445 potentially relevant citations was identified, which included 438 unique citations, 419 of which did not meet inclusion criteria. Final search included nine studies. The most frequent pain types reported were low back pain and neck pain. Descriptions of financial stress varied. Overall, exposure to financial stress was determined according to some difficulty in relation to afford necessities. All studies, except one, found significant associations between some type of MP and FS. CONCLUSION: This systematic review brought the available data on the relationship between FS and MP. It is possible to state that there is reasonable evidence of FS as a strong predictor for the onset of MP. It is necessary to be aware of this issue when dealing with pain patients during the current humanitarian crisis.

RESUMO JUSTIFICATIVA E OBJETIVOS: Na história recente, grandes catástrofes são seguidas de crises econômicas, que comumente são acompanhadas por altos níveis de estresse psicológico relacionado a dificuldades financeiras. A relação entre esse estresse financeiro (EF) e a dor musculoesquelética (DME) não está elucidada. O objetivo desta revisão sistemática foi avaliar criticamente as evidências da relação entre tais dificuldades financeiras e a DME. MÉTODOS: Uma busca abrangente foi realizada nas seguintes bases de dados: Medline, LILACS, Scielo e PsycINFO. Os estudos incluídos foram observacionais, entre adultos, aferindo o EF e sua associação com a piora ou desenvolvimento de uma DME, recrutando participantes ou dados de qualquer ambiente, e fornecendo dados de resultado para ao menos uma medida de resultado de dor. RESULTADOS: Foram identificadas 445 citações potencialmente relevantes, que incluíram 438 citações únicas, 419 das quais não atenderam aos critérios de inclusão. A pesquisa final incluiu 9 estudos. Os tipos de dor mais frequentes relatados foram lombalgia e cervicalgia. Descrições de estresse financeiro variaram. No geral, a exposição ao estresse financeiro foi determinada de acordo com alguma dificuldade em relação às necessidades de pagamento. Todos os estudos, exceto um, encontraram associações significativas entre algum tipo de DME e EF. CONCLUSÃO: Este estudo trouxe os dados disponíveis sobre a relação entre EF e DME. É possível afirmar que há razoável evidência do EF como um forte preditor para o aparecimento de DME. É preciso estar ciente dessa questão ao lidar com pacientes com dor durante a atual crise humanitária.

Birth Preparedness and Complication Readiness among Pregnant and Recently Delivered Women in Gandhinagar District, Gujarat, India: A Community-based Cross-sectional Study

Background: Birth Preparedness and Complication Readiness (BPCR) helps in improving the effective utilization of available maternal and newborn health care services through knowledge of danger sign, identifying birth place and attendant, means of transportation, managing fund for an emergency, birth companion and identification of blood donor. Aim: To find the association between socio-demographic characteristics and BPCR index indicators. Settings and Design: A cross-sectional study was conducted among the recently delivered and pregnant women in urban and rural areas of the Gandhinagar district of Gujarat. Methods and Material: Total 420 pregnant and recently delivered women from urban and rural areas were interviewed for study. A pretested semi-structured questionnaire was used to interview women at household setting. BPCR index is estimated by set of 7 quantifiable indicators and expressed in the percentage of women with specific characteristics. Results: Regarding ANC registration within 12th weeks of pregnancy and skilled birth attendant for delivery. Significant difference was observed with variable like APL/BPL status, education of women and their husband, parity and type of family. Conclusions: Hindu religion, APL economic status, higher education level, joint family, high parity and joint family were found important predictor of better BPCR practice.

A Study On Awareness Of Pradhan Mandri Jandhan Yojana In Erode District

Financial inclusion is an important factor for a country's development. Government is continuously taking some measures for financial inclusion, one among such measure is introduction of Pradhan Mandri Jan Dhan Yojan with so many useful features. Even though the Government is taking initiatives, the awareness of public on this scheme questionable. This study is an attempt to study the awareness of PMJDY in Erode District. The researcher has collected 110 samples using convenient sampling technique. The findings stated that, all the socio-economic variables are associated with awareness. Further certain segments are more aware of PMJDY than of others.When it comes to source of awareness, visual media is found to be more influential than others.

LEVEL OF FINANCIAL LITERACY: A STUDY IN KODAGU DISTRICT OF KARNATAKA

The financial world today is so much influenced by technology and is as such very innovative with a lot of financial products. Hence it becomes imperative for all to be financially literate. It is very important to be cautious in all our financial dealings and management of financial resources both at individual and at organization level. This paper focuses on the level of financial literacy in Kodagu district of Karnataka. The sample consisted of people with graduation as the minimum qualification. The study reveals that the level of financial literacy (knowledge, behavior and attitude towards financial matters) among the graduate population is quite satisfactory, though there is a scope for more people to adopt or use various financial products and services. Also the sample respondents were found to exercise caution when taking financial decisions.

Indirect costs associated with "free" paediatric haemodialysis: Experience from Karachi, Pakistan

Treatment of children with end-stage kidney disease (ESKD), requiring maintenance dialysis, poses unique challenges. In low- and middle-income countries, lifelong treatment leads to significant stress on the overall family unit. Families face serious financial, social and psychological consequences despite free treatment. This pilot study, utilising primarily quantitative methods, supplemented by two case studies, is set in Sindh Institute of Urology and Transplantation, a tertiary care hospital in Karachi, Pakistan, providing free medical treatment. Fifty-two caretakers of children receiving haemodialysis for more than five years participated in the quantitative arm. Findings reveal that additional financial challenges may send the entire household into financial catastrophe. Social problems include migration from native cities, impact on the education of the sick child along with changes in lives of siblings. One-third of primary caretakers screened positive for anxiety/depression. Healthcare professionals 'practising' in developing countries face considerable ethical dilemmas in their practice when offering “free” paediatric dialysis services knowing the financial and psychological burden imposed on families.

Prevalence of Health Problems, Professional and Financial Satisfaction among Doctors Working Across Vadodara City: A Cross-sectional Study

Background: The present study was conducted to know the distribution of various health problems among doctors and to assess professional and financial satisfaction levels among doctors. Methods: A Google Form questionnaire-based cross-sectional study was conducted among 122 doctors in Vadodara selected purposively after taking consent. Google form was circulated by email and WhatsApp groups. The form consisted of questions related to demographic details, health problems, financial and job satisfaction. All the responses were recorded and analyzed in MS Excel 2019. Results: Among the 122 doctors, 89 (72.95%) were male and 33 (27.04%) were female and 101 (82.78%) doctors were taking treatment for some ailment. Around 86.9% of doctors regularly opt for a health check-up. Among the health problems reported by doctors, the most common were musculoskeletal ailments (72.13%) followed by hypertension (28.9%), diabetes (17.2), cardiac (12.3%), endocrinal (10.65%), eye (9.01), mental (6.55) problems. Approximately 37.70% of doctors answered that health problems temporarily affect their work; 5.73% of doctors felt the need to modify their work pattern. About 91.80% of doctors were satisfied by their profession, while 108 (88.52%) doctors were financially satisfied with their work. Conclusion: More than half of the professionals complained of musculoskeletal problems. The majority of health care professionals were professionally and financially satisfied.

Interferências da toxicidade financeira na qualidade de vida de adultos com insuficiência renal crônica em tratamento hemodialítico / Interferences of financial toxicity in the quality of life of adults with chronic renal failure undergoing hemodialysis treatment

Resumo: O diagnóstico da doença renal crônica acarreta, muitas vezes, modificações às quais obrigam a pessoa a reduzir a jornada de trabalho, diminuindo a renda familiar, situação que pode ocasionar um fenômeno chamado toxicidade financeira que contribui para redução da qualidade de vida relacionada a saúde. Trata-se de um estudo observacional, analítico e correlacional com corte transversal de abordagem quantitativa, com objetivo de investigar a relação da toxicidade financeira na qualidade de vida relacionada à saúde de pessoas com doença renal crônica em tratamento hemodialítico. A coleta de dados foi realizada de fevereiro de 2022 a maio de 2022 em um grupo de clínicas de diálise de Curitiba-PR e Região Metropolitana. O processo de amostragem foi probabilístico, mas o recrutamento foi por conveniência, obedecendo aos critérios de inclusão: pessoas com doença renal crônica, idade igual ou acima de 18 anos e que estavam em tratamento hemodialítico por período maior que seis meses (n=214). Para realização do estudo, foram utilizados os instrumentos sociodemográfico e clínico, Comprehensive Score For Financial Toxicity - COST e Kidney Disease Quality Of Life - Short Form -KDQOL-SFTM. A análise dos dados foi realizada descritivamente com frequências absolutas e relativas das variáveis da caracterização sociodemográfica e clínica da população do estudo, para os escores da toxicidade financeira e qualidade de vida relacionada à saúde foi usado o odds ratio, modelos de regressão logística bayesiano e o método de análise de variância (Anova). Participaram do estudo 214 pessoas com doença renal crônica, sendo 54,67% do sexo masculino, 52,80% tinham 60 anos ou mais, 53,52% eram casados ou estavam em união consensual, 56,07% tinham de 1 a 3 filhos, mais da metade 54,67% tinham menos de 9 anos de escolaridade, 54,97% eram aposentados, 81,75% apresentavam alguma comorbidade além da doença renal crônica, 59,34% tinham o diagnóstico de doença renal crônica de 1 a 5 anos, 88,26% faziam uso de medicação de uso contínuo, 69,69% não eram tabagistas e 72,89% não ingeriam bebida alcoólica. Em relação à toxicidade financeira, a média do escore total encontrado, considerando todas as unidades de coleta de dados, foi de 20,30/44. Pessoas do sexo feminino e renda familiar mensal de no máximo dois salários-mínimos têm maiores chances de apresentarem algum grau de toxicidade financeira (odds ratio: 0,85; 0,76). Verificou-se que na relação entre as medidas COST e qualidade de vida relacionado à saúde o maior impacto da toxicidade financeira foi associado a pior qualidade de vida relacionado à saúde. Sendo assim, foi identificado neste estudo a existência da toxicidade financeira em pessoas com doença renal crônica em hemodiálise e há, também, associação dos piores graus de toxicidade financeira com características sociodemográficas e clínicas. Portanto, a mensuração da toxicidade financeira pode auxiliar a enfermagem a orientar ações para minimizar esse evento.

Abstract: The diagnosis of chronic kidney disease often entails changes that force the person to reduce the workday, reducing family income, a situation that can cause a phenomenon called financial toxicity that contributes to a reduction in the quality of life related to health. This is an observational, analytical and correlational study with a cross-sectional quantitative approach, with the aim of investigating the relationship between financial toxicity and the health-related quality of life of people with chronic kidney disease undergoing hemodialysis treatment. Data collection was carried out from February 2022 to May 2022 in a group of dialysis clinics in Curitiba-PR and the Metropolitan Region. The sampling process was probabilistic, but the recruitment was for convenience, according to the inclusion criteria: people with chronic kidney disease, aged 18 years or older and who were on hemodialysis for a period longer than six months (n=214). To carry out the study, the sociodemographic and clinical instruments, Comprehensive Score For Financial Toxicity - COST and Kidney Disease Quality Of Life - Short Form -KDQOL-SFTM were used. Data analysis was performed descriptively with absolute and relative frequencies of the variables of the sociodemographic and clinical characterization of the study population, for the scores of financial toxicity and health-related quality of life, the odds ratio, Bayesian logistic regression models and the analysis of variance method (Anova). The study included 214 people with chronic kidney disease, 54.67% male, 52.80% aged 60 years or older, 53.52% married or in a consensual union, 56.07% had 1 to 3 children, more than half 54.67% had less than 9 years of schooling, 54.97% were retired, 81.75% had some comorbidity in addition to chronic kidney disease, 59.34% had a diagnosis of chronic kidney disease from 1 to 5 years, 88.26% used continuous medication, 69.69% were non-smokers and 72.89% did not drink alcohol. Regarding financial toxicity, the mean total score found, considering all data collection units, was 20.30/44. Females with a monthly family income of at most two minimum wages are more likely to have some degree of financial toxicity (odds ratio: 0,85; 0.76). It was found that in the relationship between COST measures and health-related quality of life, the greater impact of financial toxicity was associated with worse health-related quality of life. Therefore, this study identified the existence of financial toxicity in people with chronic kidney disease on hemodialysis and there is also an association of the worst degrees of financial toxicity with sociodemographic and clinical characteristics. Therefore, measuring financial toxicity can help nursing guide actions to minimize this event.

Professional indemnity/medical malpractice insurance—Awareness among medical students and consultants of India: An online survey study

Introduction: Professional indemnity (PI) or medical malpractice insurance (MMI) has been a hot topic considering the increasing number of medical negligence cases rising worldwide. However, there is a palpable difference in understanding and usage of this tool in developed countries and regions such as India. Aim: This study aimed to analyze the general understanding of resident doctors and consultants about MMI and knowledge about its technical jargon. Materials and Methods: We distributed short Google Form questionnaires about various aspects of MMI. We recorded the data from 141 resident doctors and 42 consultants in the Navi Mumbai area of India. As it was a survey, we required no ethical review. Results: As consultants’ experience grew, so did their understanding of medical indemnity. Approximately 90%, 64%, and 22% of consultants with 10 years, 5–10 years, and 5 years of experience had acquired PI. The AOY:AOT (any one year:anyone time) ratio was known to just 35% of these specialists. About half of the resident doctors were aware of PI and the effects of medical specialization on PI. Around a fifth of the individuals had only acquired the PI. Conclusion: There needs to be more clarity between the need and knowledge of MMI in India. This needs to be addressed by teaching medical postgraduates about it during training. “There should be special emphasis on medical indemnity in terms of its need, clauses, and cost during postgraduate medical training.”

Follow-up of patients diagnosed with and treated for tuberculosis in Brazil: financial burden on the household / Acompanhamento de pacientes com diagnóstico e tratamento de tuberculose no Brasil: ônus financeiro para a família

ABSTRACT Objective: To evaluate the implications of the proportion of annual family income spent in the pre- and post-diagnosis periods in tuberculosis patients followed for after at least one year after completing tuberculosis treatment in Brazil. Methods: This was a cross-sectional study of tuberculosis patients followed for at least one year after completing tuberculosis treatment in five Brazilian capitals (one in each region of the country). Results: A total of 62 patients were included in the analysis. The overall average cost of tuberculosis was 283.84 Brazilian reals (R$) in the pre-diagnosis period and R$4,161.86 in the post-diagnosis period. After the costs of tuberculosis disease, 71% of the patients became unemployed, with an overall increase in unemployment; in addition, the number of patients living in nonpoverty decreased by 5%, the number of patients living in poverty increased by 6%, and the number of patients living in extreme poverty increased by 5%. The largest proportion of annual household income to cover the total costs of tuberculosis was for the extremely poor (i.e., 40.37% vs. 11.43% for the less poor). Conclusions: Policies to mitigate catastrophic costs should include interventions planned by the health care system and social protection measures for tuberculosis patients with lower incomes in order to eliminate the global tuberculosis epidemic by 2035-a WHO goal in line with the United Nations Sustainable Development Goals.

RESUMO Objetivo: Avaliar as implicações da proporção da renda familiar anual gasta nos períodos pré e pós-diagnóstico em pacientes com tuberculose acompanhados durante pelo menos um ano após o término do tratamento da tuberculose no Brasil. Métodos: Estudo transversal com pacientes com tuberculose acompanhados durante pelo menos um ano após o término do tratamento da tuberculose em cinco capitais brasileiras (uma em cada região do país). Resultados: Foram incluídos na análise 62 pacientes. O custo médio global da tuberculose foi de R$ 283,84 no período pré-diagnóstico e de R$ 4.161,86 no período pós-diagnóstico. Após os custos da doença tuberculosa, 71% dos pacientes ficaram desempregados, com um aumento global do desemprego; além disso, o número de pacientes não pobres diminuiu 5%, o número de pacientes pobres aumentou 6% e o número de pacientes extremamente pobres aumentou 5%. A maior proporção de renda familiar anual para cobrir os custos totais da tuberculose foi observada nos pacientes extremamente pobres (40,37% vs. 11,43% nos menos pobres). Conclusões: As políticas para mitigar os custos catastróficos devem incluir intervenções planejadas pelo sistema de saúde e medidas de proteção social para pacientes de baixa renda com tuberculose, a fim de eliminar a epidemia global de tuberculose até 2035, uma meta da OMS alinhada com os Objetivos de Desenvolvimento Sustentável propostos pela Organização das Nações Unidas.

Financial toxicity in people with chronic kidney disease undergoing hemodialysis treatment / Toxicidad financiera en personas con enfermedad renal crónica en tratamiento de hemodiálisis / A toxicidade financeira em pessoas com doença renal crônica em tratamento hemodialítico

ABSTRACT Objective: to assess the financial toxicity of people with chronic kidney disease undergoing hemodialysis treatment. Method: a descriptive analytical cross-sectional study, carried out with 214 people, between February and May 2022. For data collection, a sociodemographic and clinical instrument and the COmprehensive Score for financial Toxicity were used. For analysis, the Odds Ratio, ANOVA and Cronbach's alpha tests were used. Results: the mean financial toxicity score was 20.30. Women with a monthly family income of at most two minimum wages are more likely to have some degree of financial toxicity (Odds Ratio: 0.85; 0.76). Conclusion: financial toxicity was identified to different degrees and varied according to sociodemographic and clinical characteristics. Measuring financial toxicity can help nurses plan care and develop strategies to avoid interrupting treatment.

RESUMEN Objetivo: evaluar la toxicidad financiera de personas con enfermedad renal crónica en tratamiento de hemodiálisis. Método: estudio transversal analítico descriptivo, realizado con 214 personas, entre febrero y mayo de 2022. Para la recolección de datos se utilizó un instrumento sociodemográfico, clínico y el COmprehensive Score for financial Toxicity. Para el análisis se utilizaron las pruebas de Odds Ratio, ANOVA y alfa de Cronbach. Resultados: la puntuación media de toxicidad financiera fue de 20,30. Las mujeres con un ingreso familiar mensual de a lo sumo dos salarios mínimos tienen más probabilidades de tener algún grado de toxicidad financiera (Odds Ratio: 0,85; 0,76). Conclusión: la toxicidad financiera se identificó en diferentes grados y varió según las características sociodemográficas y clínicas. Medir la toxicidad financiera puede ayudar a las enfermeras a planificar la atención y desarrollar estrategias para evitar la interrupción del tratamiento.

RESUMO Objetivo: avaliar a toxicidade financeira de pessoas com doença renal crônica em tratamento hemodialítico. Método: estudo descritivo analítico com corte transversal, realizado com 214 pessoas, entre os meses de fevereiro e maio de 2022. Para coleta de dados, utilizou-se instrumento sociodemográfico e clínico e o COmprehensive Score for financial Toxicity. Para análise, utilizaram-se os testes Odds Ratio, ANOVA e alfa de Cronbach. Resultados: a média do escore da toxicidade financeira foi de 20,30. Pessoas do sexo feminino e com renda familiar mensal de no máximo dois salários mínimos têm maiores chances de apresentar algum grau de toxicidade financeira (Odds Ratio: 0,85; 0,76). Conclusão: a toxicidade financeira foi identificada em diferentes graus e variou de acordo com as características sociodemográficas e clínicas. A mensuração da toxicidade financeira pode auxiliar o enfermeiro no planejamento do cuidado e na elaboração de estratégias para evitar a interrupção do tratamento.

A prospective descriptive study on emergency medicines used most frequently from the emergency medicine packs at Universitas Academic Hospital and the associated financial loss of expired emergency medicines

Resuscitation trolleys with equipment and medicines for emergencies are required in all clinical areas in hospitals. Emergency medicines kept separately are more likely to expire than non-emergency medicines, as these are generally used less frequently. An updated list of essential emergency medicines was implemented in 2016 at an academic hospital in central South Africa. The aim of this study was to determine the frequency of both the use and the expiry, with associated financial losses, of the emergency medicines on this list. Methods: A prospective, descriptive study was conducted over a six-month period in 2019. Forms accompanying the emergency packs were returned to the pharmacy whenever packs expired or were opened. These forms were collected and the type and quantity of medicines either used or expired were recorded. Results: In total, 168 of the returned forms were included. The most frequently used emergency medicines were adrenaline, sodium bicarbonate and Ringer's lactate. Adrenaline use was recorded on 52.8% and 25% of the forms from the adult/paediatric and neonatal emergency packs, respectively. Medicines that were never used included: betamethasone, Darrow's half-strength solution and most of the neonatal pack medications. Neonatal emergency medicine packs were rarely used and the neonatal fluid packs were never used. The total cost of the expired medicines was R7 960.29 (US$569.41 at the time of the study). Adrenaline was the medication that expired most frequently but the greatest financial losses occurred from expired sodium bicarbonate. Conclusion: The total financial losses were low but can be reduced further. The contents of the emergency packs should be reviewed to possibly reduce the amount of items used infrequently. Also, the removal of those items not recommended in emergency care guidelines could be considered. Ensuring the policy was followed of returning unused medicines close to expiry and redistributing these to high-use areas would further reduce wastage

Full Financial Education Programmes for People with Disabilities: a Scoping Review / Programas Integrais de Educação Financeira para Pessoas com Incapacidade: uma Revisão de Literatura

ABSTRACT: Financial literacy has been recognised worldwide as a way to confront social inequalities in work access, own financial control and education, particularly among vulnerable groups. People with disabilities, especially those with intellectual and developmental disabilities, experience additional challenges accessing opportunities to learn financial-related competencies. There is an extensive bibliography on this subject that stretches for decades, but this does not translate into an extensive availability of science-based programmes. To our knowledge, no comprehensive search to find the gaps in this evidence has been conducted. We conducted a scoping review that sought to identify the core goals, contents, approaches, gaps and limitations of full financial education programmes for youths and adults with disabilities. Seven publications met the inclusion criteria, which included implementation of programmes that embrace a multidimensional set of skills. Selection and categorisation of the programmes' contents were conducted independently by three researchers. Findings suggest that money and transactions is the content most consistently addressed in the programmes designed for persons with disabilities. A stronger focus on self-determination skills is needed to support financial-related decision-making and self-advocacy. The results indicate that the use of approaches based on Universal Design for Learning, problem-based learning and the combined use of simulated and community-based instruction are critical strategies to support access to financial competencies. Gaps and future orientations include the need to broaden the number of studies that implement and evaluate programmes considering the multidimensional nature of the financial competencies and its critical role for social inclusion of people with disabilities.

RESUMO: A literacia financeira tem sido reconhecida mundialmente como uma forma de responder a desigualdades sociais no acesso ao trabalho, controlo financeiro e educação, principalmente em grupos vulneráveis. As pessoas com incapacidade, principalmente intelectual e desenvolvimental, enfrentam barreiras adicionais no acesso a oportunidades para a aprendizagem de competências financeiras. A bibliografia é extensa e estende-se por décadas, mas não resulta na mesma proporção em programas completos, baseados na evidência, e que estejam disponíveis. No nosso conhecimento, não existe uma revisão detalhada direcionada para as lacunas desta evidência. Realizamos uma revisão do tipo Scoping Review para identificar os objectivos, conteúdos, abordagens, lacunas e limitações de programas integrais para a Educação Financeira dirigidos a jovens e adultos com Incapacidade. Foram selecionadas sete publicações que cumpriam os critérios de inclusão, designadamente a implementação de programas que englobassem um espectro multidimensional de competências. A selecção e a categorização dos conteúdos dos programas foram conduzidos independentemente por três investigadores. Os resultados sugerem que o uso de dinheiro e as transacções constituem os conteúdos mais abordados nos programas. Parece ser necessário um maior enfoque nas competências de autodeterminação para apoiar tomadas de decisão e autoadvocacia na vida financeira. As abordagens baseadas no Desenho Universal para a Aprendizagem, a Aprendizagem Baseada em Problemas e o uso combinado de aprendizagem em contexto simulado e real foram identificadas como estratégias fundamentais. As lacunas e as orientações para o futuro incluem a necessidade de ampliar o número de estudos que implementem e avaliem programas assentes na natureza multidimensional das competências financeiras e no seu papel crítico na inclusão social de pessoas com incapacidade.

Influence of the size of the cities of birth and residence in the sports career: an analysis through the bolsa-atleta program / Influência do tamanho das cidades de nascimento e residência na carreira desportiva: uma análise por meio do programa bolsa-atleta

ABSTRACT This study aimed to verify whether the size of municipalities in which Brazilian high-performance athletes are born or live influences the federal government subsidy, in addition to pointing out whether factors such as human development index, demographic density and municipal investment in sports also exert influence. The sample consisted of 2,033 Brazilian municipalities that had athletes, born or resident, receiving the Brazilian incentive Bolsa-Atleta program. The size of municipalities influences the amount and level of grant obtained, demonstrating that the smaller the population size, the lower the chance of obtaining a higher grant level. In addition, factors such as human development index, demographic density and investment in sport influence the acquisition of grants by athletes, mainly by resident athletes, which shows an internal sports migration in the country as a result.

RESUMO O presente estudo teve por objetivo verificar se o tamanho dos municípios em que os atletas brasileiros de rendimento nascem ou residem gera influência na obtenção de subsídio pelo governo federal, além de apontar se fatores como índices de desenvolvimento humano, densidade demográfica e investimento municipal no esporte também exercem influência. A amostra consistiu em 2033 municípios brasileiros que apresentaram atletas nascidos ou residentes contemplados pelo programa de incentivo brasileiro Bolsa-Atleta. Por meio da análise, pode-se verificar que o tamanho dos municípios influência na quantidade e no nível de bolsa obtido, demonstrando que quanto menor o tamanho da população, menor a chance de se obter um nível mais alto de bolsa. Além disto, pode-se notar que fatores como índices de desenvolvimento humano, densidade demográfica e investimento no esporte exercem influência na aquisição de bolsas pelos atletas, principalmente, por parte de atletas residentes, o que evidencia uma migração esportiva interna no país.

Dificuldades financeiras, aspectos alimentares e de saúde em estudantes universitários, durante a pandemia de Covid-19 / Financial difficulties, dietary and health aspects in university students during the Covid-19 pandemic

Introdução: As dificuldades financeiras advindas da pandemia, em virtude de mudanças econômicas do país, além de refletirem no estado de segurança alimentar e nutricional e no estado de saúde dos indivíduos, acarretaram o aumento da evasão dos cursos superiores. Objetivo: Verificar a associação entre as dificuldades financeiras, durante a pandemia de Covid-19, com os aspectos alimentares e de saúde dos graduandos da Universidade Federal de Juiz de Fora (UFJF). Método: Estudo transversal com graduandos da UFJF. Os dados foram coletados entre setembro de 2020 e março de 2021, através de questionário on-line. Utilizou-se Teste Qui-quadrado (p<0,05) para avaliar os fatores associados às dificuldades financeiras durante a pandemia. Verificou-se a razão de chances (Odds Ratio - OR) das associações encontradas. Resultados: Avaliaram-se 584 graduandos, dentre os quais se constatou que 31,7% passaram por dificuldades financeiras durante a pandemia. Notou-se que a presença de dificuldades financeiras no período pandêmico se associou positivamente à presença de Insegurança Alimentar e Nutricional (INSAN), à autopercepção negativa de saúde, à má qualidade do sono e às alterações de depressão, ansiedade e estresse. Além disso, os indivíduos caracterizados com dificuldades financeiras tinham maiores chances de apresentarem INSAN, percepção negativa de saúde, má qualidade do sono, bem como alterações nos níveis de depressão, ansiedade e estresse, quando comparados à sua contraparte. Conclusão: Conclui-se que as dificuldades financeiras durante o período pandêmico são associadas à presença de INSAN e aspectos de saúde alterados. Assim, ressalta-se a necessidade de criação de estratégias que visem à assistência financeira e psicológica dos graduandos.

Introduction: The financial difficulties caused by the pandemic due to economic changes in the country, in addition to affecting food and nutrition security and the state of health of individuals, resulted in greater evasion from higher education courses. Objective: To check the association between financial difficulties during the COVID-19 pandemic with the dietary and health aspects of undergraduate students from Universidade Federal de Juiz de Fora (Federal University of Juiz de Fora ­ UFJF). Methods: Transversal study with UFJF undergraduate students. The data were collected between September 2020 and March 2021, via an online survey. The chi-square test (p<0.05) was used to evaluate the factors associated with financial difficulties during the pandemic. We also checked the odds ratio (OR) for the associations found. Results: We assessed 584 undergraduate students, 31.7% of which were found to have gone through financial difficulties during the pandemic. We observed that the presence of financial difficulties in that period was positively associated with Food and Nutrition Insecurity (INSAN, Portuguese acronym), negative self-perception of health, bad sleep quality, and changes in depression, anxiety, and stress levels. Moreover, individuals characterized as having financial difficulties had a higher chance of having INSAN, negative perception of health, bad sleep quality, as well as changes in the levels of depression, anxiety, and stress, when compared to their counterparts. Conclusion: We concluded that financial difficulties during the pandemic period are associated with INSAN and affected health aspects. Therefore, we highlight that there is a need for the development of strategies which aim to provide financial and psychological assistance to undergraduate students.