Perfil académico y profesional de los egresados de la especialidad de Cardiología de 2000 a 2015 en el Instituto Nacional de Cardiología Ignacio Chávez / Academic and professional profile of cardiology fellowship graduates of National Institute of Cardiology Ignacio Chávez from 2000 to 2015

Resumen Antecedentes: El Instituto Nacional de Cardiología Ignacio Chávez (INC) se ha posicionado como un referente internacional en la educación médica cardiológica, destacándose por su alto nivel académico y calidad humana. Objetivo: El objetivo de este estudio fue identificar el perfil laboral y académico actual de los egresados del Instituto Nacional de Cardiología Ignacio Chávez (INC). Métodos: Se llevó a cabo un estudio transversal y retrospectivo que incluyó a 473 egresados del INC graduados entre 2000 y 2015. Se utilizó una encuesta electrónica para recopilar los datos. Resultados: Un total de 221 egresados aceptaron participar en el estudio, lo que representa el 46.7% del total de egresados. El 85.2% de los participantes son hombres. La mayoría de los egresados son de nacionalidad mexicana (82.4%), mientras que el resto se distribuye en varios países de Latinoamérica. El 89% de los egresados completó otro posgrado después de cardiología. De este grupo, el 95.4% realizó al menos una alta especialidad, mientras que el 4.6% obtuvo una maestría o doctorado. La especialidad más comúnmente elegida fue Cardiología Intervencionista. Los egresados del INC trabajan en promedio 10.8 horas al día, de las cuales 6.4 horas se dedican a la cardiología clínica y 4.3 horas al otro posgrado. Aquellos que trabajan en el sector público y privado dedican 6.1 horas y 5.2 horas al día, respectivamente. Además, el 75% de los egresados desempeña actividades de enseñanza. El 84% de los egresados trabajan en México. Conclusión: En su mayoría, los egresados del INC son médicos especialistas que continúan su formación académica a través de la realización de otros posgrados. Trabajan más horas al día en comparación con el resto de la población mexicana, y dedican la mayor parte de su tiempo al ejercicio de la cardiología clínica. También buscan transmitir sus conocimientos a través de actividades académicas y de enseñanza.

Abstract Background: The Ignacio Chávez National Institute of Cardiology (NIC) has positioned itself as an international benchmark in cardiovascular medical education, standing out for its high academic standards and human quality. Objective: This study aims to identify the employment and academic profile of cardiology fellowship graduates from the National Institute of Cardiology of Mexico (NIC). Methods: A cross-sectional and retrospective study was conducted, involving 473 graduates from the period 2000-2015. Data was collected through an electronic survey. Results: A total of 221 graduates agreed to participate, accounting for 46.7% of the total number of graduates. Among the participants, 85.2% were male. The majority of graduates (82.4%) held Mexican nationality, while the remaining individuals represented various Latin-American nationalities. Following the completion of the cardiology fellowship, 89% of graduates pursued further postgraduate degrees. Within this group, 95.4% completed at least one additional fellowship, while 4.6% pursued a master's or PhD program. The most popular fellowship program chosen was Interventional Cardiology. On average, NIC graduates dedicate 10.8 hours per day to their work, with 6.4 hours dedicated to cardiology and 4.3 hours to their other postgraduate degree. Those employed in both public and private health systems allocate 6.1 hours and 5.2 hours per day, respectively. Additionally, 75% of graduates are involved in teaching activities. Currently, 84% of graduates are employed in Mexico. Conclusion: The majority of NIC graduates are physicians who further their academic training by pursuing additional postgraduate programs. They work longer hours per day compared to the general Mexican population, with a significant focus on clinical cardiology. Graduates actively seek opportunities to share their expertise through various academic activities.

Condições de trabalho de enfermeiros da atenção primária à saúde nas capitais da região sudeste do Brasil / Working conditions of primary health care nurses in the capitals of the southeastern of Brazil / Condiciones de trabajo de las enfermeras de atención primaria de salud en las capitales de la región sureste de Brasil

Introdução: As condições de trabalho de enfermeiros que atuam na Atenção Primária à Saúde se relacionam a questões de ordem interpessoal, política, organizacional e de infraestrutura. Objetivo: analisar a categoria "condições de trabalho" oriunda da pesquisa "Práticas de Enfermagem na Atenção Primária à Saúde: estudo nacional de métodos mistos", com foco nas capitais da região Sudeste do Brasil. Métodos: estudo qualitativo que analisou 108 entrevistas de enfermeiros residentes em Belo Horizonte, Rio de Janeiro, São Paulo e Vitória, realizadas entre novembro de 2020 e setembro de 2021. Os dados foram submetidos à análise temática, com apoio do software MAXQDA®. Resultados: os participantes eram majoritariamente do sexo feminino (88,0%), idade média de 42 anos, cor ou raça parda e tempo de atuação em atenção primária superior a 12 anos. Há uma diversidade temática quanto às condições de trabalho referidas por enfermeiros, destacando-se positivamente relacionamentos interpessoais. Infraestrutura das unidades de saúde e a fragilidade dos vínculos empregatícios foram referidos como dificultadores do trabalho na APS. Conclusão: Há uma diversidade de fatores que se relacionam com as condições de trabalho dos enfermeiros, sendo necessário intervenções sobre aquelas que trazem prejuízos, como o excesso de atribuições e infraestrutura das unidades de saúde. (AU)

Background: The working conditions of nurses working in Primary Health Care are related to interpersonal, political, organizational and infrastructure issues. Objective: to analyze the category "working conditions" from the research "Nursing Practices in Primary Health Care: a national study of mixed methods", focusing on the capitals of the Southeast region of Brazil. Methods: qualitative study that analyzed 108 interviews with nurses residing in Belo Horizonte, Rio de Janeiro, São Paulo and Vitória, carried out between November 2020 and September 2021. Data were subjected to thematic analysis, with the support of the MAXQDA® software. Results: the participants were mostly female (88.0%), mean age of 42 years, brown color or race, and working in primary care for more than 12 years. There is a thematic diversity regarding the working conditions mentioned by nurses, with positive emphasis on interpersonal relationships. Infrastructure of the health units and the fragility of employment relationships were mentioned as obstacles to work in PHC. Conclusion: There are a variety of factors that are related to the working conditions of nurses, requiring interventions on those that bring harm, such as excess attributions and infrastructure of health units. (AU)

Introducción: Las condiciones de trabajo de los enfermeros que actúan en la Atención Primaria de Salud están relacionadas con cuestiones interpersonales, políticas, organizativas y de infraestructura. Objetivo: analizar la categoría "condiciones de trabajo" de la investigación "Prácticas de Enfermería en la Atención Primaria de Salud: un estudio nacional de métodos mixtos", con foco en las capitales de la región Sudeste de Brasil. Métodos: estudio cualitativo que analizó 108 entrevistas con enfermeros residentes en Belo Horizonte, Rio de Janeiro, São Paulo y Vitória, realizadas entre noviembre de 2020 y septiembre de 2021. Los datos fueron sometidos a análisis temático, con el apoyo del software MAXQDA®. Resultados: los participantes eran mayoritariamente del sexo femenino (88,0%), edad media de 42 años, color moreno o raza, y actuaban en la atención primaria hace más de 12 años. Hay diversidad temática en cuanto a las condiciones de trabajo mencionadas por los enfermeros, con énfasis positivo en las relaciones interpersonales. La infraestructura de las unidades de salud y la fragilidad de las relaciones laborales fueron mencionadas como obstáculos para el trabajo en la APS. Conclusión: Hay una variedad de factores que se relacionan con las condiciones de trabajo de los enfermeros, requiriendo intervenciones sobre aquellos que traen perjuicio, como el exceso de atribuciones e infraestructura de las unidades de salud. (AU)

Processo de trabalho das enfermeiras da atenção primária à saúde frente à pandemia por covid-19 / Nurses' work process of primary health care in the face of the covid-19 pandemic / Proceso de trabajo de las enfermeras de la atención primaria de salud ante la pandemia del covid-19

Objetivo: Analisar o processo de trabalho das enfermeiras da Atenção Primária à Saúde frente à pandemia de COVID-19. Métodos: Trata-se de uma pesquisa qualitativa, descritiva e exploratória. A coleta de dados ocorreu de abril a maio de 2021, por meio de entrevista semiestruturada com 09 enfermeiras. Os dados foram analisados por meio de análise temática, e interpretados à luz da literatura pertinente. Resultados: Evidenciou-se o medo de faltar Equipamentos de Proteção Individual e recusa de atendimentos na falta destes. Utilizou-se a teleconsulta como meio de assistência de enfermagem, que mostrou limitações, como: invasão de privacidade das enfermeiras, extensão da jornada de trabalho e sobrecarga. Priorizou-se o atendimento à saúde da mulher e da criança. E ainda, notou-se o esforço no acolhimento aos casos suspeitos e agudos de COVID-19. Verificou-se a sobrecarga de trabalho e acúmulo de funções. Entretanto, lições foram adquiridas como a valorização de medidas de proteção, como a higiene das mãos. Conclusão: Infere-se a necessidade de criação e validação de novos protocolos que fortaleçam a assistência de enfermagem, bem como a importância de estimular as políticas de saúde para controle das Infecções Relacionadas à Assistência à Saúde. (AU)

Objective: To analyze the work process of Primary Health Care nurses in the face of the COVID-19 pandemic. Methods: This is a qualitative, descriptive and exploratory research. Data were analyzed using thematic analysis and interpreted in light of the relevant literature. Results: The fear of lacking personal protective equipment was evidenced and the refusal of care in the absence of these. Teleconsultation was used as a means of nursing care, which showed limitations such as invasion of nurses' privacy, extension of the workday and overload. The health care of women and children was prioritized. Also, there was an effort to host suspected and acute cases of COVID-19. There was work overload and accumulation of functions. However, lessons were learned, such as valuing protective measures such as hand hygiene. Conclusion: The need to create and validate new protocols that strengthen nursing care is inferred, as well as the importance of stimulating health policies to control Health-Related Infections. (AU)

Objetivo: Analizar el proceso de trabajo de las enfermeras de Atención Primaria de Salud frente a la pandemia de COVID-19. Métodos: Se trata de una investigación cualitativa, descriptiva y exploratoria. Los datos se analizaron mediante un análisis temático y se interpretaron a la luz de la bibliografía pertinente. Resultados: Se evidenció el miedo a la falta de equipo de protección personal y la negativa de atención en ausencia de estos. La teleconsulta fue utilizada como medio de atención de enfermería, que mostró limitaciones como la invasión de la privacidad de los enfermeros, la duración de la jornada laboral y la sobrecarga. Se priorizó la atención de la salud de las mujeres y los niños. Además, hubo un esfuerzo para albergar casos sospechosos y agudos de COVID-19. Había sobrecarga de trabajo y acumulación de funciones. Sin embargo, se aprendieron lecciones, como la valoración de medidas de protección como la higiene de manos. Conclusión: Se infiere la necesidad de crear y validar nuevos protocolos que fortalezcan los cuidados de enfermería, así como la importancia de estimular políticas de salud para el control de las Infecciones Relacionadas con la Salud. (AU)

Percepção dos enfermeiros sobre condições de trabalho na atenção primária durante a pandemia de sars-cov-2 / Nurses perception of working conditions in primary care during the sars cov-2 pandemic / Percepción de las enfermeras sobre las condiciones de trabajo en atención primaria durante la pandemia por sars-cov-2

Objetivo: Analisar a percepção do enfermeiro acerca das condições de trabalho no contexto da Atenção Primária à Saúde (APS) durante a pandemia de SARS-CoV-2. Métodos: Trata-se de um estudo descritivo, transversal, de abordagem qualitativa, recorte de um estudo multicêntrico e de abrangência nacional. Os dados apresentados neste estudo correspondem aos obtidos no estado do Rio Grande do Norte, onde foram entrevistados 45 enfermeiros da APS no período de dezembro de 2020 a abril de 2021. Após as entrevistas, as narrativas gravadas foram transcritas e analisadas através da Análise de Conteúdo de Bardin. Resultados: A partir da fala dos enfermeiros, evidenciou-se que a utilização de Equipamentos de Proteção Individual, a organização e desenvolvimento de novos protocolos e fluxos assistenciais trouxeram sofrimento psíquico aos profissionais, tanto pelas condições de trabalho inadequadas, quanto pela proximidade com o sofrimento de pacientes e o medo de contágio. Conclusão: Mesmo com tantas dificuldades, os enfermeiros lotados na atenção primária à saúde tiveram que reconstruir suas práticas na perspectiva de garantir, dentro dos limites impostos pela situação adversa, a melhor assistência possível, mostrando a força e resiliência das equipes da APS nos mais diversos contextos. (AU)

Objective: To analyze the perception of nurses about working conditions in the context of PHC during the COVID-19 pandemic. Methods: This is a descriptive, cross-sectional study with a qualitative approach, part of a multicenter study with a national scope. The data presented in this study correspond to those obtained in the state of Rio Grande do Norte, in which 45 nurses from primary health care were interviewed from December 2020 to April 2021. After the interviews, the recorded narratives were transcribed and analyzed through the Bardin's Content Analysis. Results: The collective discourse showed that the use of Personal Protective Equipment, the organization and development of new protocols and care flows brought psychic suffering to professionals, both due to inadequate working conditions and the proximity to the suffering of patients and the fear of Contagion. Conclusion: Even with so many difficulties, nurses working in primary health care had to rebuild their practices in order to guarantee, within the limits imposed by the adverse situation, the best possible assistance, showing the strength and resilience of PHC teams in the most diverse contexts. (AU)

Objetivo: Analizar la percepción de los enfermeros sobre las condiciones de trabajo en el contexto de la APS durante la pandemia de COVID-19. Métodos: Se trata de un estudio descriptivo transversal con enfoque cualitativo, parte de un estudio multicéntrico de alcance nacional. Los datos presentados en este estudio corresponden a los obtenidos en el estado de Rio Grande do Norte, en el que fueron entrevistados 45 enfermeros de atención primaria de salud entre diciembre de 2020 y abril de 2021. Después de las entrevistas, las narraciones grabadas fueron transcritas y analizadas a través de la escala de Bardin. Análisis de contenido. Resultados: El discurso colectivo mostró que el uso de Equipos de Protección Individual, la organización y desarrollo de nuevos protocolos y flujos de atención trajeron sufrimiento psíquico a los profesionales, tanto por las inadecuadas condiciones de trabajo como por la proximidad al sufrimiento de los pacientes y el miedo al Contagio. Conclusión: Incluso con tantas dificultades, los enfermeros que actúan en la atención primaria de salud tuvieron que reconstruir sus prácticas para garantizar, dentro de los límites impuestos por la situación adversa, la mejor asistencia posible, mostrando la fortaleza y resiliencia de los equipos de APS en los más diversos contextos. (AU)

Enfermeiras da atenção primária à saúde: olhares para aspectos trabalhistas em municípios urbanos / Nurses in primary health care: looks at labor aspects in urban municipalities / Enfermeras de atención primaria de salud: mira a aspectos laborales en los municipios urbanos

Objetivo: Caracterizar os aspectos trabalhistas das enfermeiras da Atenção Primária à Saúde nos municípios de tipologia urbana do estado da Bahia. Métodos: Estudo descritivo através de abordagem quantitativa a partir de informações obtidas com 32 enfermeiras, no período entre novembro de 2020 a maio de 2021, nos três maiores municípios do estado da Bahia. Resultados: Enfermeiras em sua maioria possuem vínculo trabalhista do tipo estatutário, com carga horária de 40 horas, atua há mais de um ano em unidades de saúde de modelo da Estratégia Saúde da Família, com diferenças salariais entre os municípios. Conclusão: Identificar aspectos trabalhistas das enfermeiras é de suma relevância, pois trazem implicações para melhoria das políticas de pessoal na Atenção Primária à Saúde. (AU)

Objective: To characterize the labor aspects of Primary Health Care nurses in urban municipalities of the state of Bahia. Methods: A descriptive study through a quantitative approach based on information obtained from 32 nurses, in the period between November 2020 and May 2021, in the 3 largest municipalities of the state of Bahia. Results: Most of the nurses have a statutory employment contract, work 40-hour shifts, and have been working for more than 1 year in health care units that follow the Family Health Strategy model, with wage differences among the municipalities. Conclusion: Identifying labor aspects of nurses is of utmost relevance, since they bring implications for improving personnel policies in Primary Health Care. (AU)

Objetivo: Caracterizar los aspectos laborales de las enfermeras de Atención Primaria de Salud en los municipios urbanos del estado de Bahia. Métodos: Estudio descriptivo a través de un enfoque cuantitativo basado en la información obtenida de 32 enfermeras, en el período comprendido entre noviembre de 2020 y mayo de 2021, en los tres mayores municipios del estado de Bahia. Resultados: La mayoría de las enfermeras tienen un contrato de trabajo legal, trabajan 40 horas y llevan más de 1 año en unidades sanitarias del modelo de la Estrategia de Salud Familiar, con diferencias salariales entre municipios. Conclusión: La identificación de los aspectos laborales de las enfermeras es de máxima relevancia, ya que aportan implicaciones para la mejora de las políticas de personal en Atención Primaria. (AU)

Capacitación con aproximación al neuroaprendizaje de salud psicosocial en profesionales peruanos con seguro sanitario: estudio experimental / Training with a psychosocial health neurolearning approach in Peruvian professionals with health insurance: Experimental study

Introducción Los factores de riesgo psicosociales como determinantes de la salud en el trabajo pueden afectar tanto al bienestar físico como al bienestar psíquico del trabajador. En los sistemas de formación que incluyen contenidos cognitivo-preventivos, funcionan mejor cuando la construcción del conocimiento está basada en el neuroaprendizaje. El objetivo del estudio fue comparar el grado de procesamiento de contenidos con inserción de frases disuasivas (grupo A) versus inserción de frases persuasivas (grupo B), como efecto de una capacitación con aproximación al neuroaprendizaje de la salud psicosocial en el trabajo de un grupo de profesionales con seguro sanitario de la Amazonía peruana. Métodos Diseño experimental con pre/posprueba, que incluyó dos grupos experimentales más un grupo de control: n = 48 sujetos en total, 16 por cada grupo, con edades entre 22 y 36 años. La capacitación se desarrolló entre diciembre de 2018 y enero de 2019 con una duración de 18 horas, espaciadas en seis semanas. Para la recogida de datos se utilizó un registro previamente validado por cinco expertos. Resultados La distribución de datos en los grupos fue adecuada tanto en preprueba como en posprueba, excepto en posprueba del grupo B (p = 0,002). En el grupo control los resultados del procesamiento de contenidos, tanto preprueba como en posprueba, se mantuvieron similares (p = 0,667). El procesamiento de contenidos sobre salud psicosocial en el trabajo en posprueba fue significativamente diferente entre los grupos de intervención y el grupo control (p = 0,001), distinguiéndose el procesamiento de contenidos con inserción de frases disuasivas. Conclusiones Los resultados indican que la capacitación con aproximación al neuroaprendizaje, puede mejorar el procesamiento de contenidos con inserción de frases disuasivas para el cumplimiento de normativas orientadas a promover la salud psicosocial en el trabajo.

Introduction Psychosocial risk factors as determinants of health at work can affect both the physical and psychological well-being of the worker. Training systems that include cognitive-preventive content work best when knowledge construction is based on neurolearning. The purpose of this study was to compare the degree of content processing with the insertion of deterrent (group A) versus persuasive sentences (group B) as an effect of a training with a neurolearning approach to psychosocial health in the work of a group of professionals with health insurance in the Peruvian Amazon. Methods Experimental design with pre-/post-test, including two experimental groups plus a control group, n = 48 subjects in total and 16 per group, aged 22-36 years. The training took place between December 2018 and January 2019 with a duration of 18 hours spaced over six weeks. A register previously validated by five experts was used for data collection. Results The distribution of data in the groups was adequate in both pre-test and post-test, except in post-test in group "B" (p = 0.002). In the control group, the results of content processing in both pre-test and post-test remained similar (p = 0.667). The processing of psychosocial occupational health content in the post-test was significantly different between the intervention and control groups (p = 0.001), distinguishing the processing of content with the insertion of deterrent phrases. Conclusions The results indicate that training with a neurolearning approach can improve the processing of content with the insertion of deterrent phrases for compliance with regulations aimed at promoting psychosocial health at work.

Condições de trabalho dos agentes comunitários de saúde em um contexto de saúde digital: velhos e novos desafios / Condiciones de trabajo de las agentes comunitarias de salud en un contexto de salud digital: viejos y nuevos desafíos / Working conditions of community health workers in a digital health context: old and new challenges

O uso de ferramentas da saúde digital tem sido intensificado na Atenção Primária à Saúde (APS) e nas práticas de agentes comunitários de saúde (ACS). Este artigo tem como objetivo analisar os desafios impostos pelas condições de trabalho dos ACS no contexto da saúde digital. Trata-se de uma pesquisa qualitativa com triangulação de métodos envolvendo lideranças sindicais, gestores e profissionais da saúde. Os resultados apontam uma reedição de velhos desafios em torno do trabalho dos ACS, como maior burocratização, controle, divisão social e técnica. Porém, novos desafios emergem em torno da manutenção, da qualidade dos instrumentos e da formação profissional. Conclui-se demarcando a necessidade de uma garantia logística, financeira e política para a implementação da saúde digital no trabalho dos ACS.

El uso de herramientas de la salud digital se ha intensificado en la Atención Primaria de la Salud (APS) y en las prácticas de Agentes Comunitarias de Salud (ACS). El objetivo de este artículo es analizar los desafíos impuestos por las condiciones de trabajo de las ACS en el contexto de la salud digital. Se trata de una investigación cualitativa, con triangulación de métodos, envolviendo liderazgos sindicales, gestores y profesionales de la salud. Los resultados señalan una reedición de viejos desafíos alrededor del trabajo de las ACS, tales como mayor burocratización, control, división social y técnica. Sin embargo, surgen nuevos desafíos alrededor del mantenimiento, calidad de los instrumentos y formación profesional. Se concluye demarcando la necesidad de una garantía logística, financiera y política para la implementación de la salud digital en el trabajo de las ACS.

The use of digital health tools has grown in intensity in Primary Health Care (PHC) and in the practices of Community Health Workers (CHWs). This article aims to analyze the challenges imposed by the working conditions of CHWs in the context of digital health. It is a qualitative study, with triangulation of methods involving union leaders, managers and health professionals. The results indicate the re-emergence of old challenges surrounding the work of CHWs, such as greater bureaucratization, control, social and technical division of work. However, new challenges emerge around maintenance, quality of tools and professional training. In conclusion, there is a need for logistical, financial and political safeguards for the implementation of digital health in the work of CHWs.

Mulheres no trabalho militar: uma revisão bibliométrica e crítica / Mujeres en el trabajo militar: una revisión bibliométrica y crítica / Women in military work: a bibliometric and critical review

Resumo: O trabalho militar, historicamente, é uma profissão predominantemente masculina. A crescente inserção das mulheres nas instituições militares tem enfrentado entraves importantes. A presente revisão bibliométrica objetivou mapear e analisar criticamente a literatura indexada sobre gênero no contexto militar, pretendendo especificamente identificar características, tendências e lacunas da produção científica sobre o tema nos últimos 10 anos na psicologia. Além da ausência de estudos brasileiros ou em língua portuguesa, identificou-se predominância de métodos quantitativos e de participantes homens nas pesquisas. O tema mais abordado foi o trauma sexual militar. Aponta-se a necessidade de mais investigações com mulheres militares em contexto brasileiro.

Resumen: El trabajo militar ha sido históricamente una profesión predominantemente masculina. La creciente inserción de la mujer en las instituciones militares ha enfrentado importantes obstáculos. La presente revisión bibliométrica tuvo como objetivo mapear y analizar críticamente la literatura indexada sobre género en el contexto militar, con el objetivo de identificar características, tendencias y vacíos en la producción científica sobre el tema en los últimos 10 años. Además de la ausencia de estudios brasileños o en lengua portuguesa, se identificó predominio de métodos cuantitativos y participantes del sexo masculino en la investigación. El tema más discutido fue el trauma sexual militar. Se destaca la necesidad de más investigaciones con mujeres militares en el contexto brasileño.

Abstract: Military work is, historically, a predominantly male profession. The growing insertion of women in military institutions has faced important obstacles. This bibliometric review aimed to map and critically analyze the indexed literature on gender in the military context, specifically intending to identify characteristics, trends and gaps in scientific production on the topic in the last 10 years. In addition to the absence of Brazilian or Portuguese-language studies, a predominance of quantitative methods and male participants was identified. The most discussed topic was military sexual trauma. The need for more research with military women in the Brazilian context is highlighted.

Health promotion of Street Clinic workers: convergent care research / Promócion de la salud de los trabajadores del Consultorio en la Calle: investigación convergente asistencial / Promoção da saúde de trabalhadores do Consultório na Rua: pesquisa convergente assistencial

ABSTRACT Objective: To develop a health promotion action for Street Clinic workers. Method: Qualitative research which used the Convergent Care Research methodology. The data collection was conducted through participant observation and convergence groups, from May to October 2021, with 39 workers from six teams of the Street Clinic. Data analysis followed the stages of apprehension, synthesis, theorization, and transfer. Results: Some integrativepractices such as, stretching, group dynamics, dance, music, massage and cinema were suggested as interventions to be implemented. Given the need, Reichian stretching was developed as an intervention which favored body awareness, promoting the well-being of workers. Conclusion: The workers presented a conception of health promotion related to access to services and guarantee of rights. Reichian stretching provided a space for care and reflection on caring and respecting limits, favoring the body awareness and promoting relaxation.

RESUMEN Objetivo: Desarrollar acciones para promover la salud de los trabajadores de la Oficina de Calle. Método: Investigación cualitativa, que utilizó la metodología de Investigación Convergente Asistencial. La producción de información se llevó a cabo a través de la observación participante y grupos de convergencia, de mayo a octubre de 2021, con 39 trabajadores de seis equipos del consultorio en la calle. El análisis de datos siguió las etapas de aprehensión, síntesis, teorización y transferencia. Resultados: Se sucedieron algunas prácticas integrativas como intervenciones a implementar, estiramientos, dinámicas de grupos, danza, música, masaje, cine. Ante la necesidad se desarrolló el estiramiento reichiano como una intervención que favoreció la conciencia corporal, promoviendo el bienestar de los trabajadores. Conclusión: Los trabajadores presentaron una concepción de promoción de la salud relacionada con el acceso a servicios y la garantía de derechos. El estiramiento reichiano proporcionó un espacio de cuidado y reflexión sobre el cuidado y el respeto de los límites, favoreciendo la toma de conciencia corporal y promoviendo la relajación.

RESUMO Objetivo: Desenvolver ação de promoção à saúde do trabalhador do Consultório na Rua. Método: Pesquisa qualitativa que utilizou a metodologia da Pesquisa Convergente Assistencial. Para a coleta de dados, utilizou-se a observação participante e grupos de convergência, de maio a outubro de 2021. Participaram 39 trabalhadores de seis equipes do Consultório na Rua. A análise dos dados seguiu as etapas de apreensão, síntese, teorização e transferência. Resultados: Foram sugeridas como intervenções a serem implementadas algumas práticas integrativas, alongamento, dinâmica em grupo, dança, música, massagem, cinema. Visto a necessidade, desenvolveu-se como intervenção o alongamento reichiano, que favoreceu a tomada de consciência corporal, promovendo bem-estar dos trabalhadores. Conclusão: Os trabalhadores apresentaram uma concepção de promoção da saúde relacionada ao acesso aos serviços e à garantia de direitos. O alongamento reichiano proporcionou um espaço de cuidado e reflexão sobre o cuidado e respeito dos limites, favorecendo a tomada de consciência corporal e promoveu o relaxamento.

Fatores psicossociais e Transtornos Mentais Comuns no teletrabalho do judiciário trabalhista na pandemia de Covid-19 / Psychosocial factors and common mental disorders in telework in the labor judiciary during the COVID-19 pandemic

RESUMO O objetivo deste estudo foi avaliar a relação entre os fatores psicossociais no teletrabalho e a prevalência de Transtornos Mentais Comuns (TCM) em um órgão do judiciário trabalhista brasileiro durante a pandemia de Covid-19. Foi realizado um estudo transversal com 119 magistrados e 934 servidores entre agosto e outubro de 2021. Os fatores psicossociais do trabalho foram avaliados por meio dos domínios de demandas, controle e suporte social da versão revisada do Maastricht Upper Extremity Questionnaire e os TCM foram avaliados por meio do Self-Reporting Questionnaire. As razões de prevalência de TCM de acordo com os fatores psicossociais do trabalho foram obtidas por meio de regressão de Poisson com variância robusta. Magistrados e servidores apresentaram prevalências de TCM de 45,38% e 36,94%, respectivamente, considerando o ponto de corte 6/7. As maiores prevalências de TCM foram associadas ao trabalho de alta exigência, especialmente quando o suporte social foi mais baixo nos dois grupos. Os resultados deste estudo sugerem ao judiciário e a outros setores a necessidade de desenvolver ações visando à redução das demandas de trabalho e à promoção de suporte social adequado para a preservação da saúde mental no teletrabalho.

ABSTRACT The aim of this study was to assess the relationship between psychosocial factors in telework and the prevalence of common mental disorders in a Brazilian labor court during the COVID-19 pandemic. A cross-sectional study was carried out with 119 judges and 934 civil servants between August and October 2021. The psychosocial work factors were assessed using the domains of demands, control and social support of the revised version of the Maastricht Upper Extremity Questionnaire and common mental disorders were assessed using the Self-Reporting Questionnaire. The prevalence ratios of common mental disorders according to psychosocial work factors were obtained using Poisson regression with robust variance. Judges and civil servants had a prevalence of common mental disorders of 45.38% and 36.94%, respectively, considering the 6/7 cut-off point. The highest prevalences of common mental disorders were associated with high work demands, especially when social support was lower in both groups. The results of this study suggest to the judiciary and other sectors the need to develop actions aimed at reducing work demands and promoting adequate social support to preserve mental health in teleworking.

Association between skin injuries and the importance atributed to prevention by health professionals during the pandemic / Asociación entre lesión cutánea e la importancia atribuida a la prevención por los profesionales de la salud durante la pandemia / Associação entre lesão cutânea e importância atribuída à prevenção pelos profissionais de saúde na pandemia

ABSTRACT Objective: To verify the association between the occurrence of skin lesions due to the use of products and/or personal protective equipment and the importance attributed to preventive care among health professionals working on the front lines of the struggle against the COVID-19 pandemic. Method: Cross-sectional, analytical study, carried out between May and June 2020, with a convenience sample (n=398) of health workers from 10 professional categories. To verify the existence of an association between the occurrence of skin lesions and exposure variables, a Contingency Table was used to obtain the Prevalence Ratio and respective Confidence Intervals. Results: 260 (65.3%) participants self-declared the development of skin lesions, predominantly nurses (53.8%), women (54.0%), from public institutions (52.8%), characterized by pressure injuries (37.3%), contact/allergic dermatitis (25.8%), or both lesions simultaneously (16.5%). More than half of professionals (53.5%) used preventive products, mainly moisturizers (51.0%). Conclusion: There was probability of an association between professionals who attributed less importance to the predictor "Protocol for proper product PPE and products" and the risk of skin injuries.

RESUMEN Objetivo: Verificar la asociación entre la aparición de lesiones cutáneas por el uso de productos y/o equipos de protección personal y la importancia atribuida al cuidado preventivo entre los profesionales de la salud que trabajaran en la primera línea de defensa contra la pandemia de la COVID-19. Método: Estudio analítico transversal, realizado entre mayo y junio de 2020, con una muestra por conveniencia (n=398) de profesionales de la salud de 10 categorías profesionales. Para verificar la existencia de asociación entre la aparición o no de lesiones cutáneas y las variables de exposición, se utilizó una Tabla de Contingencia para obtener el Índice de Prevalencia y los respectivos Intervalos de Confianza. Resultados: 260 (65,3%) participantes declararon el desarrollo de lesiones cutáneas, predominantemente enfermeras (53,8%), mujeres (54,0%), de instituciones públicas (52,8%), caracterizadas por lesiones por presión (37,3%), de dermatitis contacto/alérgicas (25,8%) y ambas lesiones simultáneamente (16,5%). Más de la mitad de los profesionales (53,5%) utilizan productos preventivos, principalmente hidratantes (51,0%). Conclusión: Hubo probabilidad de asociación de riesgo entre la aparición de lesiones cutáneas y la atribución de menor importancia al factor predictor "Protocolo para el uso adecuado de productos y EPP".

RESUMO Objetivo: Verificar a associação entre ocorrência de lesão cutânea por uso de produtos e/ou equipamentos de proteção individual e importância atribuída aos cuidados preventivos entre profissionais de saúde atuantes na linha de frente durante a pandemia da Covid-19. Método: Estudo transversal, analítico, realizado entre maio e junho de 2020, com uma amostra por conveniência (n=398) de profissionais de saúde de 10 categorias profissionais. Para verificar a existência de associação entre a ocorrência ou não de lesão de pele e as variáveis de exposição utilizou-se Tabela de Contingência para obter a Razão de Prevalência e respectivos Intervalos de Confiança. Resultados: 260 (65,3%) participantes autodeclararam desenvolvimento de lesões na pele, predominando enfermeiros (53,8%), mulheres (54,0%), provenientes de instituições públicas (52,8%), caracterizadas por lesões por pressão (37,3%), dermatite de contato/alérgica (25,8%), e ambas as lesões de forma simultânea (16,5%). Mais da metade dos profissionais (53,5%) usou produtos preventivos, principalmente hidratantes (51,0%). Conclusão: Ocorreu probabilidade de associação de risco entre a ocorrência de lesão de pele e a menor importância atribuída ao fator preditor Protocolo para uso adequado de produtos e EPIs.

Assessment of sociodemographic and psychological well-being of primary school teachers

Abstract Background Teaching is very stressful and demanding and it intensifies psychological and related disorders compared to other occupations. Most teachers in Nigeria are battling emotional distress, burnout, depression, and anxiety due to excess workload, which has affected their psychological well-being. This study assessed the sociodemographic and psychological well-being of primary school teachers in Enugu State, Nigeria. Methods This is a study with a cross-sectional design. The psychological well-being of 254 primary school teachers was assessed using a psychological well-being scale and a sociodemographic information inventory was also used to ascertain their personal information. The data collected were analyzed using chi-square, mean, standard deviation, and bivariate correlation statistics. Results The results showed that the majority of primary school teachers experience unhealthy psychological well-being irrespective of age, gender, working status, qualification, and years of teaching experience. These teachers' sociodemographic variables are significantly correlated with psychological well-being. Only location is not significantly correlated with psychological well-being. Conclusion Therefore, this study concluded that primary school teachers' psychological well-being is not positive or healthy and is significantly related to their sociodemographic characteristics.

Factors associated with interprofessional collaboration in Primary Health Care: a multilevel analysis / Fatores associados à colaboração interprofissional na Atenção Primária à Saúde: uma análise multinível

Abstract Working with an interprofessional focus is increasingly necessary, in view of the growing complexity of the population's health needs. This study aims to assess interprofessional collaboration and the teamwork climate in primary health care (PHC) and determine whether there is a relationship between these two variables. The AITCS-II instrument was used to measure interprofessional collaboration, while to diagnose teamwork climate, the ECTE instrument was used, a version adapted to the SUS context of the Teamwork Climate Inventory instrument. These two instruments were applied online together with a questionnaire for the sociodemographic characterization of the 544 participants, who belonged to 97 Family Health Strategy (FHS) teams in a Brazilian municipality. The obtained data were submitted to a multilevel analysis. A positive correlation was observed between interprofessional collaboration and three of the four teamwork climate factors. The better the work climate, the better the interprofessional collaboration in the corresponding team, and this characteristic stands out in relation to other individual analyzed characteristics.

Resumo Trabalhar com foco interprofissional é cada vez mais necessário, tendo em vista a crescente complexidade das necessidades de saúde da população. Este estudo tem como objetivo avaliar a colaboração interprofissional e o clima de trabalho em equipe na atenção primária à saúde (APS) e verificar possível relação entre estas duas variáveis. Para mensurar a colaboração interprofissional foi utilizado o instrumento AITCS-II, enquanto para o diagnóstico do clima de trabalho em equipe foi utilizado o instrumento ECTE, versão adaptada para o contexto SUS do instrumento Teamwork Climate Inventory. Esses dois instrumentos foram aplicados on-line juntamente com um questionário para caracterização sociodemográfica dos 544 participantes, pertencentes a 97 equipes da Estratégia Saúde da Família (ESF) de um município brasileiro. Os dados obtidos foram submetidos a uma análise multinível. Foi observada uma correlação positiva entre a colaboração interprofissional e três dos quatro fatores do clima de trabalho em equipe. Quanto melhor o clima de trabalho, melhor a colaboração interprofissional na equipe correspondente, e essa característica se destaca em relação às demais características individuais analisadas.

Scale development and validation of perimenopausal women disability index in the workplace

BACKGROUND@#Menopausal disorders include obscure symptomatology that greatly reduce work productivity among female workers. Quantifying the impact of menopause-related symptoms on work productivity is very difficult because no such guidelines exist to date. We aimed to develop a scale of overall health status for working women in the perimenopausal period.@*METHODS@#In September, 2021, we conducted an Internet web survey which included 3,645 female workers aged 45-56 years in perimenopausal period. We asked the participants to answer 76 items relevant to menopausal symptomatology, that were created for this study and performed exploratory and confirmatory factor analyses for the scale development. Cronbach's alpha, receiver operating characteristic analysis, and logistic regression analysis were used to verify the developed scale.@*RESULTS@#Approximately 85% participants did not have menstruation or disrupted cycles. Explanatory factor analysis using the maximum likelihood method and Promax rotation identified 21 items with a four-factor structure: psychological symptoms (8 items, α = 0.96); physiological symptoms (6 items, alpha = 0.87); sleep difficulty (4 items, alpha = 0.92); human relationship (3 items, alpha = 0.92). Confirmatory factor analyses found excellent model fit for the four-factor model (RMSR = 0.079; TLI = 0.929; CFI = 0.938). Criterion and concurrent validity were confirmed with high correlation coefficients between each of the four factors, previously validated menopausal symptom questionnaire, and Copenhagen Burnout Inventory scales, respectively (all ps < 0.0001). The developed scale was able to predict absenteeism with 78% sensitivity, 58% specificity, and an AUC of 0.727 (95%CI: 0.696-0.757). Higher scores of each factor as well as total score of the scale were more likely to be associated with work absence experience due to menopause-related symptoms even after adjusting for Copenhagen Burnout Inventory subscales (all ps < 0.0001).@*CONCLUSION@#We found that the developed scale has high validity and reliability and could be a significant indicator of absenteeism for working women in perimenopausal period.

Discussion on common problems after introducing "reduction factor" into different working hour systems in occupational exposure assessment in GBZ 2.1—2019 / 环境与职业医学

Occupational exposure limits for hazardous agents in the workplace—Part 1: Chemical hazardous agents (GBZ 2.1—2019) has been implemented since April 1, 2020. The document redefines the evaluation of occupational exposure by introducing a "reduction factor" to adjust the occupational exposure limits of chemical hazardous agents for long working hour systems to ensure a protection level reasonable for the workers and equivalent to conventional occupational exposure limits. This paper discussed common problems encountered in the context of using this adjustment strategy, such as the adjustment being unable to cover all working hours, and the adjustment of values of terms associated with occupational exposure limits. Corresponding solutions were proposed. Working cycle and average exposure time of each working cycle were introduced to evaluate the actual working hours of workers. Regarding involved terms, adjustments of their corresponding values were clarified according to their definitions and application scenarios. Examples were provided for occupational health service providers so that their occupational health practices could be carried out in a more scientific and reasonable manner.

Effect of multi-target transcranial direct current stimulation on performance of working memory-postural control dual-task in healthy adults / 中国康复理论与实践

ObjectiveTo investigate the effect of multi-target transcranial direct current stimulation (tDCS) and single-target tDCS on the performance of working memory-postural control dual-task in healthy adults, and to compare the regulatory effect of the two stimulation protocols. MethodsFrom November, 2020 to February, 2021, 19 healthy adults in Shanghai University of Sport were recruited and randomly accepted multi-target tDCS, single-target tDCS and sham stimulation with at least one week interval between any two stimulation protocols. The target areas of multi-target tDCS included left dorsal lateral prefrontal cortex (L-DLPFC) and bilateral primary motor cortex (M1), and single-tDCS only applied to L-DLPFC. Before and after stimulation, participants completed walking and standing balance tests under single task and dual-task conditions with the second task being a N-back task. The dual-task postural control performance, dual-task cost (DTC) and working memory performance were observed before and after stimulation. ResultsSignificant differences were observed among three stimulation protocols in the changes of stride variability (F = 3.792, P = 0.029), DTC of stride variability (F = 3.412, P = 0.040) and velocity of center of pressure (Vcop) (F = 3.815, P = 0.029). The stride variability (P = 0.047) and Vcop (P = 0.015) were significantly lower and the decrease in DTC of stride variability tended to be significant (P = 0.073) following multi-target tDCS, as compared to sham stimulation. Single-target tDCS significantly decreased the changes of stride variability (P = 0.011), DTC of stride variability (P = 0.014) and Vcop (P = 0.025), as compared to sham stimulation. Compared with single target tDCS, multi-target tDCS reduced the changes of the dual-task cost of the area of center of pressure (P = 0.035). Moreover, no significant difference was observed among the three stimulation protocols in the changes of each measure in the working memory test (P > 0.05). ConclusionBoth multi-target tDCS and single-target tDCS can improve the performance of working memory-postural control dual-task in healthy adults, and compared with single-target tDCS, multi-target tDCS has some advantages in regulating postural control.

Health status of photovoltaic module production workers in Shanghai / 环境与职业医学

Background Photovoltaic (PV) cells can convert solar energy into electricity and alleviate the dilemma of energy supply shortage. Shanghai's PV module industry is booming, but there are few reports on the health status of the workers and there is an urgent need for health risk assessment. Objective To evaluate the health status of PV module production workers and the association between work and health status, in order to provide a direction for the health management of the workers. Methods Among the PV module production workers who completed prescriptive occupational health examination by a designated medical institution in 2021, 2453 workers with more than one year of working age were selected as the exposure group and 538 newly hired workers as the control group. On the basis of the Technical specifications for occupational health surveillance (GBZ 188−2014), the health examination included physical examination and laboratory examination and information such as sociodemographics, living habits, and disease history. We compared the indicators of pure-tone hearing test, blood routine examination, electrocardiogram (ECG), liver function, and kidney function between the two groups. The blood routine results included erythrocyte-related indicators, leukocyte-related indicators, and platelet-related indicators, and the results of liver function included hepatocyte injury indicators, hepatic secretory function indicators, and hepatic synthesis function indicators. The workers were divided into four groups by quartiles of working age. Trend chi-square test was used to analyze differences in health status between the four working age groups. Multiple logistic regression models were used to evaluate the association between working age and health indicators. Results Among the exposure group workers, 2035 (83.0%) were male and 418 (17.0%) were female. The median (P25, P75) age was 34.0 (30.0, 39.0) years and the median (P25, P75) working age was 6.0 (3.0, 10.0) years. The abnormality rate of blood routine was 61.7%. Among them, the abnormality rates of platelet-related indicators and liver secretory function indicators were 39.8% and 48.1% respectively. The risks of abnormal hepatocyte injury-related indicators, fatty liver, and platelet-related indicator abnormalities among the exposure group were 1.471 (95%CI: 1.060, 2.054), 1.691 (95%CI: 1.208, 2.385), and 7.576 (95%CI: 4.967, 11.994) times higher than those in the control group respectively. The single-factor analysis demonstrated a positively linear trend between working age and hypertension prevalence, electrical audiometry abnormality rate, or liver secretory function indicator abnormality rate. Corrected for gender, age, smoking status, hypertension, etc., the results of logistic analysis showed that quartile working age was positively related to abnormal liver secretion function and abnormal platelet-related indicators respectively (OR=1.047, P=0.005; OR=1.037, P=0.014), and inversely associated with the abnormal rate of renal function (OR=0.953, P=0.044). Conclusion Negative associations between health status and working age are identified in PV module production workers. The target PV module production employees are in younger age, and with the increase of working age, the abnormalities of liver function and platelets may increase. Therefore, the enterprises should extend occupational health work from workplace to workers.

Theta Oscillations Support Prefrontal-hippocampal Interactions in Sequential Working Memory / 神经科学通报·英文版

The prefrontal cortex and hippocampus may support sequential working memory beyond episodic memory and spatial navigation. This stereoelectroencephalography (SEEG) study investigated how the dorsolateral prefrontal cortex (DLPFC) interacts with the hippocampus in the online processing of sequential information. Twenty patients with epilepsy (eight women, age 27.6 ± 8.2 years) completed a line ordering task with SEEG recordings over the DLPFC and the hippocampus. Participants showed longer thinking times and more recall errors when asked to arrange random lines clockwise (random trials) than to maintain ordered lines (ordered trials) before recalling the orientation of a particular line. First, the ordering-related increase in thinking time and recall error was associated with a transient theta power increase in the hippocampus and a sustained theta power increase in the DLPFC (3-10 Hz). In particular, the hippocampal theta power increase correlated with the memory precision of line orientation. Second, theta phase coherences between the DLPFC and hippocampus were enhanced for ordering, especially for more precisely memorized lines. Third, the theta band DLPFC → hippocampus influence was selectively enhanced for ordering, especially for more precisely memorized lines. This study suggests that theta oscillations may support DLPFC-hippocampal interactions in the online processing of sequential information.

Methodology for the Development of Clinical Practice Guidelines for Chinese Patent Medicine： 2.Establishment of Guideline Working Group and Management of Conflict of Interests / 中医杂志

This paper summarized the key points and methods in terms of the establishment of the guideline working group and the management of conflict of interests， trying to provide reference for the development of clinical practice guidelines for Chinese patent medicine （CPM）. The establishment of the working group is the first important step for developing CPM guidelines. Considering the characteristics of the clinical practice guidelines for CPM， this study suggests that the three key elements of ‘multidisciplinarity’， ‘clinical relevance’ and ‘geographical representativeness’ should be put focus on when forming the working group. The guideline advisory committee， clinical expert group， evidence systematic evaluation group， secretary group and the external review group should be established. All group members should clarify the conflict of interest， and the process and management method of the conflict of interest should be clearly reported.

Relación entre la edad, la memoria de trabajo y la capacidad de reserva cognitiva en adultos mayores de 40 años / Relationship between age, working memory and cognitive reserve capacity

Resumen Objetivo. En este trabajo, se pretende conocer la relación entre la edad, la memoria de trabajo verbal y visoespacial, y la reserva cognitiva en adultos mayores de 40 años. Método. Se trabajó con una muestra conformada por 50 personas de 40 años en adelante, de ambos sexos y sin patologías asociadas. Para la recolección de datos, se administraron las subpruebas de INECO frontal screening, que corresponden al índice de memoria de trabajo (IMT), y el Cuestionario de Reserva Cognitiva (CRC). Resultados. En esta muestra, se pudo determinar que, mientras mayor capacidad de reserva cognitiva posea una persona, mayor será su capacidad de memoria de trabajo, en especial, de tipo visoespacial.

Abstract Objective. In this work, it was intended to show the relationship between age, verbal and visuospatial working memory, and cognitive reserve in people over 40 years old. Method. The sample was composed of 50 people from 40 years old onwards, of both genders and without associated pathologies. For data collection, the INECO frontal screening subtests and the Cognitive Reserve Questionnaire (CRC) were administered. Results. In this sample, it was possible to determine that the greater the cognitive reserve capacity a person has, the greater their working memory capacity will be, specially the visuospatial type.