Workplace bullying and sexual harassment among general surgery residents in Colombia / Acoso laboral y sexual en residentes de cirugía general en Colombia

Introduction. Workplace bullying and sexual harassment are concerns among general surgery residents in Colombia. Objective. To explore the prevalence and impact of workplace bullying and sexual harassment incidents among general surgery residents in Colombia. Materials and methods. This nationwide study was conducted in 2020. Residents selfrated their exposure to workplace bullying and to sexual harassment in the forms of gender harassment, unwanted sexual attention, and sexual coercion. We analyzed demographic variables, perpetrator's characteristics, and differences between victims and non-victims. Results. The study included 302 residents. It found that 49% of general surgery residents in Colombia suffered from workplace bullying and 14.9% experienced sexual harassment. The main forms of sexual harassment were gender harassment (47%) and unwanted sexual attention (47%). Women reported significantly higher rates of being sexually harassed. Surgeons were the main perpetrators of sexual harassment. Conclusions. Workplace bullying and sexual harassment are frequent events in general surgery residency in Colombia. These findings suggest the need for interventions to improve the educational culture of surgical departments and decrease the prevalence of these behaviors.

Introducción. El acoso laboral y el acoso sexual son preocupaciones en la formación quirúrgica. Objetivo. Exploramos la magnitud de estos problemas entre los residentes de cirugía general en Colombia. Materiales y métodos. Se realizó un estudio nacional en junio de 2020. Los residentes autoevaluaron su exposición a la intimidación y el acoso sexual en forma de acoso de género, atención sexual no deseada y coerción sexual. Se analizaron variables demográficas y perpetradores entre víctimas y no víctimas. Resultados. Se incluyeron un total de 302 residentes. Las tasas de acoso laboral y sexual fueron del 49% y 14,9%, respectivamente. Las principales formas de acoso sexual correspondieron al acoso de género (47%) y la atención sexual no deseada (47%). El acoso sexual fue significativamente mayor entre las mujeres. Los cirujanos fueron los principales perpetradores. Conclusiones. El acoso laboral y el acoso sexual son frecuentes en la formación quirúrgica en Colombia. Estos hallazgos conducen a intervenciones para mejorar la cultura educativa de los departamentos quirúrgicos para disminuir la prevalencia de estos comportamientos.

Associação entre características sociodemográficas e de saúde e o grau de dificuldade de locomoção dos idosos / Association between sociodemographic and health characteristics and the level of difficulty of locomotion of elderly / Asociación entre características sociodemograficas y de salud y el grado de dificultad de locomoción de ancianos

Objetivo: O presente artigo tem como objetivo analisar a associação entre características sociodemográficas e de saúde e o grau de dificuldade de locomoção dos idosos, no Brasil. Método: Foi utilizado o modelo de chances proporcionais parciais e os dados da Pesquisa Nacional de Saúde 2013. Resultados: Na análise ajustada, observou-se maior grau de dificuldade de locomoção entre idosos mais velhos, não casados (OR=1/0,759=1,318;p-valor<0,001), sem instrução (OR=1,433;p-valor=0,026), residentes na região Sul (OR=1,448;p-valor=0,019) e que reportaram piores níveis de saúde geral. Além disso, idosos com diagnóstico de doença crônica, física ou mental apresentaram maior chance de reportar dificuldade de locomoção (OR=1,645;p-valor<0,001). Conclusão: Devido à natureza dos fatores associados, destaca-se a necessidade de ações de promoção e educação em saúde a fim de reduzir as complicações e danos à saúde dos idosos que comprometam a sua capacidade funcional, especialmente na região Sul do Brasil

Objective: this article aims to analyze the association between sociodemographic and health characteristics and the degree of locomotion difficulty of the elderly in Brazil. Methods: the partial proportional odds model and data from the National Health Survey 2013 were used. Results: in the adjusted analysis, a greater degree of locomotion difficulty was observed among older, unmarried elderly (OR=1/0.759=1.318; p-valor<0,001), without education level (OR=1.433, p-value=0.026), who were in the southern region (OR=1.448, p-value=0.019) and reported worse overall health. In addition, the elderly with a diagnosis of chronic, physical or mental illness had a greater odds of reporting difficulty in locomotion (OR=1.645; p-value<0.001). Conclusion: due to the types of factors associated, health promotion and education actions are necessary to reduce the complications and damages to the health of the elderly that compromise their functional capacity, especially in the Southern region of Brazil

Objetivo: el presente artículo tiene como objetivo analizar la asociación entre características sociodemográficas y de salud y el grado de dificultad de locomoción de los ancianos en Brasil. Métodos: se utilizó el modelo de odds proporcionales parciales y los datos de la Encuesta Nacional de Salud 2013. Resultados: en el análisis ajustado, se observó mayor grado de dificultad de locomoción entre ancianos mayores, no casados (OR =1/0,759=1,318; p-valor r<0,001). sin instrucción (OR=1,433; p-valor=0,026), residentes en la región Sur (OR=1,448; p-valor=0,019) y que reportaron peor salud general. Además, ancianos con diagnóstico de enfermedad crónica, física o mental presentaron mayor odds de reportar dificultad de locomoción (OR =1,645;p-valor<0,001). Conclusión: debido a la naturaleza de los factores asociados, se destaca la necesidad de acciones de promoción y educación en salud para reducir las complicaciones y daños a la salud de los ancianos que comprometen su capacidad funcional, especialmente en la región Sur de Brasil

Queda em idosos: estudo de base populacional / Falls in the elderly: a population-based study

OBJETIVO: Avaliar a prevalência de quedas em idosos e possíveis fatores associados. MÉTODOS: Estudo transversal de base populacional realizado por meio da aplicação de questionário domiciliar a todos os idosos com 60 anos ou mais residentes nas zonas urbana e rural do município de Arroio Trinta (SC), em 2013. Realizou-se análise bivariada, buscando medir o nível de associação entre as variáveis independentes com o desfecho "presença de quedas". Para a comparação entre proporções, foi utilizado o teste qui quadrado. RESULTADOS: Do total de 568 idosos, 552 participaram do estudo. A prevalência de quedas foi de 28,3%; a prevalência de três ou mais quedas (38,5%) foi ligeiramente superior a de uma única (35,9%), sendo o próprio lar (49,3%) o local de maior ocorrência. Em 13,5% das quedas, ocorreram fraturas. O aumento da idade mostrou-se associado às quedas nos idosos (p=0,04). CONCLUSÃO: A prevalência encontrada, mesmo dentro dos padrões brasileiros, é elevada, considerando que se trata de um desfecho evitável. A idade avançada foi a única variável associada ao desfecho neste estudo. As quedas em idosos são multifatoriais e de complexa análise, sendo necessários mais estudos para se definirem os fatores associados, bem como comparar as diferentes realidades brasileiras.(AU)

OBJECTIVE: To evaluate the prevalence of falls in the elderly, as well as the possible associated factors. METHODS: Crosssectional, population-based study performed through the application of a household questionnaire to every person of 60 years of age or older living in the urban and rural areas of the city of Arroio Trinta (state of Santa Catarina) in 2013. A bivariate analysis was performed to evaluate the association level among independent variables and the outcome (occurrence of falls). The Chi-square test was performed for proportion comparison. RESULTS: There were 568 elderly people, of whom 552 participated in the study. The prevalence of falls was 28.3%;the prevalence of three or more falls (38.5%) was slightly above that of one single fall (35.9%), with the own home (49.3%) being the place of greatest occurrence of falls. Fractures occur in 13.5% of falls. Age increase was associated with falls (p=0.04). CONCLUSION: The prevalence found, even though within Brazilian standards, is high because it is a preventable outcome. The advanced age was the only variable associated with the outcome in this study. Falls in the elderly are multifactorial and of complex analysis; therefore, more studies are necessary to define the associated factors, as well as to compare the different realities in Brazil.(AU)

Misoprostol como método de interrupción del embarazo, una alternativa clínica económica / Misoprostol as a method of pregnancy interruption, a clinical and economical alternative

Fundamento: el aborto es la expulsión del producto de la concepción cuando todavía no es capaz de sobrevivir fuera del seno materno. Objetivo: comparar clínica y económicamente la efectividad del misoprostol como método de interrupción del embarazo con el método tradicional. Método: se realizó un estudio transversal descriptivo en el Hospital Universitario Manuel Piti Fajardo, Florida Camagüey, desde de enero hasta diciembre de 2010. El universo estuvo formado por 600 pacientes que acudieron a consulta de planificación familiar, la muestra quedó constituida por 450 embarazadas que cumplían los criterios de inclusión. Los datos fueron recogidos y procesados de forma computarizada, como medidas estadísticas números y por cientos. Resultados: el método se consideró efectivo ya que provocó el aborto completo sin requerir procedimiento quirúrgico. El aborto completo ocurrió en 409 pacientes, en el primer ciclo se presentaron 41 fallos, a 19 pacientes se les aplicó una segunda dosis y a las 22 restantes se les aplicó método quirúrgico, se logró mayor efectividad con el primer ciclo en 390 pacientes. Con la aplicación del método no quirúrgico existió un ahorro en el presupuesto de $16793.54. Conclusiones: los efectos secundarios más frecuentes después de aplicado el método fueron escalofríos, náuseas y dolores pélvicos, el mayor número de pacientes logró el aborto completo con la utilización del misoprostol vaginal en el primer ciclo donde fue poco representativo el número de fallos. Con la aplicación del método farmacológico existió un ahorro en el presupuesto de $16793.54 comparándolo con el aborto quirúrgico.

Background: abortion is the expulsion of a human fetus when it is not yet able to survive outside the womb. Objective: to compare clinical and economic effectiveness of misoprostol as a method of termination of pregnancy with the traditional method. Method: a descriptive, cross-sectional study was conducted at the University Hospital Manuel Piti Fajardo, Florida Camagüey, from January to December 2010. The universe was constituted by 600 patients who came to family planning consultation; the sample was made up 450 pregnants which met the inclusion criteria. Data were collected and processed in computerized form, as statistical measures, numbers and percents. Results: this method was considered effective because comprehensive abortion was achieved without requiring surgical procedure. Comprehensive abortion occurred at 409 patients, 41 failures were presented in the first cycle, 19 patients were applied a second dose and the 22 remaining surgical method was applied to them, the method was more effective with the first cycle in 390 patients. With the implementation of non-surgical method, there was a saving in the budget of $16793.54. Conclusions: the most common side effects after the use of this method were chills, nausea, and pelvic pain, the largest number of patients achieved comprehensive abortion with the use of vaginal misoprostol in the first cycle where the number of failures was unrepresentative. With the implementation of the pharmacological method, there was a saving in the budget compared to surgical abortion.

Patterns of Alcohol Consumption among Male Adults at a Slum in Kolkata, India.

Globally, alcohol-abuse is a major cause of mortality and morbidity. Consumption of alcohol has increased in India in the recent decades. It is imperative to know the patterns of alcohol consumption among different types of consumers to launch a well-planned nationwide programme for the prevention and control of this devastating social pathology. This community-based, cross-sectional study was undertaken to identify the patterns of alcohol intake among different types of alcohol consumers and to assess the clinical signs of chronic harmful alcohol-use. A predesigned, pretested, semi-structured alcohol-use disorders identification test (AUDIT) questionnaire was used for interviewing males, aged >18 years, selected by random sampling from an updated household list of a randomly-selected sector of the service area of the Urban Health Centre in Chetla, Kolkata, West Bengal, India. Written informed consents were obtained from all the respondents. Relevant clinical examination for chronic harmful alcohol-use was done according to the AUDIT clinical screening procedures. The results revealed that 65.8% (150/228) were current consumers of alcohol; 14% were alcohol-dependents; 8% were hazardous or harmful consumers, and 78% were nonhazardous non-harmful consumers. The mean age of the respondents at the initiation of drinking alcohol was 20.8+5.9 years. Eighty-six percent of dependents (n=21) took both Indian-made foreign liquor and locally-made alcoholic beverages. The proportions of alcohol consumers who drank alone among alcoholdependents, hazardous or harmful consumers, and non-hazardous non-harmful consumers were 71.4%, 50%, and 7.7% respectively, and the difference was significant (p<0.01). Forty-one percent of the consumers drank at public places and workplaces, which may be socially harmful. About 38% of the dependents purchased alcohol from unlicensed liquor shops. Only 16% expressed concerns for their drinking habit mainly to the past illness. The proportion of the concerned respondents was higher in the hazardous and harmful drinking patterns than in the non-hazardous non-harmful drinking pattern, and the difference was significant (p<0.05). About 62% of the dependents had clinical signs of chronic alcohol consumption. The presence of a considerable proportion of alcohol-dependents, the low mean age at initiation of drinking alcohol, and the habit of drinking in public places and workplaces are the main areas that need special emphasis by intervention programmes.

Perfil sociodemográfico e antropométrico de idosos de grupos de convivência / Sociodemographic and anthropometric profile of elderly people from coexistence groups

Objetivou-se neste estudo descrever e analisar o perfil sociodemográficoe antropométrico de idosos de grupos de convivência. Oestudo transversal foi formado por 181 idosos (98 mulheres e 83homens) de 18 diferentes grupos de Aracaju-SE. As variáveis sociodemográficasforam: idade, escolaridade, estado civil e renda.As antropométricas foram: massa corporal (MC), estatura, circunferênciada cintura (CC) e do quadril (CQ). Calculou-se o IMC e oRCQ. Empregou-se a estatística descritiva, teste “t” para amostrasindependentes e análise de variância, com comparações post-hocde Tukey, adotando um p<0,05. A maioria dos idosos tinha mais de70 anos (64%), eram do sexo feminino (54%), com no máximo ensinofundamental (73%), casados (68%) e com renda própria (60%). A MC e a estatura diminuíram com o passar da idade. Em média,o IMC foi superior aos recomendados em todas as faixas etárias.Mais mulheres do que homens apresentaram inadequação na CCe RCQ.

The aim of this study was to describe and analyze sociodemographicand anthropometric profile of elderly from coexistence groups. Thecross-sectional study was formed by 181 elderly people (98 womenand 83 men) of 18 different groups of Aracaju-SE. The sociodemographicvariables were: age, education, marital status and income.The anthropometric were: body mass (BM), height, waist circumference(WC) and hip (WH). The BMI and the WHR were calculates.It was applied the descriptive statistics, “t” test for independentsamples and analysis of variance, with post-hoc of Tukey, adopting p <0.05. Most elderly people had more than 70 years (64%), werefemale (54%), with at most elementary school (73%), married (68%),and with own income (60%). The BM and stature declined with theage passage. On average, BMI was higher than those recommendedfor all ages. More women than men showed inadequacy in the WCand WHR.

Fatores associados à não realização do exame de Papanicolau: estudo transversal de base populacional em duas capitais brasileiras

O câncer do colo do útero corresponde a cerca de 15% de todos os tipos de câncer em mulheres, no mundo. No Brasil, em 2002, o câncer de colo do útero foi responsável por 7,1% de todas as mortes por câncer em mulheres, ocupando a quarta posição entre os demais. Para o mesmo ano, a taxa de mortalidade por câncer do colo do útero ajustada por idade, pela população padrão mundial, foi de 5,03/100.000. Já as taxas de incidência ajustadas por idade variaram entre 14,3 por 100.000 mulheres em Salvador e 50,7 por 100.000 mulheres no Distrito Federal, para o período compreendido entre 1991 e 2001. O câncer do colo do útero inicia-se a partir de uma lesão pré-invasiva, curável em até 100% dos casos, que geralmente progride lentamente, por anos, antes de atingir o estágio invasor da doença, quando a cura se torna mais difícil, quando não impossível. A abordagem mais efetiva para o controle do câncer do colo do útero continua sendo o rastreamento por meio o exame preventivo de Papanicolaou. O objetivo deste estudo foi identificar fatores associados à não realização do exame de Papanicolaou em mulheres de 25 a 59 anos nos três anos anteriores à pesquisa, nos municípios de Fortaleza e Rio de Janeiro. Para cada localidade foi utilizado o delineamento transversal, de base populacional com amostragem por conglomerados com dois estágios de seleção e auto-ponderada. Os dados foram analisados por regressão de Poisson obedecendo a um modelo hierárquico previamente determinado. O percentual de mulheres não submetidas ao exame de Papanicolaou nos três nos anteriores à pesquisa, em Fortaleza e no Rio de Janeiro, foi de 19,1% (IC95%: 16,1- 22,1) e 16,5% (IC95%: 14,1-18,9), respectivamente. Mulheres de baixa escolaridade, de menor renda per capita, de maior idade, não casadas, não submetidas a mamografia, ao exame clínico das mamas, aos exames de glicemia e colesterolemia foram as que apresentaram as maiores de razões de prevalências para a não realização do exame de Papanicolaou, em ambas as localidades. As fumantes foram menos submetidas ao exame em relação às demais mulheres, sendo essa diferença estatisticamente significativa somente no Rio de Janeiro. Finalmente, as informações aqui apresentadas apontam para a necessidade de intervenção em um grupo específico de mulheres. Deve-se priorizar atividades de educação para o diagnóstico precoce e rastreamento em mulheres sintomáticas e assintomáticas, respectivamente, além da garantia de acesso aos métodos de diagnóstico e tratamento adequados.

Cervical cancer corresponds to about 15% of all cancer types in women, in the world. In Brazil, in 2002, the cervical cancer was responsible for 7.1% of all cancer deaths in women, occupying the fourth position. In the same year, the age standardized mortality rate for cervical cancer was of 5.03/100,000. The age standardized incidence rate varied from 14.3 per 100,000 women in Salvador to 50.7 per 100,000 women in Federal District, for the period between 1991 and 2001. Cervical cancer arises from a pre-invasive lesion, curable in up to 100% of the cases, that progresses usually slowly, per years, before reaching the invasive stage, when the cure becomes more difficult, if not impossible. The most effective approach for the control of cervical cancer continues to be screening through the Pap smear. The aim this study was to identify factors associated with failure of women from 25 to 59 years old to be submitted to the exam in the last three years, in Fortaleza and Rio de Janeiro. To each city we used a population-based cross-sectional study with self-weighting two-satage cluster sampling. Data analysis used Poisson regression according to a previously determined hierarchical framework. The women's percentage not submitted to the Pap smear three years previous to the survey, in Fortaleza and in Rio de Janeiro, was 19.1% (95%CI: 16.1-22.1) and 16.5% (95%CI: 14.1-18.9), respectively. Women of low education and per capita income, old age, not married, not submitted mammography, breast clinical examination, glycemia and cholesterolemia presented the largest prevalence ratios of failure to be submitted to the Pap Smear, in both places. The smokers were less submitted to the exam in relation to the other women, being that difference statistically significant only in Rio de Janeiro. Finally, the information presented points to the necessity of intervention in a specific group of women. Education activities must have priority for early diagnosis and screening in symptomatic and assymptomatic women, respectively, providing access to adequated methods of diagnosis and treatment..