The Prevalence of Abdominal Adiposity among Primary Health Care Physicians in Bahia, Brazil: An Epidemiological Study.

BACKGROUND: Labor activities are demanding for workers and can induce occupational stress. Primary health care (PHC) workers have faced problems that can lead to the development of stress and abdominal obesity. The aim of this study was to estimate the prevalence of abdominal adiposity among primary health care physicians in the metropolitan mesoregion of Salvador, Bahia. METHODS: This is a cross-sectional study conducted with physicians from the family health units (FHUs) of the metropolitan mesoregion of Salvador, Bahia, Brazil. The number of FHUs corresponded to 41 teams (52 physicians). Anamnesis was performed and a questionnaire was applied. The clinical examination consisted of measuring waist circumference (WC), blood pressure levels (BP), and body mass index (BMI), as well as examining for acanthosis nigricans. Blood samples were collected for biochemical dosages. The data obtained were analyzed by SPSS version 22.0. RESULTS: The sample included 41 physicians (response rate: 78.8%), of which 18 were women (44.0%). The percentage of overweight participants represented by BMI was 31.7%. The hypertriglyceridemia prevalence was 29.2%. HDL-c was low in 48.7% of the participants. The waist circumference measurement revealed a prevalence of abdominal adiposity of 38.8% (women) and 34.8% (men). CONCLUSIONS: Medical professionals in PHC are more susceptible to having higher abdominal adiposity, especially female physicians.

Prevalence and Factors Associated with Burnout Syndrome among Primary Health Care Nursing Professionals: A Cross-Sectional Study.

The objective of the study was to evaluate the prevalence and factors associated with Burnout Syndrome (BS) in Primary Health Care (PHC) nursing professionals from the state of Bahia, Brazil. A multicentre, cross-sectional population-based study was conducted in a cluster sample among 1125 PHC Nursing professionals during the years 2017 and 2018. We used a questionnaire that included sociodemographic, labor and lifestyle variables and the Maslach Burnout Inventory scale to identify BS. The associations were evaluated using a robust Poisson regression with the hierarchical selection of the independent variables. The prevalence of BS was 18.3% and the associated factors were ethnicity (prevalence ratio (PR) = 0.62, confidence interval (CI) 95% = 0.47-0.83), residence (PR = 2.35, CI 95% = 1.79-3.09), economic situation (PR = 1.40, CI 95% = 1.06-1.86), satisfaction with current occupation (PR = 1.75, CI 95% = 1.31-2.33), (PR = 1.60, CI 95% = 1.23-2.08), rest (PR = 1.83, 95% CI = 1.41-2.37), technical resources and equipment (PR = 1.37, CI 95% = 1.06-1.77), night shift (PR = 1.49, CI 95% = 1.14-1.96), physical activity practice (PR = 1.72; CI 95% = 1.28-2.31), smoking (PR = 1.82, CI 95% = 1.35-2.45), and satisfaction with physical form (PR = 1.34, CI 95% = 1.01-179). Strategies are needed to prevent BS, with an emphasis on implementing worker health programs in the context of PHC.

Percepções de familiares/cuidadores sobre internação domiciliar de pessoas com dependência de cuidado / Family members'/Caregivers' perceptions about domiciliary hospitalization of people dependent on care

Objetivo: Analisar as percepções de familiares/cuidadores sobre a internação domiciliar de pessoas com doenças crônicas ou em estado terminal na assistência prestada por profissionais de saúde. Métodos: Realizou-se um estudo qualitativo, entre março e abril de 2014, com entrevistas semiestruturadas, no domicílio de pacientes em internação domiciliar, com oito familiares/cuidadores em um município da Bahia, Brasil. Analisaram-se os dados pelo método da análise de conteúdo, que permitiu a apreensão da categoria do estudo ­ percepções dos familiares/cuidadores de pessoas com dependência de cuidado sobre a internação domiciliar. Resultados: Os entrevistados demonstraram satisfação com a internação domiciliar, pelo cuidado diferenciado desse modo de atenção, pela redução de deslocamentos e por proporcionar conforto e interação entre equipe de saúde, familiares e a pessoa que necessita de cuidados. Além disso, o cuidado é respaldado no respeito à individualidade e à singularidade de cada família. Também viu-se que os entrevistados compreendem o quantitativo de profissionais como insuficiente, havendo necessidade de ampliar a equipe. Assim, convém sensibilizar a equipe sobre a relevância de discutir com familiares/cuidadores sobre seus direitos como cidadãos. Conclusão: O internamento domiciliar, na percepção dos entrevistados, é uma modalidade complementar à hospitalização essencial, uma vez que a equipe domiciliar proporciona um cuidado humanizado e próximo à família. Contudo falas evidenciam que o serviço ofertado a esses pacientes parece ser um favor prestado a eles, e não um direito do paciente de receber esse serviço público de saúde. (AU)

The presence of eschars, but not greater severity, in Portuguese patients infected with Israeli spotted fever.

In Portugal, Mediterranean spotted fever (MSF) is caused by R. conorii Malish and Israeli spotted fever (ISF) strains. It has been suggested that the ISF strain isolated from patients with MSF causes different clinical manifestations compared to those caused by Malish strain, namely the absence of eschar and greater severity. The aim of this study was to analyze the presence or absence of eschar and of fatality in Portuguese patients infected with either Malish or ISF strain. Of 94 patients with a clinical diagnosis of MSF between 1994 to 2004, 47 were infected with Malish strain and 47 with ISF strain. Eschars were reported in 20 patients (49%) infected with Malish strain, and in 17 (39%) with ISF strain. The presence of eschar is not statistically associated to a greater extent with either R. conorii strain (P=0.346). A total of 22 patients died, 9 infected with Malish strain and 13 infected with ISF strain, and no statistically significant difference was found (P=0.330). This study showed that the concepts of absence of the eschar and greater severity in Israeli spotted fever infection should be revised.