Assessing community health workers' conditions for delivering care to patients in low-income communities.

In this paper we study the working conditions of Community Health Workers in performing house calls within low-income, violent communities in order to understand the challenges in delivering primary care in developing countries. We conducted field studies in two primary healthcare clinics and telephone surveys for 5 months in 2017 within systematic sample of 1690 community health workers based on clinics distributed along the health regions of the city of Rio de Janeiro, Brazil. A number of 759 interviews were completed, approximately 50% of the sample, 86% men and 14% women. Most participants are 30-39 years old (35%), followed by 27% of 40-49 years old participants. Results show that exposure to territorial violence and environmental or health-related diseases significantly affects CHWs. Moreover, CHWs have to develop a significant set of skills to cope with aspects of the territory, and those skills are not present in their training. As community health workers work on the sharp end of the healthcare system, responsible for outreaching, community education, counseling, and social support, our study presents contributions to government and management levels on working conditions inside communities, constraints in assistance, and difficulties in implementing primary care policies.

Effects of Urban Violence on Primary Healthcare: The Challenges of Community Health Workers in Performing House Calls in Dangerous Areas.

Community health workers in developing countries usually perform house calls in degraded and violent territories. Thus, in this paper we study the effects of urban violence in the performance of CHWs in poorly developed territories, in order to understand the challenges of delivering care to dangerous communities in developing countries. We conducted telephone surveys for 5 months in 2017, within a systematic sample of 2.000 CHWs based on clinics distributed along the health regions of the city of Rio de Janeiro, Brazil. We completed 766 interviews, approximately 40% of the sample, 86% man and 14% women. Most participants are 30 to 39 years old (35%), followed by 27% of 40 to 49 years old participants. As CHWs work on the sharp end of the healthcare system, responsible for outreaching, community education, counseling, and social support, our study presents contributions to government and management levels on working conditions inside communities, constraints in assistance, and difficulties in implementing primary care policies.

Ergonomics, safety, and resilience in the helicopter offshore transportation system of Campos Basin.

BACKGROUND: Air transportation of personnel to offshore oil platforms is one of the major hazards of this kind of endeavor. Pilot performance is a key factor in the safety of the transportation system. OBJECTIVE: This study seeks to identify the ergonomic factors present in pilots' activities that may in some way compromise or enhance their performance, the constraints and affordances which they are subject to; and where possible to link these to their associated risk factors. METHODS: Methodology adopted in this project studies work in its context. It is a merging of Activity Analysis (Guerin et al. 2001) of European tradition with Cognitive Task Analysis (CTA - www.ctaresource.com) articulated with the recent approaches to cognitive systems engineering developed by Professors David Woods and Erik Hollnagel. Fifty-five hours of field interviews provided the input for analysis. RESULTS: Sixteen ergonomic constraints were identified, some cognitive, some physical, all considered relevant by the research subjects and expert advisers. CONCLUSIONS: Although the safety record of the personnel transportation system studied is considered acceptable, there is low hanging fruit to be picked which can help improve the system's safety.

Modeling activities in air traffic control systems: antecedents and consequences of a mid-air collision.

In this article we present a model of some functions and activities of the Brazilian Air traffic Control System (ATS) in the period in which occurred a mid-air collision between flight GLO1907, a commercial aircraft Boeing 737-800, and flight N600XL, an executive jet EMBRAER E-145, to investigate key resilience characteristics of the ATM. Modeling in some detail activities during the collision and related them to overall behavior and antecedents that stress the organization uncover some drift into failure mechanisms that erode safety defenses provided by the Air Navigation Service Provider (ANSP), enabling a mid-air collision to be happen.

A method for work modeling at complex systems: towards applying information systems in family health care units.

Work in organizations requires a minimum level of consensus on the understanding of the practices performed. To adopt technological devices to support the activities in environments where work is complex, characterized by the interdependence among a large number of variables, understanding about how work is done not only takes an even greater importance, but also becomes a more difficult task. Therefore, this study aims to present a method for modeling of work in complex systems, which allows improving the knowledge about the way activities are performed where these activities do not simply happen by performing procedures. Uniting techniques of Cognitive Task Analysis with the concept of Work Process, this work seeks to provide a method capable of providing a detailed and accurate vision of how people perform their tasks, in order to apply information systems for supporting work in organizations.