Análise dos indicadores de boas práticas durante a assistência no trabalho de parto e nascimento em um hospital terciário de Santa Catarina / Analysis of indicators of good practice during care in labor and birth at a tertiary hospital in Santa Catarina / Análisis de indicadores de buenas prácticas durante la asistencia en la labor de nacimiento y nacimiento en un hospital terciario de Santa Catarina

Objetivos: Analisar os indicadores de boas práticas de assistência à mulher no trabalho de parto e pós-parto imediato em um hospital terciário de Santa Catarina. Métodos: Estudo observacional, analítico, transversal e retrospectivo, com abordagem quantitativa, onde foi realizada análise de prontuários das pacientes admitidas, entre dezembro de 2021 a julho de 2022. Sendo uma pesquisa censitária, na qual todas as pacientes que preencheram os critérios de elegibilidade integraram o estudo. Resultados: Foram analisados 1328 prontuários, destes, 549 atenderam os critérios de inclusão. Observamos bons índices de partos normais (58,57%) quando comparados a média nacional, referente aos indicadores de boas práticas, o contato pele a pele ao nascer, amamentação na primeira hora de vida e clampeamento tardio são executados de maneira satisfatória, assim como, os baixos índices de episiotomia e parto instrumental. Contudo, a alimentação no trabalho de parto e utilização de métodos não farmacológicos possuem baixa adesão. Conclusão: Pode-se concluir que o hospital estudado realiza, de forma global, boas práticas conforme o preconizado pelo Ministério da Saúde e OMS. PALAVRAS-CHAVE: Análise de Boas Práticas; Qualidade de Assistência à Saúde; Parto Humanizado; Trabalho de Parto; Métricas de Saúde.

Objectives: To analyze the indicators of good practices of assistance to women in labor and immediate postpartum in a tertiary hospital in Santa Catarina. Methods: Observational, analytical, cross-sectional and retrospective study, with a quantitative approach, where the analysis of medical records of the admitted patients was carried out, between December 2021 and July 2022. It is a census survey, in which all patients who met the eligibility criteria were included in the study. Results: 1328 records were analyzed, of which 549 met the inclusion criteria. We observed good rates of normal births (58.57%) when compared to the national average, referring to the indicators of good practice, skin-to-skin contact at birth, breastfeeding in the first hour of life and late clamp are performed satisfactorily, as well as the low rates of episiotomy and instrumental delivery. However, feeding in labor and the use of non-pharmacological methods have low adherence. Conclusion: It can be concluded that the hospital studied performs, in a global manner, good practices as recommended by the Ministry of Health and WHO. KEYWORDS: Analysis of Good Practices; Quality of Health Care; Humanized Delivery; Labor; Health Metrics.

Objetivos: analizar los indicadores de buenas prácticas para ayudar a las mujeres en el trabajo de parto y post parto inmediato en un hospital terciario de Santa Catarina. Métodos: Estudio observacional, analítico, transversal y retrospectivo con enfoque cuantitativo, donde se analizaron los registros médicos de los pacientes ingresados entre diciembre de 2021 y julio de 2022. Como encuesta censal, se incluyeron en el estudio todos los pacientes que cumplían los criterios de elegibilidad. Resultados: se analizaron 1328 registros, de los cuales 549 cumplían los criterios de inclusión. Se observaron buenos niveles de partos normales (58,57%) en comparación con la media nacional, referidos a indicadores de buenas prácticas, contacto cutáneo y cutáneo al nacer, lactancia materna durante la primera hora de vida y atadura tardía, se realizan de manera satisfactoria, así como los bajos niveles de episiotomía y parto instrumental. Sin embargo, la alimentación del trabajo de parto y el uso de métodos no farmacológicos son bajos. Conclusión: Se puede concluir que el hospital estudiado lleva a cabo, de manera global, buenas prácticas, como lo recomiendan el Ministerio de Salud y la OMS.

The Intersecting Consequences of Race-Gender Health Disparities on Workforce Engagement for Older Workers: An Examination of Physical and Mental Health.

The dramatic growth of older adults' labor participation over the past 25 years, including women and people of color, is reshaping the American labor force. The current study contributes new knowledge concerning why individuals over age 50 years may be working longer despite negative impacts of deteriorating physical and mental health associated with aging. Inquiries regarding who continues to work and why can be answered, in part, by addressing how workforce engagement and health are shaped by notable social inequities along the dimensions of age, race, and gender. Guided by cumulative advantage/disadvantage and intersectionality frameworks, we examine whether having multiple chronic conditions (MCC)-two or more physical conditions-and depression affect workforce participation. Using multinomial logistic regression models, we analyze the 2014-2016 waves of the Health and Retirement Study (N = 4250). Findings reveal that having multiple chronic illnesses increase the likelihood of labor force exit, especially among workers who also have depression. We also discover intersectional nuances which illuminate complex race-gender dynamics related to health and work processes in later life. We conclude with recommendations for workplace policy that promote the retention of older workers with chronic illness and depression and aim to decrease disparities in older workers' work engagement.

Estrés laboral: una revisión de las principales causas consecuencias y estrategias de prevención / Work Stress: A Review of the Main Causes, Consequences, and Prevention Strategies / O estresse no trabalho: uma revisão das principais causas, consequências e estratégias de prevenção

Introducción: El estrés laboral es una enfermedad peligrosa que altera el estado psicológico de la persona, porque genera reacciones y respuestas de tipo emocional, cognitivo, fisiológico y del comportamiento frente a situaciones con alta demanda laboral que sobrepasa los recursos personales y del trabajo. Se considera una problemática de tipo social y económica asociada con factores de riesgo psicosocial y con desencadenantes. Por ello, es fundamental su detección precoz, para evitar sus secuelas y para emplear estilos de afrontamiento. Objetivo: Analizar los referentes teóricos del estrés laboral, teniendo en cuenta sus principales causas, consecuencias y estrategias de prevención en el ámbito laboral. Metodología: Revisión documental disponible en las bases de datos Epistemonikos, ProQuest, Frontiers in Psychology, Academy, Biblioteca Digital, Elsevier, Redalyc, Dialnet, SciELO y Science Direct, de estudios publicados entre 2015 y 2020 que incluyeran conceptos de estrés laboral, causas, consecuencias y estrategias de prevención. Se revisaron 60 artículos, y para seleccionar la información se aplicó búsqueda, organización, categorización y análisis de 5554 documentos electrónicos. Se excluyeron 6 estudios relacionados con temas específicos del síndrome de burnout. Conclusiones: El estrés es una problemática prevalente en el contexto organizacional que se genera por múltiples factores asociados con las condiciones laborales y personales y origina en el individuo consecuencias fisiológicas y mentales que afectan su desempeño y productividad. De ahí que sea necesario incentivar una cultura preventiva que fomente la salud de los colaboradores.

Introduction: The labor stress is dangerous disease that alters the psychological state of the person, by generating emotional, cognitive, physiological and behavioral reactions and responses to situa-tions with high work demand that exceeds personal and work resources. It is considered as a social and economic problem associated with psychosocial risk factors and triggers, which, it is essential to attach importance to its early detection and thus avoid its consequences, as well as the use of coping styles. Objective: To analyze the theoretical references of work stress, considering the main causes, conse-quences and prevention strategies in the workplace. Methodology: Documentary review available in the databases Epistemonikos, ProQuest, Frontiers in Psychology, Academy, Bibliotheca Digital, Elsevier, Redalyc, Dialnet, SciELO and Science Direct. Inclusion criteria: works published between 2015 and 2020 that include concepts of work stress, causes, consequences and prevention strategies. 60 articles were reviewed to select the information, a search, organization, categorization and analysis of 5554 electronic documents were applied, 6 studies related to specific topics of Burnout syndrome were excluded. Conclusions: Stress is a prevalent problem in the organizational context that is generated by multiple factors associated with the work and personal conditions, originating in the individual consequences of physiological and mental type affecting the performance and the productivity, being necessary to stimulate a preventive culture that promotes the health of the collaborators.

Introdução: O estresse relacionado ao trabalho é uma doença perigosa que altera o estado psicoló-gico da pessoa, pois gera reações emocionais, cognitivas, fisiológicas, comportamentais e respostas a situações com altas exigências de trabalho que excedem os recursos pessoais e de trabalho. É conside-rado um problema social e econômico associados a fatores de risco psicossociais e desencadeadores. É, portanto, essencial detectá-lo cedo, para evitar suas consequências e usar estilos de enfrentamento. Objetivo: Analisar as referências teóricas do estresse relacionado ao trabalho, levando em conta suas principais causas, consequências e estratégias de prevenção no local de trabalho. Metodologia: revisão documental disponível nas bases de dados Epistemonikos, ProQuest, Frontiers in Psychology, Academy, Digital Library, Elsevier, Redalyc, Dialnet, SciELO e Science Direct, de estudos publicados entre 2015 e 2020 que incluíam conceitos de estresse relacionado ao trabalho, causas, consequências e estratégias de prevenção. Sessenta artigos foram revisados, e para selecionar as informações, foi aplicada uma pesquisa onde foram organizados, categorizados e analisados 5554 documentos eletrônicos. Foram excluídos seis estudos relacionados a questões específicas da Síndro-me de Burnout. Conclusões: O estresse é um problema predominante no contexto organizacional que é gerado por múltiplos fatores associados às condições de trabalho e pessoais, e causa consequências fisiológicas e mentais no indivíduo que afetam seu desempenho e produtividade. Portanto, é necessário incentivar uma cultura preventiva que promova a saúde dos funcionários.Palavras-chave: estresse ocupacional; psicossocial; saúde ocupacional; trabalhadores.

[Future of acute inpatient rheumatology in Germany : Statement of the Boards of the German Society for Rheumatology and the Association of Rheumatological Acute Clinics on hospital planning North-Rhine/Westphalia 2019 for the discipline rheumatology]. / Zukunft der akutstationären Rheumatologie in Deutschland : Stellungnahme der DGRh- und VRA-Vorstände zur Krankenhausplanung NRW 2019 für den Leistungsbereich Rheumatologie.

In September 2019 the Ministry of Labor, Health and Welfare (MAGS) of North-Rhine/Westphalia (NRW) published an expert report on hospital planning. In this report a fundamental reform of hospital planning was recommended, in that a requirements planning should be carried out in the future on the basis of a detailed designation of disciplines and organizational groups. At the request of the MAGS NRW, the German Society for Rheumatology (DGRh) with the support of the Association of Rheumatological Acute Clinics (VRA) has also commented on this issue.

Occupational Assessments of Risk Factors for Cardiovascular Diseases in Labors: An Application of Metabolic Syndrome Scoring Index.

Unlike a traditional diagnosis of metabolic syndrome (MS), a numerical MS index can present individual fluctuations of health status over time. This study aimed to explore its value in the application of occupational health. Using a database of physiological and biochemical tests and questionnaires, data were collected from 7232 participants aged 20 to 64 years who received occupational health screenings at a health screening institution in 2018. Using confirmatory factor analysis, five components of MS were used to design an MS severity scoring index, which was then used to evaluate the risks of occupation factors. Waist circumference was the largest loading factor compared with the other MS components. Participants who worked in the traditional industrial, food processing, or electronic technology industries had higher MS severity than those in the logistics industry. Those who worked as a manager or over five years had a relatively high severity. The research showed that assessments based on an MS severity score are applicable when the risk factors of suboptimal health are involved. By monitoring the scores over time, healthcare professionals can propose preventive strategies in time, thus enhancing the effectiveness of occupational health examination services.

Hematobium schistosomiasis control for health management of labor force generation at Nkhotakota and Lilongwe in the Republic of Malawi-assumed to be related to occupational risk.

BACKGROUND: In Malawi, hematobium schistosomiasis is highly endemic. According to previous studies, countermeasures have been conducted mainly in school-aged children. In this study, we focused on the age groups, which are assumed to be major labor force generation. Hematobium schistosomiasis is supposed to be related to occupational activities in schistosome-endemic countries because of its infectious route. We chronologically followed the transition of schistosome egg-positive prevalence before and after mass drug administration of praziquantel (MDA) by using a urine filtering examination. We also analyzed the effectiveness of urine reagent strips from the cost perspective. RESULTS: The egg-positive prevalence was 34.3% (95% CI 28.5-40.5) just before MDA in June 2010 and the highest prevalence was in the age of twenties. The egg-positive prevalence reduced to 12.7% (95% CI 9.2-17.3, p < 0.01) 8 weeks after the first MDA and the prevalence reduced to 6.9% (95% CI 4.6-10.0, p < 0.01) after the second MDA in August 2011. The egg-positive prevalence after MDA in 2013 was reduced from 3.8% (95% CI 2.1-6.9) to 0.9% (95% CI 0.3-3.4) and p value was 0.050. Using urine reagent strips after MDA, the positive predictive value decreased, but the negative predictive value remained high. The cost of one urine reagent strip and one tablet of praziquantel were US$0.06 and US$0.125 in 2013 in Malawi. If the egg-positive prevalence is 40%, screening subjects for MDA using urine reagent strips, the cost reduction can be estimated to be about 24%, showing an overall cost reduction. CONCLUSIONS: MDA of praziquantel can assuredly reduce schistosome egg-positive prevalence. The combination of MDA and urine reagent strips could be both a practical and cost-effective countermeasure for hematobium schistosomiasis. It is key to recognize that hematobium schistosomiasis could be considered a disease that is assumed to have some concern with occupational risk at Nkhotakota and Lilongwe in Malawi. From this point of view, it is very important to manage workers' health; the sound labor force generation is vital for economic growth and development in these areas and countries.

La política pública de seguridad y salud en el trabajo: el caso colombiano / Public Policy for Safety and Health at the Worksite: the Colombian Case / A política pública de segurança e saúde no trabalho: o caso colombiano

Resumen Se espera que el trabajo proporcione riqueza y bienestar al ser humano, pero toda actividad laboral incluye fatalidades, accidentes y enfermedades ocupacionales que afectan la productividad laboral y el desarrollo sostenible. La seguridad y la salud buscan construir una cultura de entornos laborales saludables, trabajo seguro y decente, y para ello el Estado colombiano promueve políticas públicas de seguridad a partir de recomendaciones de organismos internacionales, algunas de ellas enmarcadas en los retos del milenio. El objetivo de esta revisión es presentar como ha sido el desarrollo de la política pública colombiana en seguridad y salud en el trabajo, para lo cual se mostrarán las directrices internacionales postuladas por la OIT y la OMS, su despliegue en estrategias iberoamericanas y la aplicación de la política pública en los programas nacionales de seguridad y salud en el trabajo.

Abstract Work is expected to provide the human being with richness and well-being; notwithstanding all working activity implies fatalities, accidents and occupational diseases affecting the work productivity and the sustainable development. Safety and health are pivotal to build a culture of both healthy working environments and safe and respectable work. To accomplish this, the Colombian State is promoting safety public policies based on the recommendations by international agencies, some of them framed in the new millennium challenges. Ae review aims to show how the Colombian public policy for safety and health at the worksite has developed so far. To do so, the international guidelines set by both the ILO and the WHO will be outlined, showing how they are implemented through the Iberian-American strategies and the application of public policy in the national programs for safety and health at the worksite.

Resumo Espera-se o trabalho fornecer riqueza e bem-estar para o ser humano, mas toda atividade laboral inclui fatalidades, acidentes e doenças ocupacionais que afetam a produtividade laboral e o desenvolvimento sustentável. A segurança e a saúde visam construir uma cultura de ambientes laborais saudáveis, trabalho seguro e decente, e para isso o Estado colombiano promove políticas públicas de segurança a partir de recomendações de organismos internacionais, algumas delas enquadradas nos desafios do milénio. O objetivo desta revisão é apresentar como tem sido o desenvolvimento da política pública colombiana em segurança e saúde no trabalho, para o qual foram mostradas as diretrizes internacionais postuladas pela OIT e pela OMS, seu desfralde em estratégias ibero-americanas e a aplicação da política pública nos programas nacionais de segurança e saúde no trabalho.

A ideologia gerencialista no Sistema Único de Saúde (SUS: a organização do trabalho de médicos / The managerialist ideology in the Unified Health System (SUS: the organization of work of doctors / La ideología gerencialista en el Sistema Único de Salud (SUS: la organización del trabajo de los médicos

As recentes mudanças no universo do trabalho alteraram o processo, a organização e as relações trabalhistas de diferentes categorias profissionais, inclusive a médica, repercutindo nas condições de trabalho e na saúde dos trabalhadores. Com base nesse cenário, esta pesquisa objetivou investigar a presença da ideologia gerencialista nas relações de trabalho de médicos do Sistema Único de Saúde do Município de Jaguariúna (SP). Foram entrevistados 15 médicos e 2 gestores da Secretaria de Saúde do Município. Os dados obtidos revelaram que aqueles profissionais estão submetidos a um processo de trabalho com forte influência da ideologia gerencialista, que lhes tira a autonomia para gerir o próprio trabalho, sobrecarregam-nos e os expõem a situações de muita pressão, interferindo em suas condições de vida e saúde.(AU)

Recent changes in the world of work have modified the process, the organization and the labor relations among different professional categories, including the medical category. All these changes have affected the work conditions and also workers' health. Based on this scenario, this study is aimed at investigating the presence of managerialist ideology in labor relations in the Sistema Único de Saúde (Unified Health System) at Jaguariúna (SP). The study was conducted through the interviewing of fifteen doctors and two managers of the Sistema Único de Saúde (county Health Department). The obtained data revealed that those professionals are undergoing a process of work with strong influence of the managerialist ideology that takes away the autonomy to manage their own work. They are also overloaded and exposed to a lot of pressure situations which end up interfering their living conditions and health.(AU)

Los recientes cambios en el mundo del trabajo, alteraron el proceso, la organización y las relaciones laborales de las distintas categorías profesionales, incluyendo la médica, afectando las condiciones de trabajo y salud de los trabajadores. En base a este escenario, este estudio tuvo como objetivo investigar la ideología gerencialista en las relaciones laborales en el Sistema Único de Salud (Seguridad Social) en el municipio de Jaguariúna (SP). Para llevar a cabo el estudio se entrevistó a 15 médicos y 2 gerentes de la Secretaría de Salud del Municipio. Los datos revelaron que los profesionales están sometidos a un proceso de trabajo con una fuerte influencia de la ideología gerencialista que les quita la autonomía para administrar su propio trabajo, los sobrecarga y los expone a situaciones de mucha presión, interfiriendo en sus condiciones de vida y salud.(AU)

Identificación y evaluación de factores psicosociales laborales en un centro de atención de llamadas / Identification and assessment of psychosocial factors at work on a call center of attention

Se realizó un estudio descriptivo transversal en el cual se aplicó el cuestionario ISTAS en su versión corta a 30 trabajadores (19 mujeres y 11 hombres) con un promedio de edad de 23,3 ± 4,0 años de un centro de atención de llamadas telefónicas para identificar factores psicosociales laborales. De las seis dimensiones individuales, tres de ellas resultaron en la situación más desfavorable para la salud: la inseguridad con un 86,7 % de los trabajadores ubicados en este nivel; el apoyo social y calidad de liderazgo con un 83,3 % y en tercer lugar las exigencias psicológicas con un 70%. En conclusión se recomienda al evaluar los puestos de trabajo incluir los aspectos psicosociales, ya que estos bajo determinadas condiciones de intensidad y tiempo de exposición pueden transformarse en riesgos y generar efectos negativos en la salud y al bienestar de los trabajadores

In this cross-sectional study the short version of COPSOQ 2: ISTAS, was used in 30 workers at a call center (19 woman & 11 men) with an average age of 23.3 ± 4.0 years to identify psychosocial factors related to the job in call center workers. Of the six (6) dimensions evaluated with ISTAS, three (3) dimensions presented the worst score, represented in red. Located in the most unfavorable situation were: first, insecurity, 86.7% of workers polled in this level of danger, followed by social support and quality of leadership with 83.3% and third, psychological demands with 70%. In conclusion we recommend including psychosocial aspects when evaluating a work place, as these under certain conditions of intensity and exposure time can become a risk and generate adverse effects to the health and well-being

Cultura organizacional e saúde: contribuições da psicodinâmica do trabalho / Organizational culture and health: contributions from the work psychodynamic

Estudos sobre Cultura Organizacional (CO) e seus efeitos na Saúde (SAU) das pessoas são raros, em especial no Brasil. Observa-se ainda que termos como saúde organizacional, saúde no trabalho e bem-estar nas organizações são usados sem o necessário discernimento. Portanto, este estudo apresenta definições relativas a eles e revisa contribuições teóricas e empíricas relativas à CO e à SAU, articulando essas dimensões. Propõe-se, ao final, diretrizes de pesquisa e delineamentos metodológicos no âmbito da psicodinâmica do trabalho. Na dimensão CO sugere-se o estudo dos valores organizacionais, sendo que a variável SAU poderia ser analisada através das vivências dos sujeitos, de prazer e de sofrimento no trabalho, bem como pelas defesas coletivas utilizadas por eles nas organizações(AU)

Studies on Organizational Culture (CO) and their effects on the Health (SAU) of individuals are rare, especially in Brazil. Terms like organizational health, labor health and welbeing in organizations are used without a necessary discernment. Therefore, this study presents relative definitions for them and revises theoretical and empiric contributions related to CO and SAU, articulating such dimensions. Research guidelines and methodological outlines are proposed in the scope of work psychodynamics. As far as CO a study of organizational values is suggested, and the variable SAU could be analysed through the individuals’ day-by-day living, of pleasure and of suffering at work, and also by the collective defenses utilized by them in the organizations(AU)

Reform of Government Employee and Labor Health Insurance in China / 中国卫生经济

This paper deals with the process of the reform and development of the social medical insurance scheme in urban China and the reasons for reform. At the same time, the paper presents the model of financing new urban employees' medical insurance in China.