Добірка наукової літератури з теми "4206 Public health"

In a comparative investigation 3 file handles were evaluated with regard to their ergonomic quality. By means of a mobile measuring system for the recording of peripheral-physiological data, the muscle strain of 9 muscles of the left and right hand-arm-shoulder system was quantified with surface electromyography. A special laboratory device facilitated the standardized execution of the tests. A specific bipolar questionnaire had enabled the subjective assessment of the design, surface material, general usability, avoidance of pressure marks and blisters, suitability for the exertion of the necessary pressure and pushing forces, and the suitability during hand perspiration. Also, the assessment of more or less favorable body positions to various filing directions was made. From substantial differences in the objective data and the subjective evaluation, the inference has to be drawn that only the combination of subjective surveys and objective measurements represent the opportunity to assess the ergonomic quality of working tools adequately.

Aims.To assess the extent to which being a victim of intimate partner violence (IPV) is associated with psychiatric disorders in men and women.Methods.A stratified multistage random sample was used in the third English psychiatric morbidity survey. Psychiatric disorders were measured by the Clinical Interview Schedule (Revised) and screening questionnaires. IPV was measured using British Crime Survey questions.Results.18.7% (95% CI 17.1–20.4; n = 595 of 3197) of men had experienced some form of IPV compared with 27.8% of women (95% CI 26.2–29.4; n = 1227 of 4206; p < 0.001). IPV was associated with all disorders measured (except eating disorders in men). Physical IPV was significantly linked to psychosis and with substance and alcohol disorders in men and women, but significant associations with common mental disorders (CMDs), post-traumatic stress disorder (PTSD) and eating disorders were restricted to women. Emotional IPV was associated with CMDs in men and women.Conclusions.The high prevalence of experiences of partner violence, and strength of the association with every disorder assessed, suggests enquiry about partner violence is important in identifying a potential risk and maintenance factor for psychiatric disorders, and to ascertain safety, particularly in women as they are at greatest risk of being victims of violence.

Aim: ‘National Tobacco Control Program’ had developed in Turkey by the Ministry of Health in 2009 with amendment of Law 4207 and all closed places became smoke-free. The National Media Campaign has been initiated with the “Smoke Free Air-Zone” slogan for raising public awareness. The aim of our study is to determine the smoking status and attitude of Health Management students about Law 4207 in a university in Turkey, four years after the application of Smoke Free Air-Zone. Methods: In this study we used a questionnaire with 33 questions, which was developed by researchers and Fagerstrom Nicotine Dependent Test to obtain the addiction level of the smokers. Results: Sixty-two percent of 244 students were female. 3.3% were ex-smokers and 10.7% were active smokers. 5.2% of females and 19.3% of males were smoking. 87.5% of smokers think smoking habbit is harmful. 41.4% of the students thought that Law 4207 was generally accepted by the society. Conclusion: Reducing the smoking prevalence and increasing the awareness about the Law 4207 among health administrators is very important for the imlementation of health policy. So our research has an importance to highlight this subject and increase the awareness of the campaign. Keywords: administrators, Law 4207, smoking cessation, tobacco use cessation

The article examines the theoretical principles of studying sustainability and security of public budget of the Visegrad Group countries and determines that indicators of the normal functioning of the economy and ensuring a decent social standard of living of the population are reaching the limits of relevant indicators, some of which are approved by international standards. At the same time, the authors identified the absence of a single system of macrofinancial indicators of sustainability and security of public budget proposing to create it, including twelve ratios reflecting levels of debt security, deficit load on the economy, debt load on the population, budgetary independence, efficiency, population well-being, productivity, economic efficiency, as well as the effectiveness of financial support for health and education, elasticity of income and expenditure from the change in GDP of the Visegrad countries. Analytical calculations of the above-mentioned macro indicators in the dynamics made it possible to draw qualitative conclusions on compliance with the sustainability and security of public budget of the Visegrad Group countries, identify possible threats to national economies and prevent the consequences in case of non-compliance with standards. Based on the results of correlation-regression analysis, the authors determined the indicators that have the greatest impact on the resultant factor-the ratio of the level of deficit load on the economy of the investigated countries. It made it possible to analyze the real situation in the economy, to determine the level of sustainability and security of public budget and to give the necessary suggestions and recommendations.

Anaemia, as defined by low haemoglobin concentration, is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiologic needs. It is a major public health problem that affects low, middle and high-income countries. The global prevalence of anaemia is 42.6% in children, 38% in pregnant women and 29.4% in all women of reproductive age. The prevalence of severe anaemia amongst women and children is in the range of 0.9% to 1.5% and is associated with substantially worse health outcomes (1).

Pacific Island countries have a high burden of scabies and impetigo. Understanding of the epidemiology of these diseases is needed to target public health interventions such as mass drug administration (MDA). The aim of this study is to determine the prevalence of scabies and impetigo in Solomon Islands as well as the relationship between them and their distribution. We conducted a prevalence study in 20 villages in Western Province in Solomon Islands. All residents of the village were eligible to participate. Nurses conducted clinical assessments including history features and skin examination. Diagnosis of scabies was made using the 2020 International Alliance for the Control of Scabies diagnostic criteria. Assessments were completed on 5239 participants across 20 villages. Overall scabies prevalence was 15.0% (95%CI 11.8–19.1). There was considerable variation by village with a range of 3.3% to 42.6%. There was a higher prevalence of scabies in males (16.7%) than females (13.5%, adjusted relative risk 1.2, 95%CI 1.1–1.4). Children aged under two years had the highest prevalence (27%). Overall impetigo prevalence was 5.6% (95%CI 4.2–7.3), ranging from 1.4% to 19% by village. The population attributable risk of impetigo associated with scabies was 16.1% (95% CI 9.8–22.4). The prevalence of scabies in our study is comparable to previous studies in Solomon Islands, highlighting a persistent high burden of disease in the country, and the need for public health strategies for disease control.

This research explores the relationship between risk factors associated with cannabis use in young people. This thesis addresses the assessment of cannabis use and its association with risk factors and implicit associations, and the suitability of these for targeting at-risk cannabis users, and how theories of drug instrumentalization and normalization frame cannabis use behaviour in young people in contact with drug services using a mixed-methods approach. Additionally, this research addresses the implications for indicated prevention and the targeting of young people considered at risk for developing problematic cannabis use behaviours. This PhD reviews the scientific literature on cannabis use, with an emphasis on prevalence and use behaviours alongside associated risk and protective factors. Cannabis markets and potency, along with policy implications, are also explored. Furthermore, this PhD aims to understand how cannabis use behaviour assessment impacts on the identification of risk, and the subsequent implications for identifying those who might benefit from further support. Frequent, habitual cannabis users and their relationship with risk factors, including implicit cognitions, and use behaviour assessment are explored. Additionally, cannabis users in touch with drug services and their use behaviour are explored through frameworks of drug use instrumentalization and normalization. Lastly, the main findings of this dissertation are surmised and future research and policy implications are discussed. This PhD illustrates the importance of cannabis use behaviour assessment in identifying young people at-risk for developing problematic use behaviours. This thesis provides evidence that suggests that psychopathology, and the over-instrumentalization of use as a self-medication, coping mechanism may be associated with the development of problematic use outcomes. These findings are contextualised within the current cultural and political environments in the United Kingdom and discussed in regards to their suitability for indicated prevention.

Syftet med denna studie var att med hjälp av arbetsterapeuter som arbetar inom hemtjänst undersöka hur tekniska hjälpmedel för personer i Sverige som är 75 år eller äldre kan bidra till ett hälsosamt åldrande. Studien har en kvalitativ och induktiv ansats med teori- och begreppsanknytningar som hälsosamt åldrande, livskvalitet och gerotranscendens. Datan samlades in via enskilda semi-strukturerade intervjuer med sex arbetsterapeuter från olika kommuner i region Skåne. Datan analyserades med hjälp av kvalitativ innehållsanalys.  Resultaten visade att arbetsterapeuterna upplever att tekniska hjälpmedel kan bidra till ett hälsosamt åldrande. Arbetsterapeuterna anser att det skapar en större grad av självständighet och bättre livskvalitet genom att bland annat underlätta vardagliga aktiviteter och skapar mer frihet att klara sig själv. Studien visar att gruppen 75 år eller äldre oftast använder tekniska hjälpmedel av enklare slag för att i huvudsak underlätta fysiska funktionsnedsättningar. Slutsatsen är att tekniska hjälpmedel kan bidra till ett hälsosamt åldrande och livskvalitet enligt arbetsterapeuterna vilket även tidigare forskning visar. Detta innebär att det är möjligt för äldre att uppleva processen i gerotranscendens där man är tillfreds såväl med sin nuvarande situation som sitt gångna liv.
The purpose of this study was to investigate the use of technical aids for people in Sweden aged 75 years or older and how it could affect healthy ageing using the help of occupational therapists. The study has a qualitative and inductive approach with theory and conceptual notions such as healthy ageing, quality of life and gerotranscendence. The data was collected through individual semi-structured interviews with six occupational therapists from different municipalities in the region of Skåne. The data was analyzed using qualitative content analysis. The results showed that occupational therapists perceive that technical aids can contribute to healthy ageing. Occupational therapists believe that it creates a greater degree of independence and a better quality of life by, for example, facilitating everyday activities and creating more freedom to manage themselves. The study shows that the target group of 75 years or older often uses technical aids of simpler types to primarily facilitate physical impairments. The conclusion is that technical aids can contribute to a healthy ageing and quality of life according to occupational therapists and as previous research shows. This means that it is possible for the elderly to experience the process of gerotranscendence where you are satisfied with your current situation as well as your past life.

Betyg i Ladok, 2018-06-05.

Folkhälsopolitiskt arbete bedrivs på flera nivåer i samhället vilket är nödvändigt för att lyckas med förebyggande och hälsofrämjande arbete. Folkhälsorapporter syftar bland annat till att ge politiker en grund i det folkhälsopolitiska arbetet. Den politiska organisationen och professionen påverkar i hög grad folkhälsan. Syftet med denna uppsats var att undersöka vad folkhälsointresserade landstingpolitiker i Stockholms län anser om, samt vilken användning de har av de folkhälsorapporter som publicerats av Centrum för folkhälsa. Sex kvalitativa intervjuer med landstingspolitiker genomfördes vilka sedan analyserades med hjälp av meningskoncentrering.

Resultatet visade att folkhälsorapporten används vid beslutsfattande och prioriteringar i politiska beredningar. Rapporten används främst av dem som har ansvar för hälso- och sjukvårdsfrågor. Det görs inga systematiska uppföljningar av beslut tagna med folkhälsorapporten som grund. Folkhälsorapporten används olika av politiker som sitter i majoritet och opposition. Detta främst på grund av olika arbetsuppgifter. Rapporten används mest inom frågor som rör barn, ungdomar, äldre och invandrare. Folkhälsorapporten ger folkhälsofrågorna uppmärksamhet i landstinget. Det finns en önskan om att rapporten ska användas i större utsträckning inom planering av kollektivtrafik och infrastruktur. De teman som tagits upp i de två senaste rapporterna anses relevanta och aktuella och rapporten uppfattas som seriös och vetenskaplig.

Sjukvården är den arbetsplats som anses vara särskilt utsatt för arbetsrelaterad stress och har under senare år fått uppmärksamhet inom forskning. Sjuksköterskor rapporterar att de upplever stress för att de inte har tillräcklig kompetens för att kunna hantera sitt arbete. Samtidigt ska arbetsplatsen säkerställa att medarbetare besitter den kunskap som efterfrågas både i nutid och framtid. En arbetsplats som satsar på kompetensutveckling kan bidra till att både kort- och långsiktiga verksamhetsmål uppnås. Syftet med studien var att undersöka upplevd stress i förhållande till behov av kompetens hos sjukvårdspersonal. För att besvara studiens syfte utfördes en kvantitativ enkätundersökning på sjukvårdspersonal från olika avdelningar på sjukhuset, där totalt 56 respondenter deltog i studien. Vidare analyserades resultatet med hjälp av SPSS genom en korrelationsanalys som presenteras genom tabeller skapade med SPSS. I studien mäts behovet av kompetens genom formellt och informellt lärande. Resultatet i studien visar att det fanns ett samband mellan behovet av kompetensutveckling och stress. Sambandet mellan kompetensutveckling och stress grundar sig enbart mellan behovet av formellt lärande och stress, då det inte fanns något signifikant samband mellan behovet av informellt lärande och stress. Slutsatsen av studien är att utökade kompetensutvecklingsinsatser kan resultera i att sjukvårdspersonalen bättre hanterar arbetskrav och att det kan minska upplevd stress.
Healthcare is the workplace that is considered to be particularly vulnerable to work-related stress and has in recent years received attention in research. Nurses report that they experience stress because they do not have sufficient skills to handle their work assignments. At the same time, the workplace must ensure that employees possess the knowledge that is demanded both in the present and in the future. A workplace that focuses on skills development can help achieve both short- and long-term business goals. The purpose of the study was to investigate perceived stress in relation to the requirement in competence of healthcare professionals at a hospital. To answer the purpose of the study, a quantitative survey was carried out on healthcare professionals from various departments of the hospital, in which a total of 56 respondents participated in the study. Furthermore, the results were analyzed using SPSS and also correlation analysis presented by tables created with SPSS. The results of the study show that there was a significant relationship between the need for competence development and stress. The relationship between competence development and stress is based solely on the connection between the need for formal learning and stress, as there was no significant relationship between the need for informal learning and stress. The conclusion of the study is that increased competence development can result in healthcare workers to better manage work demands and may help to reduce the perception of stress.

In Brazil, to serve the population with total sanitation services is still a challenge. Despite of the visible progress indicators that show the expansion of the sanitation sector in Brazil pointed to by the last census of the IBGE (2010), the shares still performed insufficiently reached the real needs of the population. Public policies aimed at achieving the universality of this sector in the country, thus obtain positive impacts on public health and is necessary to have preventive actions involving the health of the environment. In the municipality of Brejo Grande deficiencies in sanitation combined with the cultural habits conducted by the population in water bodies, such as washing clothes, bathing and farming, and the very economic conditions of the same, certainly exposes to health disorders. To achieve satisfactory levels through health becomes key measure levels of environmental indicators in a certain locality. Thus, this study aimed to analyze the sanitation conditions in the seat of the municipality of Brejo Grande/SE and its influence on public health, through the adaptation of the Environmental Health Indicator (ISA). The adaptation was necessary because the research focus is based on the analysis of sanitation in the study area, as well as the need to obtain information to assess the health status of the population. The ISA was called to this work as ISA/BG, as it is specific to this location. Their analysis took place from the Sub-water supply indicator, Sub-Solid Waste Indicator, Sub-Sewage indicator, Sub-Drainage indicator Urban and Sub-Public Health Indicator. For this study, a descriptive exploratory and qualitative and quantitative nature was developed. The data used to feed the ISA/BG and interpret the results were collected in the field with the community and government agencies of federal, state and municipal levels. From the results it was found that the existing sanitation infrastructure in urban Brejo Grande, negatively interfere with the health of the population. And that despite the actions taken and in progress by the municipality of Brejo Grande, carried out in order to fulfill determined by the National Sanitation Policy, the difficulties they pass the sanitation sector in the country, are reflected in the locality of study.
No Brasil, atender a população em sua totalidade com os serviços de saneamento básico ainda é um desafio. Apesar dos avanços visíveis dos indicadores que demonstram a ampliação no setor de saneamento no Brasil apontado pelo último censo do IBGE (2010), as ações executadas ainda não atingiram suficientemente as reais necessidades da população. As políticas públicas voltadas para alcançar a universalização deste setor no país, obterão consequentemente impactos positivos na saúde pública, sendo necessário haver ações preventivas que envolvam a salubridade do meio. No município de Brejo Grande as deficiências do saneamento básico aliado aos hábitos culturais realizados pela população nos corpos d’água, como a lavagem de roupas, banhos e atividade agrícola, e as próprias condições econômicas das mesmas, certamente, a expõe aos agravos de saúde. Para alcançar níveis satisfatórios de salubridade do meio torna-se fundamental mensurar os níveis dos indicadores ambientais de determinada localidade. Desta forma, esta pesquisa teve como objetivo geral analisar as condições do saneamento básico na sede do município de Brejo Grande/SE e sua influência na saúde pública, através da adaptação do Indicador de Salubridade Ambiental (ISA). A adaptação se fez necessária em virtude do foco da pesquisa está baseada na análise do saneamento básico da área estudada, bem como da necessidade de se obter informações para a avaliação do estado de saúde da população. O ISA foi denominado para este trabalho como ISA/BG, visto que é específico para esta localidade. Sua análise decorreu a partir do Sub- Indicador de Abastecimento de Água, Sub- Indicador de Resíduos Sólidos, Sub-Indicador de Esgotamento Sanitário, Sub-Indicador de Drenagem Urbana e Sub-Indicador de Saúde Pública. Para a realização deste estudo, foi desenvolvida uma pesquisa descritiva de caráter exploratório e de natureza quali-quantitativa. Os dados utilizados para alimentar o ISA/BG e para interpretar os resultados foram coletados em campo junto à comunidade e aos órgãos públicos de âmbito federal, estadual e municipal. A partir dos resultados obtidos verificou-se que a infraestrutura de saneamento básico existente na área urbana de Brejo Grande, interfere negativamente na saúde da população. E apesar das ações desenvolvidas e em andamento pelo município de Brejo Grande, realizadas a fim de se cumprir o determinado pela Política Nacional do Saneamento Básico, as dificuldades pelas quais passam o setor de saneamento no país, se refletem na área de estudo.

Introduction/background: Epidemics of infectious diseases (ID) are re-occurring now more often and spreads faster into many different parts of the world due to globalization. The increasing evidence of climate change and man-made events have shown impacts to increase the emergency and re-emerging of animal- borne IDs. Studies claims that background factors of these IDs are biological, environmental and human-lifestyle related changes. The pathogen Lassa fever virus (LASV) is a zoonotic organismthat circulates in rodent reservoirs, and the animal´s hosts are rodent species (rats) of the genus Mastomys natalensis. Mastomys natalensis is primarily the reservoir species of the animal-borne disease of Lassa fever (LF) which is most prevalent in west Africa, particularly in Nigeria. Lassa fever (LF) has limited information with under-documented cases, its health effect on pregnant women especially in Nigeria is within the rural areas of Edo, Ondo, Delta, Ebony, Bauchi, Taraba and Plateau states where maternal mortalities are higher.  Aim: The overarching aim of this thesis is to analyse and discuss the health effects of Lassa fever occurrence and outcomes on pregnant women in Nigeria, with emphasis on the maternal mortality and fatality during pregnancy. Method: A statistical and systematic review was performed from retrospective studies of case series, case-control, observational and cohort studies of patients in Nigeria (pregnant women with gestation ages of pregnancy from 2 weeks –32 weeks) that tested positive to LASV. Publication status and publication date was applied for the inclusion of respective studies by electronic searches via Web of Science, Google scholar, MEDLINE and PubMed. Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines (PRISMA) was used to illustrate the flow of relevant articles in my study. R-commander and R-Studio software was used to analyze the data and to find the causal significant relationship between LF and maternal mortality using “Linear regression and linear model plot”. Result: The total number of full-text and Peer-view publications on Lassa fever virus cases was 1 609 articles. 94 articles out of the 1 609 articles were eligible for full text revision. Exclusion criteria finally yielded 6 studies that were relatively relevant to my study. However, 3 out of the 6 articles were statistically reviewed to know the influence of Lassa fever and the risk of maternal mortality during pregnancy.  Conclusion: Lassa fever occurrence have significantly shown potential increase in the severity of maternal mortality, and is predominant among pregnant women from 39 - 45 years old in Nigeria especially within the risk endemic areas of Ondo, Edo, Ebony and Bauchi states showing significant long-term diseases on LF affected pregnant women, such as encephalopathy, acute kidney dysfunction and acute kidney failure that leads to further health problems or complications like coma and sensorineural deafness.

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Background: Sickness absence (SA), known as work disability justified by sick leave, can be an indicator of workers health status. In municipal government, like the rest of the country, the prevalence of SA and its main causes are still poorly documented, and are restricted to the analysis of some occupational groups, especially those who engage in health care or in institutions education. Estimates of the magnitude of SA vary widely and socio-demographic aspects related to nature and working conditions are among the main factors associated with the frequency and duration. Aims: To study the prevalence and the factors related to SA workers from the public sector in the municipality of Goiânia. Methods: Cross-sectional population-based study assessing prevalence and factors associated with sick leave lasting longer than three days for the health treatment from 2005 to 2010, in civil servants. Outcomes: 40.578 sick leave were assessed among 14.484 absent workers which generated 944.722 absent days. The indicators of sickness absence in that period were: prevalence of sick leave of 39.0%, higher among education professionals (47.7%) and health (41.9%), the mean duration of SA was 40 days / year per worker away and the average duration of Licenses was 23 days per episode. Predominance of female sexual workers, aged between 41 and 50 years, married, white, with high educational background, earning up to three minimal salaries, with their own house, with from 3 to 10 years of public service, having a professional bond and basically in operational tasks registered in the Municipal Secretariat of Education and Health. The main cause of sickness was mental and behavioral disorder followed by musculoskeletal diseases. The Multivariate analysis showed an association between sickness absence and the female subjects (OR 1,54 IC95%1,41-1,68), being older (OR 1,86 IC95% 1,48-2,32), married (OR 1,51 IC95% 1,13-2,02), having elementary school degree (OR 12,35 IC95% 10,39-14,69), income of up to three minimal salaries (OR 1,37 IC95% 1,21-1,55), having more working experience concerning the time(OR 3,39 IC95% 2,50-4,59), being professional in the health and educational area (OR 2,96 IC95% 2,60-3,38 and OR 2,90 IC95% 2,51- 3,36), as well as being part of the staff in the Municipal Secretariat of Education and Health (OR 1,69 IC95% 1,30-2,21 e OR 1,60 IC95% 1,23-2,09 ). Conclusions: The indicators of SA express the magnitude of this phenomenon in public service and can assist in the planning of health worker prioritizing the most vulnerable occupational groups whose socio-demographic characteristics and work organization influence on absenteeism due to illness.
Introdução: O absenteísmo-doença (AD), entendido como ausência ao trabalho por motivo de doença, é um importante indicador das condições de saúde dos trabalhadores. Na administração pública municipal, a exemplo do restante do país, a prevalência de AD e as suas principais causas ainda estão insuficientemente documentadas, e restringem-se a analise de alguns grupos ocupacionais, sobretudo daqueles que desenvolvem atividades nos serviços de saúde ou em instituições de ensino. Estimativas da magnitude do AD variam amplamente e características sóciodemográficas, aspectos ligados à natureza e às condições de trabalho situam-se entre os principais fatores associados à sua frequência e duração. Objetivos: Estudar a prevalência e os fatores associados ao absenteísmo-doença entre os servidores públicos estatutários do Município de Goiânia. Métodos: Estudo populacional de corte transversal, com análise de todas as licenças para tratamento de saúde (LTS), com duração superiores a três dias, cerificadas pela junta médica municipal no período janeiro de 2005 a dezembro de 2010. Resultados: Foram analisadas 40.578 LTS concedidas a 14.484 servidores que geraram 944.722 dias de ausências. Os indicadores de AD demonstraram uma prevalência média anual de 23,0% de servidores ausentes em decorrência de problemas de saúde; prevalência de licenças de 39,0%, sendo maior entre os profissionais de educação (47,7%) e saúde (41,9%); a duração média do AD foi de 40 dias/ano por servidor licenciado e a duração média das Licenças foi de 23 dias por episódio. Considerando os episódios de LTS houve Predomínio dos seguintes grupos: mulheres, faixa etária entre 41 a 50 anos, casados, brancos, com ensino superior, renda de até três salários mínimos, com até 10 anos de serviço público, lotados nas secretarias de educação e de saúde. A análise de regressão de Poisson demonstrou, no período, tendência de estabilidade dos indicadores entre as mulheres, e de aumento da prevalência de licenças entre os homens. A principal causa de AD foi por transtornos mentais e comportamentais seguidas pelas doenças do sistema osteomuscular e Lesões/causas externas. A análise Multivariada demonstrou associação estatisticamente significativa entre os afastamentos e ser do sexo feminino (OR 1,54 IC95%1,41-1,68), ter mais que 60 anos (OR 1,86 IC95% 1,48-2,32), ser casado (OR 1,51 IC95% 1,13-2,02), possuir até o ensino fundamental (OR 12,35 IC95% 10,39- 14,69), receber de até três salários mínimos (OR 1,37 IC95% 1,21-1,55), ter maior tempo de serviço (OR 3,39 IC95% 2,50-4,59), ser profissional de saúde e educação (OR 2,96 IC95% 2,60-3,38 e OR 2,90 IC95% 2,51-3,36 respectivamente), bem como estar lotado nas Secretarias Municipais de Saúde e Educação (OR 1,69 IC95% 1,30- 2,21 e OR 1,60 IC95% 1,23-2,09 respectivamente). Conclusões: Os indicadores de AD expressam a magnitude desse fenômeno no serviço público e podem auxiliar no planejamento das ações de saúde do trabalhador priorizando os grupos ocupacionais mais vulneráveis, cujas características sócio-demográficas e de organização do trabalho influenciaram nos afastamentos por motivos de doença.

Over the past 20 years there has been a clear shift in Peru’s mortality profile towards non-communicable diseases. As part of this transition, childhood overweight and obesity (O&O) has become a growing public health concern. In order to address this challenge, context-specific information is needed concerning prevalence, associated factors and culturally appropriate interventions. To this end, I conducted a mixed methods study using a socio-ecological framework to investigate childhood overweight and obesity in Peru. This study found a prevalence of 19.2% overweight and 8.6% obesity among children aged seven to eight in a pro-poor cohort in Peru. Factors associated with being overweight in this cohort included: a high socioeconomic status, living in metropolitan Lima, an O&O mother, being male and being an only child or having only one sibling. The quantitative analysis highlighted the prevalence in O&O in this population and revealed a number of relationships explored in more depth via interviews and focus group discussions. The qualitative component of this research explored these associations amongst a sub-sample of children, parents and teachers in three distinct geographical regions in Peru. My qualitative research showed that parents, teachers and children are aware of the health implications of childhood overweight and obesity and that they have a sophisticated understanding of the many factors that influence its aetiology. Participants also had many suggestions for ways to address this issue in their community. This information was complemented by a systematic review and meta-analysis of the evidence of childhood O&O interventions that took place in Latin America published between 1990 and 2011. A combination of diet, physical activity and pharmaceutical strategies have shown modest effect on BMI reduction in O&O children, but more evidence is needed for effective population-level prevention strategies. The findings highlight the need for comprehensive, multi-level interventions. Notable intervention components include: kiosco reform, junk food taxation, creation of recreational space and enhancement of school-based physical activity programmes. To accomplish this, communities need to be mobilised and work together with school administration, municipal and national government.

High-performance athletes are known to be at risk of adverse physical and mental health outcomes related to the extreme performance demands they face. Australian high-performance sport has traditionally been reactive to the healthcare needs of athletes who present having experienced compromised health, whether that be in the form of an illness, an injury, or a mental health challenge. Recently, there has been a move toward implementing limited health promotion approaches addressing identified health risks in the current athlete/sport environment. At present, there is no theoretical framework to help those working with this highly selective group to promote the development and maintenance of optimal holistic health. Moreover, the early and ongoing development of optimal holistic athlete health has not commonly been viewed as a performance requirement within sporting organisations. This research aimed to understand health and its determinants for Australian high-performance athletes from the perspective of a representative sample of expert health practitioners who currently work or have recently worked in high-performance sports healthcare. Determinants of health are factors that influence how likely we are to stay healthy or become ill/ injured. Understanding these determinants will help researchers and practitioners develop a theoretical health promotion framework that may be applied broadly across Australian high-performance sport. This study used a mixed-methods approach, including a Delphi survey and subsequent semi-structured one-to-one qualitative interviews to derive a consensus on athlete health determinants and the factors which influence these. The purpose of the qualitative interviews was to explore, more deeply, the experiences, beliefs and thinking behind participant responses to the questions posed in the Delphi survey, to add both nuance and context to those responses. The Delphi survey was conducted at two time points over a period of three months. Descriptive statistical analysis of the Delphi survey results demonstrated that there was general recognition of the relevance of the World Health Organisation definition of health and its determinants to the health of high-performance athletes, a finding that is not usually evident in the literature, nor reflected in the provision of health services to this population cohort. Thematic analysis of the Delphi survey data, using a socio-ecological theoretical lens, revealed a need to consider a broader range of influences on athlete health than those that relate specifically to participation in high-performance sport. These include geographic isolation, access to appropriate health services, ethnicity, and socio- economic status. The interview findings revealed that there is a need to apply additional consideration to factors that can be categorized as social determinants of health in healthcare planning for, and management of, Australian high-performance athletes. This study's findings will help form a theoretical framework for Australian high-performance athlete health. Specifically, this framework would address the need for sporting organisations to create and provide health-promoting environments for their athletes and to support athletes in developing their capacity to manage better the impact of the health stressors to which they are exposed, as identified by the high-performance healthcare experts surveyed in this study.

The incidence of falls and serious injuries related to patient falls in hospitals is on the rise. This situation could potentially result in serious injuries and even death for the patient, as well as financial burden for acute care hospitals and increased workloads and stress for nursing staff. The incidence of falls in the metropolitan acute care hospital medical ward where this study was conducted continues to be problematic. This research study investigates the factors that cause patient falls in order to maintain and enhance sustainable falls prevention management. The falls risk assessment tool used in the hospital was part of the 6-PACK Falls prevention program for patients that was developed in 2002. A mixed method case study was employed for the research. Data was collected from a medical ward in two phases: Phase 1 analysed the quantitative falls data from the hospital RiskMan software tool and Patient Centred Care Plan (PCCP). This analysis informed the development of the qualitative research in Phase 2 which included the nurse questionnaire and nurse focus group discussions, as well as patient interviews to examine the complexities involved in falls management prevention. The triangulation of nurse and patient viewpoints of the falls prevention program, together with the administrative (RiskMan, PCCP) data, provides a fuller exploration of the contributing factors and adds to the body of knowledge in this important area. The Donabedian model of structure, process and outcome (SPO) was adapted to form an Inpatient Falls Prevention model that could be effective in the analysis of all aspects of patient care. The data collected in the quantitative and qualitative phases was analysed using this Inpatient Falls Prevention model. The case study identified that there were a significant number of patients whose falls risk assessment was not documented as part of their daily care plan. This resulted in high-risk patients not having falls prevention strategies implemented in their nursing care. For cognitively impaired patients falls were much higher for several reasons, including patient-nurse ratios, time challenges and issues surrounding the management of patients with dementia, delirium, and behavioural issues. The ward and bed layout, equipment malfunction, lack of patient education, and engagement in their falls prevention plan were also identified as contributing factors to inpatient falls. This study found that nurses failed to properly implement falls prevention strategies and management in the medical ward, and makes a number of recommendations for the benefit to all stakeholders - the healthcare system, hospitals, nurses, and most importantly, the patients. There is an increased need for professional development of nursing staff to identify and document patients at risk of falls and to modify the falls risk assessment tool. Patients need to be more actively engaged in their falls prevention plan and there needs to be better stakeholder communication: nurse to nurse, nurse to patient and nurse to allied health professionals. In addition, there is a need for more frequent PCCP auditing and immediate feedback to nursing staff. In this way, nurse knowledge of patient assessment, falls documentation and implementation strategies would assist in increasing patient safety and enhancing their hospital experience.

Abstract The transfer of knowledge entails a challenge for any research activity. It drives the promise and results towards implemented and replicable facts. The transfer is frequently crystallised in contracts and patents, but not solely: scientific communication, general publication, property rights, or public R&D + innovation projects generated in the heat of research are also transference products and tools. This article lays out the benefits and weaknesses of these devices, underlining the participation of technology, especially online tech, when appropriate. We found that there are a variety of resources for transference, and that technology is only valid in some of them.

In the last decades the ageing of the populations has become a worldwide phenomenon. In 1990, 26 nations had more than 2 million elderly citizens aged 65 years and older, and the projections indicate that an additional 34 countries will join the list by 2030. In 2000, the number of old persons (65+ years) in the world was estimated to be 420 million and it was projected to be nearly 1 billion by 2030, with the proportion of old persons increasing from 7 to 12 per cent. The largest increase in absolute numbers of old persons will occur in developing countries; it almost triples from 249 million in 2000 to an estimated 690 million in 2030. The developing regions’ share of the worldwide ageing population will increase from 59 to 71 per cent. Developed countries, which have already seen a dramatic increase in people over 65 years of age, will experience a progressive ageing of the elderly population itself (see Fig. 8.3.1). The global trend in the phenomenon of population ageing has dramatic consequences for public health, health care financing, and delivery systems in the whole world. The absolute number of chronic diseases as well as psychiatric disorders is expected to increase. In this chapter, the epidemiological aspects of the most common psychiatric disorders of the elderly are summarized and discussed.

Background: Quality clinical laboratory service provision is very important in order to enhance diagnostic value and improve the health status of the community. However, there is very little information on the actual standard adaptation, and implementation, or the impact policy guidelines have had on laboratory services delivery and the community. This study assessed the quality of clinical laboratory services in a tertiary health care facility in Ibadan North Local Government Area, Oyo state. Methods: Interview was conducted for 125 laboratory staff and 426 patients. Five laboratory units were assessed. Data collection was through an observational checklist and semi-structured questionnaires. Observational checklist obtained information on the level of compliance to standard practices and processes. Questionnaires obtained information on laboratory staff socio-demographic characteristics and competency level, and patients’ sociodemographic characteristics and satisfaction with the domains of clinical laboratory services. Descriptive analysis was performed and associations explored between relevant variables using Chi-square test at ‘p’ level of 0.05. Results: Highest level of quality management systems were maintained by the five laboratories while 28.6% had structural deficiencies; 86.9% had compliance with practice quality with Microbiology laboratory unit having highest rating of standard practices (94.6%). Laboratory staff were considered as competent (93.6%) and most are certified by their accreditation body. About 38.6% and 20% attended training in the last 3 months and 6 months respectively. Overall patients’ level of satisfaction was moderate with 53.3% satisfied with the laboratory service received. Half were dissatisfied with the cost of the laboratory tests (49.8%). Patients with higher educational level and income were significantly satisfied than others. Conclusion: Quality of clinical laboratory service delivery in the study setting was good. There is a need for adequate internal and external quality assurance schemes to be in place to constantly monitor the quality of management systems for good service delivery. Key words: Quality, Clinical services, Tertiary healthcare facility, management systems.

Attention to safety and health are of ever-increasing priority to industrial organizations. Good Safety is demanded by stockholders, employees, and the community while increasing injury costs provide additional motivation for safety and health excellence. Safety has always been a strong corporate value of DuPont and a vital part of its culture. As a result, DuPont has become a benchmark in safety and health performance. Since 1990, DuPont has re-engineered itself to meet global competition and address future vision. In the new re-engineered organizational structures, DuPont has also had to re-engineer its safety management systems. A special Discovery Team was chartered by DuPont senior management to determine the “best practices’ for safety and health being used in DuPont best-performing sites. A summary of the findings is presented, and five of the practices are discussed. Excellence in safety and health management is more important today than ever. Public awareness, federal and state regulations, and enlightened management have resulted in a widespread conviction that all employees have the right to work in an environment that will not adversely affect their safety and health. In DuPont, we believe that excellence in safety and health is necessary to achieve global competitiveness, maintain employee loyalty, and be an accepted member of the communities in which we make, handle, use, and transport products. Safety can also be the “catalyst” to achieving excellence in other important business parameters. The organizational and communication skills developed by management, individuals, and teams in safety can be directly applied to other company initiatives. As we look into the 21st Century, we must also recognize that new organizational structures (flatter with empowered teams) will require new safety management techniques and systems in order to maintain continuous improvement in safety performance. Injury costs, which have risen dramatically in the past twenty years, provide another incentive for safety and health excellence. Shown in the Figure 1, injury costs have increased even after correcting for inflation. Many companies have found these costs to be an “invisible drain” on earnings and profitability. In some organizations, significant initiatives have been launched to better manage the workers’ compensation systems. We have found that the ultimate solution is to prevent injuries and incidents before they occur. A globally-respected company, DuPont is regarded as a well-managed, extremely ethical firm that is the benchmark in industrial safety performance. Like many other companies, DuPont has re-engineered itself and downsized its operations since 1985. Through these changes, we have maintained dedication to our principles and developed new techniques to manage in these organizational environments. As a diversified company, our operations involve chemical process facilities, production line operations, field activities, and sales and distribution of materials. Our customer base is almost entirely industrial and yet we still maintain a high level of consumer awareness and positive perception. The DuPont concern for safety dates back to the early 1800s and the first days of the company. In 1802 E.I. DuPont, a Frenchman, began manufacturing quality grade explosives to fill America’s growing need to build roads, clear fields, increase mining output, and protect its recently won independence. Because explosives production is such a hazardous industry, DuPont recognized and accepted the need for an effective safety effort. The building walls of the first powder mill near Wilmington, Delaware, were built three stones thick on three sides. The back remained open to the Brandywine River to direct any explosive forces away from other buildings and employees. To set the safety example, DuPont also built his home and the homes of his managers next to the powder yard. An effective safety program was a necessity. It represented the first defense against instant corporate liquidation. Safety needs more than a well-designed plant, however. In 1811, work rules were posted in the mill to guide employee work habits. Though not nearly as sophisticated as the safety standards of today, they did introduce an important basic concept — that safety must be a line management responsibility. Later, DuPont introduced an employee health program and hired a company doctor. An early step taken in 1912 was the keeping of safety statistics, approximately 60 years before the federal requirement to do so. We had a visible measure of our safety performance and were determined that we were going to improve it. When the nation entered World War I, the DuPont Company supplied 40 percent of the explosives used by the Allied Forces, more than 1.5 billion pounds. To accomplish this task, over 30,000 new employees were hired and trained to build and operate many plants. Among these facilities was the largest smokeless powder plant the world had ever seen. The new plant was producing granulated powder in a record 116 days after ground breaking. The trends on the safety performance chart reflect the problems that a large new work force can pose until the employees fully accept the company’s safety philosophy. The first arrow reflects the World War I scale-up, and the second arrow represents rapid diversification into new businesses during the 1920s. These instances of significant deterioration in safety performance reinforced DuPont’s commitment to reduce the unsafe acts that were causing 96 percent of our injuries. Only 4 percent of injuries result from unsafe conditions or equipment — the remainder result from the unsafe acts of people. This is an important concept if we are to focus our attention on reducing injuries and incidents within the work environment. World War II brought on a similar set of demands. The story was similar to World War I but the numbers were even more astonishing: one billion dollars in capital expenditures, 54 new plants, 75,000 additional employees, and 4.5 billion pounds of explosives produced — 20 percent of the volume used by the Allied Forces. Yet, the performance during the war years showed no significant deviation from the pre-war years. In 1941, the DuPont Company was 10 times safer than all industry and 9 times safer than the Chemical Industry. Management and the line organization were finally working as they should to control the real causes of injuries. Today, DuPont is about 50 times safer than US industrial safety performance averages. Comparing performance to other industries, it is interesting to note that seemingly “hazard-free” industries seem to have extraordinarily high injury rates. This is because, as DuPont has found out, performance is a function of injury prevention and safety management systems, not hazard exposure. Our success in safety results from a sound safety management philosophy. Each of the 125 DuPont facilities is responsible for its own safety program, progress, and performance. However, management at each of these facilities approaches safety from the same fundamental and sound philosophy. This philosophy can be expressed in eleven straightforward principles. The first principle is that all injuries can be prevented. That statement may seem a bit optimistic. In fact, we believe that this is a realistic goal and not just a theoretical objective. Our safety performance proves that the objective is achievable. We have plants with over 2,000 employees that have operated for over 10 years without a lost time injury. As injuries and incidents are investigated, we can always identify actions that could have prevented that incident. If we manage safety in a proactive — rather than reactive — manner, we will eliminate injuries by reducing the acts and conditions that cause them. The second principle is that management, which includes all levels through first-line supervisors, is responsible and accountable for preventing injuries. Only when senior management exerts sustained and consistent leadership in establishing safety goals, demanding accountability for safety performance and providing the necessary resources, can a safety program be effective in an industrial environment. The third principle states that, while recognizing management responsibility, it takes the combined energy of the entire organization to reach sustained, continuous improvement in safety and health performance. Creating an environment in which employees feel ownership for the safety effort and make significant contributions is an essential task for management, and one that needs deliberate and ongoing attention. The fourth principle is a corollary to the first principle that all injuries are preventable. It holds that all operating exposures that may result in injuries or illnesses can be controlled. No matter what the exposure, an effective safeguard can be provided. It is preferable, of course, to eliminate sources of danger, but when this is not reasonable or practical, supervision must specify measures such as special training, safety devices, and protective clothing. Our fifth safety principle states that safety is a condition of employment. Conscientious assumption of safety responsibility is required from all employees from their first day on the job. Each employee must be convinced that he or she has a responsibility for working safely. The sixth safety principle: Employees must be trained to work safely. We have found that an awareness for safety does not come naturally and that people have to be trained to work safely. With effective training programs to teach, motivate, and sustain safety knowledge, all injuries and illnesses can be eliminated. Our seventh principle holds that management must audit performance on the workplace to assess safety program success. Comprehensive inspections of both facilities and programs not only confirm their effectiveness in achieving the desired performance, but also detect specific problems and help to identify weaknesses in the safety effort. The Company’s eighth principle states that all deficiencies must be corrected promptly. Without prompt action, risk of injuries will increase and, even more important, the credibility of management’s safety efforts will suffer. Our ninth principle is a statement that off-the-job safety is an important part of the overall safety effort. We do not expect nor want employees to “turn safety on” as they come to work and “turn it off” when they go home. The company safety culture truly becomes of the individual employee’s way of thinking. The tenth principle recognizes that it’s good business to prevent injuries. Injuries cost money. However, hidden or indirect costs usually exceed the direct cost. Our last principle is the most important. Safety must be integrated as core business and personal value. There are two reasons for this. First, we’ve learned from almost 200 years of experience that 96 percent of safety incidents are directly caused by the action of people, not by faulty equipment or inadequate safety standards. But conversely, it is our people who provide the solutions to our safety problems. They are the one essential ingredient in the recipe for a safe workplace. Intelligent, trained, and motivated employees are any company’s greatest resource. Our success in safety depends upon the men and women in our plants following procedures, participating actively in training, and identifying and alerting each other and management to potential hazards. By demonstrating a real concern for each employee, management helps establish a mutual respect, and the foundation is laid for a solid safety program. This, of course, is also the foundation for good employee relations. An important lesson learned in DuPont is that the majority of injuries are caused by unsafe acts and at-risk behaviors rather than unsafe equipment or conditions. In fact, in several DuPont studies it was estimated that 96 percent of injuries are caused by unsafe acts. This was particularly revealing when considering safety audits — if audits were only focused on conditions, at best we could only prevent four percent of our injuries. By establishing management systems for safety auditing that focus on people, including audit training, techniques, and plans, all incidents are preventable. Of course, employee contribution and involvement in auditing leads to sustainability through stakeholdership in the system. Management safety audits help to make manage the “behavioral balance.” Every job and task performed at a site can do be done at-risk or safely. The essence of a good safety system ensures that safe behavior is the accepted norm amongst employees, and that it is the expected and respected way of doing things. Shifting employees norms contributes mightily to changing culture. The management safety audit provides a way to quantify these norms. DuPont safety performance has continued to improve since we began keeping records in 1911 until about 1990. In the 1990–1994 time frame, performance deteriorated as shown in the chart that follows: This increase in injuries caused great concern to senior DuPont management as well as employees. It occurred while the corporation was undergoing changes in organization. In order to sustain our technological, competitive, and business leadership positions, DuPont began re-engineering itself beginning in about 1990. New streamlined organizational structures and collaborative work processes eliminated many positions and levels of management and supervision. The total employment of the company was reduced about 25 percent during these four years. In our traditional hierarchical organization structures, every level of supervision and management knew exactly what they were expected to do with safety, and all had important roles. As many of these levels were eliminated, new systems needed to be identified for these new organizations. In early 1995, Edgar S. Woolard, DuPont Chairman, chartered a Corporate Discovery Team to look for processes that will put DuPont on a consistent path toward a goal of zero injuries and occupational illnesses. The cross-functional team used a mode of “discovery through learning” from as many DuPont employees and sites around the world. The Discovery Team fostered the rapid sharing and leveraging of “best practices” and innovative approaches being pursued at DuPont’s plants, field sites, laboratories, and office locations. In short, the team examined the company’s current state, described the future state, identified barriers between the two, and recommended key ways to overcome these barriers. After reporting back to executive management in April, 1995, the Discovery Team was realigned to help organizations implement their recommendations. The Discovery Team reconfirmed key values in DuPont — in short, that all injuries, incidents, and occupational illnesses are preventable and that safety is a source of competitive advantage. As such, the steps taken to improve safety performance also improve overall competitiveness. Senior management made this belief clear: “We will strengthen our business by making safety excellence an integral part of all business activities.” One of the key findings of the Discovery Team was the identification of the best practices used within the company, which are listed below: ▪ Felt Leadership – Management Commitment ▪ Business Integration ▪ Responsibility and Accountability ▪ Individual/Team Involvement and Influence ▪ Contractor Safety ▪ Metrics and Measurements ▪ Communications ▪ Rewards and Recognition ▪ Caring Interdependent Culture; Team-Based Work Process and Systems ▪ Performance Standards and Operating Discipline ▪ Training/Capability ▪ Technology ▪ Safety and Health Resources ▪ Management and Team Audits ▪ Deviation Investigation ▪ Risk Management and Emergency Response ▪ Process Safety ▪ Off-the-Job Safety and Health Education Attention to each of these best practices is essential to achieve sustained improvements in safety and health. The Discovery Implementation in conjunction with DuPont Safety and Environmental Management Services has developed a Safety Self-Assessment around these systems. In this presentation, we will discuss a few of these practices and learn what they mean. Paper published with permission.

This report forms part of the deliverables produced by the international research project Fighting pandemics with enhanced risk communication: Messages, compliance and vulnerability during the COVID-19 outbreak (PAN-FIGHT), funded by the Norwegian Research Council. It provides an overview of project findings pertaining the gender dimensions of the pandemic, with a particular focus on risk perceptions, compliance and vulnerability. The COVID-19 pandemic has reiterated that the impacts of a crisis are not homogenous. Gender, which encapsulates both biological and socio-cultural ways of being, plays a role in how crises are experienced. This is evidenced by the health, economic as well as societal consequences of the COVID-19 pandemic which have affected women and men, girls and boys differently. Knowledge about gendered implications of the pandemic is thus vital for designing equitable policy responses. This report draws on evidence from former research as well as on findings from an online survey conducted as part of the project’s data collection in 2021. The survey, reaching out to respondents in Norway, Sweden, Germany, Switzerland and the United Kingdom, investigated public risk perceptions, reactions to governmental of risk communication about COVID-19, compliance with governmental restrictions and risk mitigation measures and vulnerability during the pandemic (N=4206).