Multidimensional aspects related to shiftworkers' health and well-being

The impact of shift and night work on health shows a high inter- and intra-individual variability, both in terms of kind of troubles and temporal occurrence, related to various intervening factors dealing with individual characteristics, lifestyles, work demands, company organisation, family relations and social conditions. The way we define "health" and "well-being" can significantly influence appraisals, outcomes and interventions. As the goal is the optimisation of shiftworkers' health, it is necessary to go beyond the health protection and to act for health promotion. In this perspective, not only people related to medical sciences, but many other actors (ergonomists, psychologists, sociologists, educators, legislators), as well as shiftworkers themselves. Many models have been proposed aimed at describing the intervening variables mediating and/or moderating the effects; they try to define the interactions and the pathways connecting risk factors and outcomes through several human dimensions, which refer to physiology, psychology, pathology, sociology, ergonomics, economics, politics, and ethics. So, different criteria can be used to evaluate shiftworkers' health and well-being, starting from biological rhythms and ending in severe health disorders, passing through psychological strain, job dissatisfaction, family perturbation and social dis-adaptation, both in the short- and long-term. Consequently, it appears rather arbitrary to focus the problem of shiftworkers' health and tolerance only on specific aspects (e.g. individual characteristics), but a systemic approach appears more appropriate, able to match as many variables as possible, and aimed at defining which factors are the most relevant for those specific work and social conditions. This can support a more effective and profitable (for individuals, companies, and society) adoption of preventive and compensative measures, that must refer more to "countervalues" rather than to "counterweights".

Digital disease detection and participatory surveillance: overview and perspectives for Brazil

ABSTRACT This study aimed to describe the digital disease detection and participatory surveillance in different countries. The systems or platforms consolidated in the scientific field were analyzed by describing the strategy, type of data source, main objectives, and manner of interaction with users. Eleven systems or platforms, developed from 1996 to 2016, were analyzed. There was a higher frequency of data mining on the web and active crowdsourcing as well as a trend in the use of mobile applications. It is important to provoke debate in the academia and health services for the evolution of methods and insights into participatory surveillance in the digital age.

Botulism: a laboratory investigation on biological and food samples from cases and outbreaks in Brazil (1982-2001)

Laboratory investigation of botulism from 1982 to 2001 confirmed the occurrence of eight positive outbreaks/cases of botulism in Brazil. From those, type A botulism was observed in seven of them. Biological material of one case (serum and feces) was positive in the first step of the bioassay, but the amount of sample was not sufficient for typification. One of the outbreaks that occurred in 2001 was negative for botulinum toxin in samples of serum, gastric washing and feces, collected eight days before the onset of the symptoms in the affected person who was clinically diagnosed as presenting the disease. Other two cases presenting compatible clinical diagnoses presented negative results. However, in those cases, the collection of samples was (1) after antiserum administration or (2) later than eight days of the onset of symptoms. Investigation was performed by mouse bioassay, as described in the Compendium of Methods for the Microbiological Examination of Foods (compiled by American Public Health Association - APHA)11, using specific antiserum from Centers for Disease Control (CDC), USA.

Paleoepidemiology: is there a case to answer?

Paleopathology is the study of disease, physiological disruptions and impairment in the past. After two centuries of mainly descriptive studies, efforts are being made towards better methodological approaches to the study of diseases in human populations of ancient times whose remains are recovered by archaeology. Paleoepidemiology can be defined as an interdisciplinary area that aims to develop more suitable epidemiological methods, and to apply those in current use, to the study of disease determinants in human populations in the past. In spite of the limits of funerary or other archaeological series of human remains, paleoepidemiology tries to reconstruct past conditions of disease and health in those populations and its relation to lifestyle and environment. Although considering the limits of studying populations of deceased, most of them represented exclusively by bones and teeth, the frequency of lesions and other biological signs of interest to investigations on health, and their relative distribution in the skeletal remains by age and sex, can be calculated, and interpreted according to the ecological and cultural information available in each case. Building better models for bone pathology and bone epidemiology, besides a more complex theoretical frame for paleoepidemiological studies is a big job for the future that will need the incorporation of methods and technology from many areas, including the tools of molecular biology.

Tele-education and competencies assessment to Brazilian's auxiliary nurse

This paper presents Brazilian's experience with the organization of methods and strategies for the assessment of competencies for technical level of nursing workers. The evaluative process proposed includes the creation of a learning-oriented and distance-based virtual assessment environment. The proposed methodology for professional competencies assessment adopted a critical-emancipatory perspective. A tele-education environment was deployed, involving software development - a virtual man - and an assessment cybertutor. Learning modules for the cybertutor were developed and videos of clinical simulations, structured around assessment in cognitive, behavioral, and simulation areas. The evaluation modules considered aspects of competencies in know-know, know-how and know-act professional ethics. Also the variability of practices of nursing - hospitals and primary health care units - was considered. This instrument showed as an important strategy for the optimization of assessment procedures that are widely used across Brazil and it is a powerful tool for incorporation into the continuing professional education.