Caracterización del ausentismo por incapacidad médica en los trabajadores administrativos de una empresa de salud

Se realizó un estudio descriptivo de corte transversal a partir de la base de datos de ausentismo por incapacidad médica del área administrativa de una empresa de salud con sede en Bogotá durante el primer semestre de 2014 Objetivo: Caracterizar las principales causas de ausentismo laboral en los funcionarios administrativos de una empresa de salud desde la revisión de una base de datos para plantear recomendaciones de prevención. Métodos: Mediante un estudio descriptivo de corte transversal se analizó a un grupo de 284 trabajadores administrativos de una empresa de salud que reportaron ausentismo por incapacidad médica en el primer semestre de 2014. Resultados: Las principales causas de ausentismo laboral en el personal administrativo para el primer periodo de 2014 fueron por enfermedad general la diarrea y gastroenteritis (22,2%) y la rinofaringitis aguda (4,4%), y por enfermedad laboral los trastornos osteomusculares (1,04%). El 72% (207) de las incapacidades se generaron en trabajadores administrativos del género femenino y el 46.3% (133) en el grupo etáreo comprendido entre los 31-40 años; según la antigüedad laboral las personas que tienen entre 1 y 10 años generaron el 59.2% de los eventos. Conclusión: Las incapacidades en la población de estudio están dadas en mayor porcentaje por incapacidad general, por enfermedades infectocontagiosas y osteomusculares. Teniendo en cuenta que el presente estudio es netamente descriptivo, puede servir como punto de partida para futuros estudios en los que pueda medirse relación causal entre tipo de incapacidad, duración, género, cargo y grupo etáreo.

Prevalencia de síntomas osteomusculares en miembros superiores en trabajadores de un call center de Bogotá – Colombia durante el año 2015

Introducción: Los trastornos del aparato locomotor son una de las principales causas del ausentismo laboral y generan un gasto considerable para el sistema de gestión pública. Objetivo: Determinar la prevalencia de síntomas osteomusculares en miembros superiores y su relación con los factores ocupacionales en trabajadores de un Call Center de Bogotá – Colombia durante el año 2015. Metodología: Estudio de corte transversal donde se evaluó la prevalencia de los síntomas osteomusculares de miembros superiores, se utilizó como instrumento el ERGOPAR validado en España . Resultados: El grupo de estudio lo conformaron 223 trabajadores de un Call Center donde el género femenino fue el más frecuente (66,8%), el grupo etario predominante fue entre 21 y 25 años (30,5%). La prevalencia de los síntomas osteomusculares por molestia estimada, fue mayor en cuello/hombro (57%), seguido del síntoma en manos/muñecas (40,8%) y por ultimo codos (17%); contrario a la prevalencia de síntomas osteomusculares manifestados por dolor ya que fue mayor en manos/muñecas (35%), seguido de cuello/hombros (28,3%) y por último codo (6,7%), esta prevalencia fue mayor en trabajadores de género femenino que en los de género masculino. Respecto a las variables relacionadas con el género, se encontró que la prevalencia por presencia de dolor en cuello/hombro fue mayor en trabajadores de género femenino (p=0,005) de la misma manera que la prevalencia por presencia de dolor en manos/muñecas (p<0,001). Conclusiones: Los síntomas osteomusculares más prevalentes en los trabajadores del Call Center fueron en cuello/hombro y manos/muñeca con mayor frecuencia en los trabajadores del género femenino. Con el fin de eliminar o disminuir la aparición temprana de estos síntomas, se recomienda la implementación de medidas de prevención dirigidas no solo al trabajador sino a todos los factores que hagan parte del desarrollo de su tarea.

The determinants of the health status in a developing country: results from the Colombian case

El artículo busca encontrar evidencia empírica de los determinantes de la salud, como una medición de capital salud en un país en desarrollo después de una profunda reforma en el sector salud. Siguiendo el modelo de Grossman (1972) y tomando factores institucionales, además de las variables individuales y socioeconómicas. Se usaron las encuestas de 1997 y 2000 donde se responde subjetivamente sobre el estado de salud y tipo de afiliación al sistema de salud. El proceso de estimación usado es un probit ordenado. Los resultados muestran una importante conexión entre las variables individuales, institucionales y socioeconómicas con el estado de salud. El efecto de tipo de acceso al sistema de salud presiona las inequidades en salud.

Prevalencia de síntomas musculo-esqueléticos en trabajadores de una institución de educación superior en el departamento de Arauca, Colombia, 2015

Introducción Los desórdenes musculo esqueléticos representan uno de los problemas de salud ocupacional más comunes de trabajadores, lo cual genera ausentismo laboral y aumento en los costos de enfermedades laborales. Objetivo Estimar la prevalencia de síntomas osteomusculares y su relación con factores de riesgo ocupacional, en personal docente y administrativo de una institución de educación superior en el Departamento de Arauca para el año 2015. Métodos Estudio analítico de corte transversal en una muestra de 116 trabajadores. Se utilizaron dos instrumentos: “La Encuesta Nacional de Condiciones de Trabajo” del Instituto Nacional de Seguridad e Higiene en el Trabajo de España (INSHT) y el “Cuestionario Ergopar”, validados al Español. Se obtuvo previa autorización del Comité de ética de la Universidad del Rosario. El análisis estadístico se realizó con el IBM SPSS Statistics versión 20.0. Resultados: Los síntomas osteomusculares con mayor prevalencia fueron en cuello (86,2%), espalda lumbar (61,2%), manos muñecas (59,5%) y pies (52,6%); no se observaron diferencias estadísticamente significantes entre administrativos e instructores. En el lugar de trabajo los factores de riesgo con mayor prevalencia fueron exposición a temperaturas extremas (48,3%), aberturas y huecos desprotegidos, escaleras, plataformas, desniveles (44%) significativamente mayor en instructores (52,6%) que en personal administrativo (27,5%) (p= 0,010). Conclusiones: Los síntomas osteomusculares más prevalentes fueron aquellos propios de la actividad docente: cuello, espalda lumbar, manos muñecas y pies. El personal de la institución en especial los docentes está expuesto a factores de riesgo físico, químico y ergonómico. Las condiciones de trabajo son adecuadas. No se encontró asociación estadística entre exposición a factores de riesgo en el puesto de trabajo y prevalencia de síntomas osteomusculares. Se debe establecer acciones dirigidas a evitar lesiones musculo esqueléticas en la población.

Correlación de las condiciones de iluminación, ángulo visual, agudeza visual y contraste con y síntomas visuales en trabajadores de un call center en Bogotá, Colombia

Objetivo: Establecer la correlación entre condiciones de iluminación, ángulo visual, discriminación de contrastes y agudeza visual en la aparición de síntomas visuales en operarios de computador. Materiales y métodos: Estudio de corte transversal y correlación en muestra de 136 trabajadores administrativos de un “call center” perteneciente a una entidad de salud en la ciudad de Bogotá, utilizando un cuestionario con el que se evaluaron las variables sociodemográficas y ocupacionales; aplicando la escala de síntomas visión – computador (CVSS17), realizando evaluación médica y midiendo iluminación y distancia operario pantalla de computador y con los datos recolectados se realizó un análisis estadístico bivariado y se estableció la correlación entre las condiciones de iluminación, ángulo visual, discriminación de contrataste y agudeza visual; frente a la aparición de síntomas visuales asociados con el uso del computador. El análisis se llevó a cabo con medidas de tendencia central y dispersión y con el coeficiente de correlación paramétrico de Pearson o no-paramétrico de Spearman, previamente se evaluó la normalidad con la prueba de Shapiro-Wilk. Las pruebas estadísticas se evaluarán a un nivel de significancia del 5% (p<0.05). Resultados: El promedio de edad de los participantes en el estudio fue de 36,3 años con un rango entre los 22 y 57 años y en donde el género predominante fue el femenino con el 79,4%. Se encontraron síntomas visuales asociados al uso de pantalla de computador del 59,6%, siendo los más frecuentes la epifora (70,6%), fotofobia (67,6%) y ardor ocular (54,4%). Se reportó una correlación inversa significativa entre niveles de iluminación y manifestación de fotofobia (p=0.02; r= 0,262). Por otra parte no se encontró correlación significativa entre los síntomas referidos con ángulo de visión y agudeza visual y discriminación de contrastes. Conclusión: Las condiciones laborales de iluminación del grupo de estudio están relacionadas con la manifestación de fotofobia, Se encontró asociación entre síntomas visuales y variables sociodemográficas, específicamente con el género, fotofobia a pantalla, fatiga visual y fotofobia

Becoming poverty focused: implications for health actors

The article explores the relationship between health sector interventions and poverty analysis. It is suggested that a dynamic asset approach to poverty and health provides a framework for intervention that recognizes the complex strategies adopted by poor individuals, households and communities. The linked nature of the asset approach leads to an inter-sectoral focus and provides extra stimulation to engage with diverse partners who may be slow to own poverty reduction and health policies.

Risks Associated With Tendinitis: Effects From Demographic, Socioeconomic, and Psychological Status Among Brazilian Workers

Background Self-reported tendinitis/tenosynovitis was evaluated by gender, age group, skin color, family income, and educational and psychological status. Methods The study was carried out in a representative sample of formally contracted Brazilian workers from a household survey. A total of 54,660 participants were included. Occupations were stratified according to estimated prevalences of self-reported injuries. Non-conditional logistic regression was performed, and all variables were analyzed in two occupational groups. Results The overall prevalence rate of tendinitis/tenosynovitis was 3.1%: 5.5% in high-prevalence occupations (n=10,726); and 2.5% in low-prevalence occupations (n=43,934). White female workers between the ages of 45 and 64 years and at a higher socioeconomic level were more likely to report tendinitis/tenosynovitis regardless of their occupational category. An adjusted OR = 3.59 [95% CI: 3.15-4.09] was found between tendinitis/tenosynovitis and psychological status. Conclusion Among formally contracted Brazilian workers, higher income can imply greater physical and psychological demands that, regardless of occupational stratum, increase the risk of tendinitis/tenosynovitis. Am. J. Ind. Med. 53:72-79, 2010. (C) 2009 Wiley-Liss, Inc.

Recent Trends in Maternal, Newborn, and Child Health in Brazil: Progress Toward Millennium Development Goals 4 and 5

We analyzed Brazil`s efforts in reducing child mortality, improving maternal and child health, and reducing socioeconomic and regional inequalities from 1990 through 2007. We compiled and reanalyzed data from several sources, including vital statistics and population-based surveys. We also explored the roles of broad socioeconomic and demographic changes and the introduction of health sector and other reform measures in explaining the improvements observed. Our findings provide compelling evidence that pro-active measures to reduce health disparities accompanied by socioeconomic progress can result in measurable improvements in the health of children and mothers in a relatively short interval. Our analysis of Brazil`s successes and remaining challenges to reach and surpass Millennium Development Goals 4 and 5 can provide important lessons for other low- and middle-income countries. (Am J Public Health. 2010;100:1877-1889. doi:10.2105/AJPH.2010.196816)

Health in Brazil 2 Maternal and child health in Brazil: progress and challenges

In the past three decades, Brazil has undergone rapid changes in major social determinants of health and in the organisation of health services. In this report, we examine how these changes have affected indicators of maternal health, child health, and child nutrition. We use data from vital statistics, population censuses, demographic and health surveys, and published reports. In the past three decades, infant mortality rates have reduced substantially, decreasing by 5.5% a year in the 1980s and 1990s, and by 4.4% a year since 2000 to reach 20 deaths per 1000 livebirths in 2008. Neonatal deaths account for 68% of infant deaths. Stunting prevalence among children younger than 5 years decreased from 37% in 1974-75 to 7% in 2006-07. Regional differences in stunting and child mortality also decreased. Access to most maternal-health and child-health interventions increased sharply to almost universal coverage, and regional and socioeconomic inequalities in access to such interventions were notably reduced. The median duration of breastfeeding increased from 2.5 months in the 1970s to 14 months by 2006-07. Official statistics show stable maternal mortality ratios during the past 10 years, but modelled data indicate a yearly decrease of 4%, a trend which might not have been noticeable in official reports because of improvements in death registration and the increased number of investigations into deaths of women of reproductive age. The reasons behind Brazil`s progress include: socioeconomic and demographic changes (economic growth, reduction in income disparities between the poorest and wealthiest populations, urbanisation, improved education of women, and decreased fertility rates), interventions outside the health sector (a conditional cash transfer programme and improvements in water and sanitation), vertical health programmes in the 1980s (promotion of breastfeeding, oral rehydration, and immunisations), creation of a tax-funded national health service in 1988 (coverage of which expanded to reach the poorest areas of the country through the Family Health Program in the mid-1990s); and implementation of many national and state-wide programmes to improve child health and child nutrition and, to a lesser extent, to promote women`s health. Nevertheless, substantial challenges remain, including overmedicalisation of childbirth (nearly 50% of babies are delivered by caesarean section), maternal deaths caused by illegal abortions, and a high frequency of preterm deliveries.

Differences in muscle activity during hand dexterity tasks between women with arthritis and a healthy reference group

Background. Impaired hand function is common in patients with arthritis and it affects performance of daily activities; thus, hand exercises are recommended. There is little information on the extent to which the disease affects activation of the flexor and extensor muscles during these hand-dexterity tasks. The purpose of this study was to compare muscle activation during such tasks in subjects with arthritis and in a healthy reference group. Methods. Muscle activation was measured in m. extensor digitorium communis (EDC) and in m. flexor carpi radialis (FCR) with surface electromyography (EMG) in women with rheumatoid arthritis (RA, n = 20), hand osteoarthritis (HOA, n = 16) and in a healthy reference group (n = 20) during the performance of four daily activity tasks and four hand exercises. Maximal voluntary isometric contraction (MVIC) was measured to enable intermuscular comparisons, and muscle activation is presented as %MVIC. Results. The arthritis group used a higher %MVIC than the reference group in both FCR and EDC when cutting with a pair of scissors, pulling up a zipper and—for the EDC—also when writing with a pen and using a key (p < 0.02). The exercise “rolling dough with flat hands” required the lowest %MVIC and may be less effective in improving muscle strength. Conclusions. Women with arthritis tend to use higher levels of muscle activation in daily tasks than healthy women, and wrist extensors and flexors appear to be equally affected. It is important that hand training programs reflect real-life situations and focus also on extensor strength.

Análise dos fundamentos do modelo value-based health care delivery à luz das teorias de estratégia

O setor de saúde, globalmente, apresenta problemas relacionados aos seus custos, qualidade e acesso. Porter e Teisberg (2004, 2006) propuseram modelo de gestão específico para a administração estratégica na área, o Value-Based Health Care Delivery (VBHCD). O modelo teve relativa repercussão e vem influenciando muitos atores no setor. Contudo, o modelo vem sendo aceito sem o devido questionamento de seus fundamentos e consistência com a teoria em estratégia. O presente trabalho busca, por meio de um ensaio teórico, analisar o modelo proposto à luz de paradigmas gerais da estratégia empresarial como, por exemplo, o modelo de Porter e a Visão Baseada em Recursos (RBV). Inicialmente, o artigo sintetiza as explicações teóricas do modelo porteriano clássico e da RBV. Em seguida, o VBHCD é examinado comparado a essas explicações, buscando-se relações e, eventualmente, contradições. Conclui-se que o modelo VBHCD não se alinha integralmente a nenhum corpo teórico isoladamente. Mesmo sendo proposto por Porter, parte de seus fundamentos advém, na verdade, de outras correntes teóricas. Esta abordagem integradora de teorias concorrentes, apesar de presente na literatura, ainda apresenta dificuldades e barreiras, um aspecto que não está explícito no modelo

O atendimento educacional especializado no processo de inclusão escolar, na rede municipal de ensino de Mossoró/RN

This dissertation aims to analyze the specialized educational services(AEE, Portuguese) implemented in four municipal schools of Mossoró/RN, with attention to the process of collaboration between regular classroom teachers and multifunctional resource classroom teachers. We use as theoretical reference the works of Vygotsky and others authors that write about education and collaboration. To accomplish the research we chose a qualitative approach, using as a methodological resources: study of cases, bibliographical, documental and field research. For the field research we make observations in regular and multifunctional classrooms. We produce group intervieus with regular and multifunctional teachers. From the analysis performed we identify that the concepts and the practices of teachers in regular classrooms changes, with integrationist predominance. The AEE s teachers had more inclusive conceptions and greater investment in continuing education than the regular classroom teachers. The practices of regular classroom teachers are more traditional, what makes the learning process more difficult for the students, even more for the students with disabilities and pervasive developmental disorders. Teachers of AEE was more interactive and creative, however, the attention to the students was more individual. In three of the four schools surveyed stand out the efforts of the teachers of specialist classroom to collaborate with regular school teachers, by notes, e-mails, phone calls and resource sharing. In one of the four was noted a good collaborative interactive between the AEE teachers and the regular school teachers. The school with the worst improvement was that in which the actions of the teachers of the AEE were limited to actions in multifunctional resource classroom. The resistance to these professionals was identified in the statements of the regular classroom teachers. Another issue raised was the lack of time for teachers to conduct AEE actions that contribute to the process of school students, because their working hours is restricted to the opposite turn in school. Transport difficulties for the students to attend the resource classroom multifunctional and the lack of dialogue with the health sector was challenges for the four schools. The families were with a practically constant interest to interact with the AEE teachers in the four schools. Thus, we believe that the presence of AEE school can make contributions to the educational process, however, it is necessary more attention to the collaborative process between teachers and the school community

A pessoa idosa com doença crônica não transmissível atendida em serviços de média complexidade na cidade de Natal/RN

The demographic and epidemiological transition process caused by a declining in birth rates and in mortality, also changes occurred in morbidity and mortality is represented by the increasing of the aging population and the raising of chronic diseases. These diseases are characterized by multiple etiologies, risk factors, long latency period, a prolonged evolution, non-infectious origin and it has association with functional impairment and disability. Thus, elderly with chronic non-communicable disease has priority because they belong to a vulnerable group to get affection of comorbidities in aging, with increased demand and spending on health services. This study is aimed to analyse the understanding of elderly people with chronic non comunicable disease in the medium complexity service as a contribution to the improvement of health care in the city of Natal / RN. This is a descriptive and exploratory study with a quantitative approach, carried out at the Specialized Center for Elderly Health Care and at the Pescadores Hospital. The population was composed of 4,180 persons with a sample of 124 elderly aged above 60 years, attended in these medium complexity services. The instrument, a structured form, adapted from a questionnaire for monitoring risk and protective factors for chronic disease of the Ministry of Health. To collect data was was used the interview form containing demographic data, habits, health status and health care services. The results were processed using the Statistical Package for Social Science, version 18.0, analyzed by simple statistics. It was found that most seniors were female, predominantly between 70 and 74 years old, married, with a brown skin tone and Catholic religion, more than half had incomplete basic education, family income between one to two minimum wages and living with their families. Regarding the interviewers lifestyle, 94.4%, of them ate chicken and 97.6%, fruits, it was observed a reduction in smoking, alcoholism habits and physical activity according to the increasing age, 58.1 and 18.5% had insomnia18,5 % used sleeping pills. The elderly (51.6%) reported using services in times of sickness, seeking primary care at first (30.6%), 52% did not receive referral and was looking for free demand (38.7%). The most reported morbidity was hypertension, followed by musculoskeletal disorders. Regarding the difficulties in seeking health services, the delay in treatment and the waiting line were the most cited by the elderly. Almost all of them reported no activities to promote health in these services and those who received individual counseling on chronic diseases. Almost always, the health professionals who care of them, were mostly doctors followed by nurses. Based on the results presented, it is considered that the health services of medium complexity must undergone a more continuous dialogue with other attention level and focus on actions of health promotion and prevention. It is also recommended the necessity for qualified professionals to delivery health care to elderly and the implementation of protocols by a multidisciplinary health team, intending to provide better and continous care for the elderly with chronic diseases. The healthcare professionals who served them, were mostly physicians, followed by nurses. Through the results presented, it is considered that the medium complexity healthcare services need to perform a more continuous dialogue with the other levels of attention focusing attention to the health promotion and prevention actions. It is also recommended the necessity for qualified professionals to delivery healthcare for the elderly, in addition, a protocol implementation for the multidisciplinary health care team, to provide better care, and also the care continuity to elderly with chronic diseases

O ensino de enfermagem gerontológica na formação do enfermeiro

At the current time of demographic changes in the world , it is observed that the health sector requires restructuring of its practices in caring for the elderly , in order to enable a comprehensive and humane care . In this sense, we identify the need for qualified professionals to assist the elderly and, therefore , it is important that training curricula are adequate to this reality . The study aims to analyze how it develops teaching gerontological nursing component in undergraduate nursing . This is a descriptive , exploratory study with a qualitative approach, in two higher education institutions in the city of Natal / RN . The population involved corresponded to the coordinators of graduate courses in nursing and teachers who teach content of health care for the elderly, a total of seven participants . The data collection instruments were used: a questionnaire containing questions related to the characterization of the participants and the teaching of gerontological nursing in undergraduate courses in nursing and a form with items of analysis for pedagogical projects . The results were presented descriptively in tables and analyzed from coming themes of the main themes of the instruments defined in: knowledge about the research participants , knowledge of teaching gerontological nursing component and knowledge of pedagogical projects , discussed under Resolution paragraph . 03 of 7/11/2001 , which establishes standards for the nursing program , the educational projects of educational institutions , the Theoretical Donald Shoon and thematically relevant literature . The results indicate that the majority of participants were female (four), all have graduate though , none of them stated in the qualification of aging or elderly health area; the organization of the contents of the component in the curriculum, workload theoretical- methodological and practical teaching strategies presented was heterogeneous and sometimes diverging at the same institution . On the definition of gerontological nursing component was identified that is not well defined along the pedagogical design of educational institutions surveyed . It was concluded that in the context of this study , teaching gerontological nursing is present in the course of nursing education, but needs reevaluation and updating in order to teach a wider range of driving and health practices

Análise da situação de trabalho do motorista em uma empresa de ônibus urbano da idade de Natal (RN)

The problem dealt with in this study concerns the analysis of bus drivers' working situation. It stemmed from the need to identify the difficulties faced by these professionals in accomplishing the results expected by the company. A case study was carried out in a public transportation company in the city of Natal. Records and observations made in the workplace, alongside perfomance indicators, such as absenteeism tax, staff turnover and traffic accidents, revealed problems in their activity. It was made clear that, in the company being studied, absenteeism was related to health problems, particularly psychiatric and musculoskeletal disorders, and that although the indicators of traffic accidents and staff turnover have declined over the years, they are still elevated. The interviews involved 50 of the 124 drivers who worked directly in the service, and contained questions covering eleven factors related to the drivers' work. They indicated a gap between the prescribed work and the work actually done, in that there were a series of embarassing or stressful situations involving traffic, itinerary length, road conditions, vehicle maintenance, physical environment (bus terminus), job post and supervision policies. On the other hand, factors such as enjoying driving, the work itself and being with workmates positively influenced the drivers' working conditions. In the propositions of the administration and human resources subsystems, some alternatives were found in order to remodel this activity