Los horarios laborales y su influencia en la percepción del equilibro trabajo-familia

Conciliar el trabajo y la familia es una lucha cotidiana que cada persona realiza para satisfacer las exigencias de ambas dimensiones de su vida. El no tener consciencia del problema que surge en el empleado para lograr esta conciliación y la ausencia de soluciones eficaces a éste, no sólo afecta a la organización a través de la baja productividad, el absentismo, el aumento del estrés, entre otros efectos; sino también a la vida familiar, social, física y psicológica del trabajador. Es por ello, que este proyecto de grado busca a partir de la revisión de la literatura mostrar cómo la percepción que tienen los trabajadores de su equilibrio trabajo-familia, se ve influenciada por un factor organizativo, como lo son los turnos laborales; además evidenciar las soluciones que se han implementado en las diferentes empresas de manera exitósa, para finalmente plantear estrategias que se puedan aplicar en las organizaciones facilitando el equilibrio trabajo-familia de los trabajadores.

Acciones de promoción de la salud organizacional y su relación con variables estructurales y el bienestar de los trabajadores: análisis desde un modelo de organizaciones saludables

El bienestar de los trabajadores es un imperativo categórico para las organizaciones tanto por razones éticas como por razones de competitividad. La creación de organizaciones o entornos laborales que promuevan el bienestar de los trabajadores constituye un gran reto para las organizaciones y un ámbito de estudio académico. En el presente artículo se describe la relación que existe entre un conjunto de factores organizacionales y su impacto en el bienestar de un grupo de trabajadores, expresado a través del engagement, la satisfacción con el trabajo y la ansiedad relacionada con el trabajo. Para probar las relaciones hipotetizadas se empleó un modelo de ecuaciones estructurales y los resultados obtenidos señalan que las acciones de promoción de la salud organizacional tiene un impacto significativo en los valores culturales y en la adopción de prácticas organizacionales

Community Health Managers: A Pilot Pedagogic Experience in the University of Rosario

The “Grupo de Estudios en Sistemas Tradicionales de Salud” from the School of Medicine of Universidad del Rosario, in agreement with the “Instituto de Etnobiología”, has designed a training course for a new health agent (the community health manager) meant to consider in its curriculum the difficulties, deficiencies and successes of the Primary Health Care Program. In particular, we have attended OMS suggestions in terms of adequate training of local leaders who should look for self-responsibility and selfdetermination in health care coverage. This training proposal is meant to take into account diverse cultures and traditions in order to offer health care models able to consider cultural particularities, epidemiological profiles, and contextual possibilities, with an intercultural point of view. Hence, the training course’s objective is to offer working tools so that community leaders be able to value and promote traditional health knowledge and practices; seek for food security by means of recovery of traditional productive systems or adaptation of appropriate technologies; environment conservation; use of medicinal plants especially in self-care, and stimulation of community and institutional health promotion activities. Preliminary evaluation suggests that this new health agent will be able to set bridges between communities and health care offers available, always looking for healthy ways of life, culturally and environmentally friendly.

The Ethics of Ethics Reviews in Global Health Research: Case Studies Applying a New Paradigm

With increasing calls for global health research there is growing concern regarding the ethical challenges encountered by researchers from high-income countries (HICs) working in low or middle-income countries (LMICs). There is a dearth of literature on how to address these challenges in practice. In this article, we conduct a critical analysis of three case studies of research conducted in LMICs.We apply emerging ethical guidelines and principles specific to global health research and offer practical strategies that researchers ought to consider. We present case studies in which Canadian health professional students conducted a health promotion project in a community in Honduras; a research capacity-building program in South Africa, in which Canadian students also worked alongside LMIC partners; and a community-university partnered research capacity-building program in which Ecuadorean graduate students, some working alongside Canadian students, conducted community-based health research projects in Ecuadorean communities.We examine each case, identifying ethical issues that emerged and how new ethical paradigms being promoted could be concretely applied.We conclude that research ethics boards should focus not only on protecting individual integrity and human dignity in health studies but also on beneficence and non-maleficence at the community level, explicitly considering social justice issues and local capacity-building imperatives.We conclude that researchers from HICs interested in global health research must work with LMIC partners to implement collaborative processes for assuring ethical research that respects local knowledge, cultural factors, the social determination of health, community participation and partnership, and making social accountability a paramount concern.

The Ethics of Ethics Reviews in Global Health Research: Case Studies Applying a New Paradigm

With increasing calls for global health research there is growing concern regarding the ethical challenges encountered by researchers from high-income countries (HICs) working in low or middle-income countries (LMICs). There is a dearth of literature on how to address these challenges in practice. In this article, we conduct a critical analysis of three case studies of research conducted in LMICs.We apply emerging ethical guidelines and principles specific to global health research and offer practical strategies that researchers ought to consider. We present case studies in which Canadian health professional students conducted a health promotion project in a community in Honduras; a research capacity-building program in South Africa, in which Canadian students also worked alongside LMIC partners; and a community-university partnered research capacity-building program in which Ecuadorean graduate students, some working alongside Canadian students, conducted community-based health research projects in Ecuadorean communities.We examine each case, identifying ethical issues that emerged and how new ethical paradigms being promoted could be concretely applied.We conclude that research ethics boards should focus not only on protecting individual integrity and human dignity in health studies but also on beneficence and non-maleficence at the community level, explicitly considering social justice issues and local capacity-building imperatives.We conclude that researchers from HICs interested in global health research must work with LMIC partners to implement collaborative processes for assuring ethical research that respects local knowledge, cultural factors, the social determination of health, community participation and partnership, and making social accountability a paramount concern.

Animal health challenges and veterinary aspects of organic livestock farming identified through a 3 year EU network project

From 2003-2006, an EU network project ‘Sustaining Animal Health and Food Safety in Organic Farming' (SAFO), was carried out with 26 partners from 20 EU-countries and 4 related partners from 4 candidate or new member states. The focus was the integration of animal health and welfare issues in organic farming with food safety aspects. Four very consistent conclusions became apparent: 1) The climatic, physical and socio-economic conditions vary considerably throughout Europe, leading to different livestock farming systems. This limits the possibility for technology transfer between regions, and creates several challenges for a harmonised regulation, 2) Implementing organic standards at farm level does not always ensure that animal health and welfare reach the high ideals of the organic principles, 3) To overcome these deficiencies, organic farmers and farmer organisations need to take ownership of organic values and, 4) In all participating countries, a strong need for training of farmers and in particular veterinarians in animal health promotion and organic principles was identified. The article presents a summary of papers presented at the five SAFO workshops.

Nutritional information of meals supplied by companies, participating in the workers` meal program in Sao Paulo, Brazil

Objective. To compare the nutritional value of meals provided by companies participating in the Workers` Meal Program in the city of Sao Paulo, Brazil, to the nutritional recommendations and guidelines established by the Ministry of Health for the Brazilian population. Methods. The 72 companies studied were grouped according to economic sector (industrial, services, or commerce), size (micro, small, medium, or large), meal preparation modality (prepared on-site by the company itself, on-site by a hired caterer, or off-site by a hired caterer), and supervision by a dietitian (yes or no). The per capita amount of food was determined based on the lunch, dinner, and supper menus for three days. The nutritional value of the meals was defined by the amount of calories, carbohydrates, protein, total fat, polyunsaturated fat, saturated fat, trans fat, sugars, cholesterol, and fruits and vegetables. Results. Most of the menus were deficient in the number of fruits and vegetables (63.9%) and amount of polyunsaturated fat (83.3%), but high in total fat (47.2%) and cholesterol (62.5%). Group 2, composed of mostly medium and large companies, supervised by a dietician, belonging to the industrial and/or service sectors, and using a hired caterer, on averaged served meals with higher calorie content (P < 0.001), higher percentage of polyunsaturated fat (P < 0.001), more cholesterol (P = 0.015), and more fruits and vegetables (P < 0.001) than Group 1, which was composed of micro and small companies from the commercial sector, that prepare the meals themselves on-site, and are not supervised by a dietitian. Regarding the nutrition guidelines set for the Brazilian population, Group 2 meals were better in terms of fruit and vegetable servings (P < 0.001). Group I meals were better in terms of cholesterol content (P = 0.05). Conclusions. More specific action is required targeting company officers and managers in charge of food and nutrition services, especially in companies without dietitian supervision.

Barriers to interventions aimed at promoting the health of health care workers in Brazil

Objective. To search the literature for circumstances that impede injury and disease prevention and other activities intended to improve the health of the health care worker. Methods. The SciELO database was searched for articles published in 1967-2008. This was supplemented by a PubMed search for the period 1950-2008. The following key words were used to identify articles in English, Portuguese, and Spanish: work, health personnel, occupational, risks, diseases, ergonomics, work ability, quality of life, organization, accidents, work conditions, intervention, and administration. Articles on injury and disease prevention and occupational health in a health care setting in Latin America were selected, along with articles focused on health promotion in the health sector. Results. The following shortcomings were identified: activities lacked a sound theoretical foundation and were not integrated with the health services management; a failure to evaluate the effectiveness of the activity; health surveillance focused solely on a specific disease or injury; management not committed to the proposed activity; miscommunication; inability of workers to participate, or control the work environment; and, programs or efforts that were limited to changing the workers` behaviors. Conclusions. The literature shows that all the barriers identified by this study affect both the health care workers` health as well as their productivity.

Oral health in transition: the case of Indigenous peoples from Brazil

The objective of this paper is to summarise epidemiological information about the distribution of dental caries among Indigenous peoples in Brazil. The authors also present a case study of a specific group of Xavante Indians, one of the most numerous of Brazil`s Indigenous peoples, describing how their oral health has deteriorated over recent decades, and showing how an oral health programme is attempting to reverse the present trend of increase in caries. The programme at Etenheritipa Xavante village incorporated three principal components: educational, preventive, and clinical. From the beginning, the programme included epidemiological record keeping for monitoring the level of caries in the population. Transversal studies of the condition of oral health among the Xavante of Etenheritipa were undertaken in 1999, 2004, and 2007. In the period from 2004 to 2007 the DMFS values in the 11-15 age cohort had a significant reduction in caries experience. The mean DMFS score fell from 4.95 in 2004 to 2.39 in 2007 (p<0.01). An increase in the percent of individuals who were free from caries was also noted: in 1999, 20% of adolescents 11-15 had no caries; in 2007, the proportion had risen to 47%. The Xavante case is a prime example of the transition in oral health that is taking place among the Indigenous peoples of the Americas, and it highlights the importance of oral health promotion through preventive measures such as access to fluoridation and basic care in reducing the inequality between Indians and non-Indians.

Hälsofrämjande arbete på SSAB i Borlänge : Hälsofrämjande processer i arbetslivet och ledarskapets betydelse för medarbetarens hälsa

Problem: Arbetsmiljön är viktig för människors välbefinnande. Hälsofrämjande faktorer antas inte bara styrka individens fysiska och psykiska hälsa, utan även företagets konkurrenskraft och lönsamhet. I uppsatsen undersöker vi hur företaget SSAB i Borlänge arbetar med hälsa genom att tillämpa ett hälsofrämjande perspektiv och utgå från teorin om Känslan av sammanhang (KASAM). Ledarskapsvärderingar har betydelse för medarbetares hälsa (Hanson, 2004) och vi undersöker vilken uppfattning ett antal chefer har om sina roller i det hälsofrämjande arbetet och deras syn på medarbetarundersökningen HälsoSAM som företagshälsovården på SSAB bedriver. Arbetsbelastningen på medarbetare och chefer ökar till följd av sparkrav, samtidigt som resurserna minskar (Gatu, 2003). Följden blir en större risk för ohälsa och ett sätt att minska sjukfrånvaron är att genomföra hälsofrämjande insatser (Prevent, 2001). Syfte: Syftet med studien är att utifrån ett hälsofrämjande perspektiv förklara vad chefer har för möjligheter att skapa förutsättningar för att främja medarbetarnas hälsa på SSAB i Borlänge. Metod: Den metod som ligger till grund för uppsatsen baseras på ett kvalitativt angreppssätt där semistrukturerade intervjuer samt litteraturstudier genomförts för att samla information. Analys: Ledarens beteende påverkar medarbetarna. Hög arbetsbelastning på SSABs chefer leder till lägre närvaro bland medarbetarna, vilket i sin tur ger sämre förutsättningar för att främja hälsan. HälsoSAM kartlägger medarbetarnas hälsoläge, både välbefinnande och arbetskapacitet. Resultaten är vägledande i det hälsofrämjande arbetet men överbelastning, tidsbrist och kunskapsbrist hos cheferna bidrar till att uppföljningen inte blir systematisk. För ett väl fungerande hälsoarbete krävs systematik. Slutsats: Hälsofrämjande processer i arbetslivet skapas genom balans mellan krav och resurser. På SSAB i Borlänge hindras hälsoarbetet av tidsbrist och kunskapsbrist hos cheferna. Kostnadsbesparingar påverkar hälsoarbetet negativt och systematiken i uppföljningsarbetet blir lidande. Ansvaret för hälsoarbetet läggs på företagshälsovården, men utan stöd från chefer blir inte hälsoarbetet en naturlig del i verksamheten. Det är viktigt att i rådande situation se vad främjande av hälsa kan ge tillbaka till företaget i både ekonomiska och kvalitativa termer. Insikt om detta ökar chefernas incitament att prioritera hälsofrämjande processer och organisera arbetet så att människor har förutsättningar att hantera, kontrollera och klara av sina uppgifter.

Knowledge and perceptions regarding sexual and reproductive health among high school students in Kathmandu, Nepal

Background: Nepal recently began teaching sexual education in the school system and has established youth friendly services in order to meet the need of increased sexual and reproductive knowledge among the youth. Objective: To examine the sexual and reproductive knowledge and perceptions among young people attending schools in Kathmandu. Method: A written questionnaire was distributed to 160 students, in a classroom environment, in four schools in Kathmandu. Results: Two thirds of the females and nearly 60% of the males knew that it was possible to get sexually transmitted infection (STI) during one sexual encounter and more than half of the students knew when in the menstrual cycle conception was more likely to occur . One third of the participants did not know that it was possible to become pregnant after having intercourse once. The males demonstrated less knowledge than the females regarding every aspect of sex and reproduction, with the exception of pregnancy prevention. Conclusion and clinical implications: For the youths in this study, it was more important to prevent unwanted pregnancies than to protect oneself from STIs. Establishment of a hotline on the internet, where personalized and confidential counselling can be offered may complement the comprehensive sexual education in schools.

Dificuldades e/ou facilidades vivenciadas pelos profissionais que compõem a Estratégia de Saúde da Família

Descriptive and quantitative study, with the objective of review the positive and negative aspects experienced by professionals working in the Family Health Strategy (ESF) of Ceará-Mirim town, at Rio Grande do Norte state. The population included 190 healthcare professionals that integrate the family healthcare staff and the data-collection occurred in a meeting at their workplace, with the implementation of a questionnaire. Results were organized in Microsoft Excel spreadsheet software, with descriptive statistical analysis in tables, graphs and tables through frequencies, averages values and standard deviations. There is a predominance of females (n = 137) and higher rates in almost all professions, and higher average age (38.9%, SD = 7.8) and income wage (average = 10) in the medical category. Regarding the more developed activities, for physicians and nurses are the healthcare actions in the Unit, the oral hygiene for dentists, the immunization for auxiliary nurses (Aux-N), educational meeting for the dental office assistants (ACD), and home visitations to community-based health workers (ACS). About the easiness of work, 93.2% said to be presence of professionals with a personal profile in public healthcare; about the difficulties, 86.8% of professionals cited the unavailability of material, followed by salary range reported by nurses (80.9% ), dentists (80.0%), physicians (73.3%), ACS (83.1%), and Aux-N (90.5%). In relation to working conditions, the unavailability of materials was the most mentioned, with the exception of dentists who reported improvement in wages. We still identify among these difficulties: the drugs availability regarded as first grade obstacle by ACS and physicians, the type of contracts in second grade cited by the ACD and dentists and, in third grade, the salary range cited by dentists and auxiliary nurses. It is concluded that the difficulties and easiness faced by ESF professionals are divergent among themselves. For physicians and nurses, whose healthcare actions become directed to specific groups, the individual and the family, their difficulties relate to the unavailability of materials. For dentists, whose actions more quoted were topical application of fluoride and supervised toothbrush, their greatest difficulty is the salary range. As to the Aux-N, ACD and ACS, for all of them the unavailability of materials has hindered the implementation of their activities in ESF

Oral health education in schools: promoting health agents

Purpose: The aim of this study was to verify the influence of preschool children participating in an oral health education programme on daily health practices of their families, through parent's perception. Methods: A sample of 119 parents of 5- to 6-year-old preschool children were selected. Data were collected using a structured open-closed questionnaire, self-administered. The questions focused on parents' knowledge about activities of oral health education conducted in school, the importance given by them to these activities, learning from their offspring and the presence of habit change at home. Results: In total, 63 (52.9%) parents agreed to participate. Ninety-eight per cent knew about educative and preventive activities developed at school and all of them affirmed that these activities were important, mainly because of knowledge, motivation and improvement in children's health. Ninety and half per cent of parents reported that they learned something about oral health from their children and, among these, almost half (47.8%) cited toothbrushing as the indicator for better learning. Besides this, 87.3% of participants revealed the change in oral health habits of their family members. Conclusion: Preschool children were able to transmit knowledge acquired at school to their parents that included change in oral health routine of their family members.

Experiences of family members regarding the oral health care of children

Este estudo objetivou verificar a compreensão das experiências dos familiares em relação ao cuidado com a saúde bucal das crianças. É estudo qualitativo, realizado em 2007, em distrito de saúde do município de Ribeirão Preto, SP, com 12 cuidadores. Utilizou-se referencial teórico da vulnerabilidade e a perspectiva hermenêutica. Três categorias empíricas foram elaboradas: os significados do cuidado com a saúde bucal, em busca das causas e da prevenção de agravos bucais e a realidade dos serviços de saúde bucal. Entre outros elementos potencializadores da vulnerabilidade infantil aos agravos bucais, emergiu a supervalorização da causalidade biológica, do atendimento de alta complexidade e da odontologia estética e, entre os protetores, a valorização do saber popular e a integração de ações e conhecimentos profissionais. Aponta-se para a revisão das estratégias de prevenção e promoção de saúde bucal, fornecendo elementos para auxiliar os serviços de saúde a reorganizarem o cuidado com a saúde bucal de crianças.

Caries and its association with infant feeding and oral health-related behaviours in 3-4-year-old Brazilian children

Objectives: To investigate the relationships between socio-demographic factors, infant feeding habits, oral hygiene and the prevalence and patterns of caries in Brazilian 3-4-year-olds. Methods: Systematic random sampling was used to select children enrolled in municipal nurseries in Araraquara, Brazil, in 1998. Clinical examinations were carried out by one examiner using dmft and dmfs indices and WHO criteria. Questionnaires for information related to the socio-demographic background, oral hygiene and dietary history of the children were completed by their mothers. Results: Caries was seen in 46% of the children; 17% of them had the more extensive pattern involving molars and incisors. Social class, mother's education, and age at which breast-feeding terminated showed statistically significant associations with caries. Feeding bottles with added sugars were still being given to 80% of the children. When the significant variables were taken into account only age at which breast-feeding terminated showed a significant relationship to the pattern of disease. Children who were never breast-fed or were breast-fed beyond the age of 24 months had a higher prevalence of the more extensive pattern of caries. Conclusions: The association between the length of time a mother breast-feeds and extensive caries should be a consideration in any local infant feeding policies or health promotion strategies. The duration for appropriate breast- or bottle-feeding should be emphasised.