Caracterización del ausentismo laboral de una IPS que presta servicios de consulta externa de medicina general, 2014

RESUMEN El ausentismo laboral genera un gran impacto económico en las empresas y a la sociedad en general. Es un problema difícil de manejar ya que es multifactorial, porque a pesar de que en su gran mayoría es generado por enfermedad general, al analizarlo se puede encontrar otros factores que conlleven a la ausencia del trabajador y con ello producir alteración al normal funcionamiento de la empresa, por lo que resulta indispensable estudiar este tema. Objetivo Caracterizar las principales causas de ausentismo laboral en los médicos generales de una IPS que presta servicios de consulta externa de medicina general a nivel nacional durante el año 2014. Materiales y Métodos: es un estudio de corte transversal sobre datos secundarios correspondientes al registro de incapacidades que presento la IPS durante el año 2014. Los criterios de inclusión fueron los médicos generales con los que contaba la IPS que presta servicios de salud a nivel nacional durante el año 2014 y los criterios de exclusión fueron las licencias de maternidad y paternidad. El tamaño de la muestra final fue de 202 médicos y el número de incapacidades que se presentó durante el año 2014 fue 313. Se realizó análisis de distribución de frecuencias, porcentaje y prevalencia de las incapacidades. Resultados: durante el año 2014 se presentaron 313 incapacidades, en una población de 202 médicos generales con prevalencia en las mujeres. El diagnóstico más frecuente de las incapacidades fue la categoría diagnostica “otros” en el cual se encuentra migraña, vértigo, alteraciones de la mama con 59 incapacidades, seguida por enfermedades gastrointestinales con 25 incapacidades. Conclusiones y recomendaciones: Las incapacidades fueron más frecuentes en mujeres que en hombres. El diagnóstico de las incapacidades más frecuente fue “enfermedad genérica o ausencia de diagnóstico”. La incapacidad más frecuente de un día que se presentaron 46 registros. El médico que mayor número de incapacidades presento fue de 18 para el año 2014. Se recomienda a la empresa tener un seguimiento de las incapacidades repetitivas, ya que estas podrían tener relación con enfermedad laboral que aún no ha sido calificada. Se recomienda complementar la base de datos con información como el antecedente de enfermedad crónica y el sedentarismo, lo que puede permitir realizar nuevos estudios respecto al riesgo cardiovascular de esta población.

Eficacia y seguridad de la melatonina para el manejo de los trastornos del sueño en el autismo: meta-análisis

INTRODUCCIÓN: El 80% de los niños y adolescentes con trastornos del espectro autista (TEA) presenta algún trastorno del sueño, en cuya génesis al parecer intervienen alteraciones en la regulación de la melatonina. El objetivo de este metaanálisis fue determinar la eficacia y seguridad de la melatonina para el manejo de ciertos trastornos del sueño en niños con TEA. MÉTODOS: Tres revisores extrajeron los datos relevantes de los ensayos clínicos aleatorizados doble ciego de alta calidad publicados en bases de datos primarias, de ensayos clínicos, de revisiones sistemáticas y de literatura gris; además se realizó búsqueda en bola de nieve. Se analizaron los datos con RevMan 5.3. Se realizó un análisis del inverso de la varianza por un modelo de efectos aleatorios para las diferencias de medias de los desenlaces propuestos: duración del tiempo total, latencia de sueño y número de despertares nocturnos. Se evaluó la heterogeneidad interestudios con el parámetro I2 RESULTADOS: La búsqueda inicial arrojó 355 resultados, de los cuales tres cumplieron los criterios de selección. La melatonina resultó ser un medicamento seguro y eficaz para aumentar la duración total del sueño y disminuir la latencia de sueño en niños y adolescentes con TEA; hasta el momento la evidencia sobre el número de despertares nocturnos no es estadísticamente significativa. DISCUSIÓN: A la luz de la evidencia disponible, la melatonina es una elección segura y eficaz para el manejo de ciertos problemas del sueño en niños y adolescentes con TEA. Es necesario realizar estudios con mayores tamaños muestrales y comparados con otros medicamentos disponibles en el mercado.

Entrevista a Roberto Fernández Retamar: la poesía, la Piadosa, me dio una razón para vivir (De la Escena Contemporánea. Entrevista)

El poeta y ensayista cubano confiesa que la poesía le dio una razón para vivir, y que sigue siendo su gran amor. Aunque difícil de definir, plantea que al ser humano le resulta imposible resistir sin ella: en toda crisis (la enfermedad, la muerte o la guerra), se recurre a la poesía. Las influencias literarias le llegaron de escritores alemanes, franceses y latinoamericanos (sobre todo, de Jorge Luis Borges, José Lezama Lima, Octavio Paz y Alfonso Reyes). El autor cubano destaca los méritos de varios poetas ecuatorianos y latinoamericanos. De Lezama Lima, quien “vivía para la poesía y el espíritu, con apenas unos pesitos”, resalta su sentido coral de la cultura (como construcción colectiva) y de la literatura. Respecto de la Revolución, aun reconociendo que hubo errores, está convencido de que es lo mejor que pudo pasarle a Cuba, no solo porque es la que buscó con insistencia, de Martí a Lezama, sino porque es la que triunfó y sigue adelante, pese al bloqueo económico de medio siglo por parte de la mayor potencia mundial, y de todas las dificultades.

Environmental quality and the productive workplace

A good working environment will help to provide the user with a good sense of wellbeing, inspiration and comfort. The main advantages of good environments is in terms of reduced upgrading investment, reduced sickness absence, an optimum level of productivity and improved overall satisfaction. Individuals respond very differently to their environments and research suggests a correlation between worker productivity and well-being, environmental, social and organisational factors. Research shows the occupants who report a high level of dissatisfaction about their job are usually the people who suffer more work and office environment related illnesses which affect their wellbeing, but not always so. Well-being expresses overall satisfaction. There is a connection between dissatisfied staff and low productivity; and a good sense of well-being is very important as it can lead to substantial productivity gain. If the environment is particularly bad people will be dissatisfied irrespective of job satisfaction. This paper describes research showing how environment affects productivity.

Health-related quality of life in Huntington's disease: a comparison of two generic instruments, SF-36 and SIP

Whereas several clinical endpoints in monitoring the response to treatment in patients with Huntington's disease (HD) have been explored, there has been a paucity of research in the quality of life in such patients. The aim of this study was to validate the use of two generic health-related quality of life instruments (the Short Form 36 health survey questionnaire [SF-36] and the Sickness Impact Profile [SIP]) and to evaluate their psychometric properties. We found that both instruments demonstrated acceptable convergent validity and reliability for patients and carers. However, there was an advantage in using the SF-36 because of its more robust construct validity and test-retest reliability; furthermore, motor symptoms appeared to influence some strictly nonmotor dimensions of the SIP. On a pragmatic level, the SF-36 is shorter and quicker to administer and, therefore, easier for patients at various stages of the disease to complete. Thus, the SF-36 would appear to be the recommended instrument of choice for patients with HD and their carers, although further work needs to be done to investigate the sensitivity of this instrument longitudinally. (C) 2004 Movement Disorder Society.

Maternal psychosocial adversity and the longitudinal development of infant sleep

Research has identified associations between indicators of social disadvantage and the presence of child sleep problems. We examined the longitudinal development of infant sleep in families experiencing high (n = 58) or low (n = 64) levels of psychosocial adversity, and the contributions of neonatal self-regulatory capacities and maternal settling strategies to this development. Assessments of infant sleep at 4-, 7-, and 12-weeks postpartum indicated no differences in sleeping difficulties between high- and low-adversity groups. However, more infant sleep difficulties were reported in the high- versus low-adversity groups at 12- and 18-month follow-ups. Neonatal self-regulatory capacities were not related to the presence or absence of adversity, or to subsequent infant sleep quality. However, there were group differences in maternal settling strategies that did predict subsequent infant sleep difficulties. The pattern of sleep disturbance observed in association with maternal psychosocial adversity at 18-months was consistent with risk for broader impairments in child functioning.

The cry of the owl: investigating decision-making in a contemporary feature film

This article extends the traditions of style-based criticism through an encounter with the insights that can be gained from engaging with filmmakers at work. By bringing into relationship two things normally thought of as separate: production history and disinterested critical analysis, the discussion aims to extend the subjects which criticism can appreciate as well as providing some insights on the creative process. Drawing on close analysis, on observations made during fieldwork and on access to earlier cuts of the film, this article looks at a range of interrelated decision-making anchored by the reading of a particular sequence. The article examines changes the film underwent in the different stages of production, and some of the inventions deployed to ensure key themes and ideas remained in play, as other elements changed. It draws conclusions which reveal perspectives on the filmmaking process, on collaboration, and on the creative response to material realities. The article reveals elements of the complexity of the process of the construction of image and soundtrack, and extends the range of filmmakers’ choices which are part of a critical dialogue. Has a relationship to ‘Sleeping with half open eyes: dreams and realities in The Cry of the Owl’, Movie: A Journal of Film Criticism, 1, (2010) which provides a broader interpretative context for the enquiry.

Terminal: a miracle play with popular music from the end of the world

Terminal: A Miracle Play with Popular Music from the End of the World is a film and live performance project exploring the politics of post-apocalyptic fiction. A theatrical staging of a morality play for end times and future folk music, it recasts eschatology, as a foundational myth for a future society. Post-apocalyptic writing and cinema are grounded in an ethos of survivalism. Invoking Rousseau’s state of nature, or time before government, these fictions propose violent scenarios in which nuclear holocaust, environmental catastrophe and other disasters generate an individualistic politics of pure pragmatism, negating the possibility of democratic deliberation. Terminal narrates this familiar scenario, but at the same time questions its validity. The film, shot on black and white VHS at Kurt Schwitters’ Merzbarn in Cumbria, dramatises a series of conversations between future-historical archetypes about the needs and pressures of the situation in which they find themselves at the end of the world. The performers then gather to play worshipful songs about acid rain, radiation sickness and eating the dog, using a mix of conventional, obscure and makeshift instruments In the tradition of books such as Russell Hoban’s Riddley Walker and Arthur M. Miller Jr.’s A Canticle for Liebowitz, Terminal imagines artistic expression and new folk traditions for a world to come after the apocalypse. If, as Slavoj Žižek would have it, it is easier to imagine the end of the world than to think of the end of capitalism, the project juxtaposes these two endpoints to test out how alternative scenarios might emerge from the collaborative practice of making theatre and music against a setting of social collapse.

The Sick Child in Early Modern England, 1580-1720

The Sick Child in Early Modern England is a powerful exploration of the treatment, perception, and experience of illness in childhood, from the late sixteenth to the early eighteenth centuries. At this time, the sickness or death of a child was a common occurrence - over a quarter of young people died before the age of fifteen - and yet this subject has received little scholarly attention. Hannah Newton takes three perspectives: first, she investigates medical understandings and treatments of children. She argues that a concept of 'children's physic' existed amongst doctors and laypeople: the young were thought to be physiologically distinct, and in need of special medicines. Secondly, she examines the family's' experience, demonstrating that parents devoted considerable time and effort to the care of their sick offspring, and experienced feelings of devastating grief upon their illnesses and deaths. Thirdly, she takes the strikingly original viewpoint of sick children themselves, offering rare and intimate insights into the emotional, spiritual, physical, and social dimensions of sickness, pain, and death. Newton asserts that children's experiences were characterised by profound ambivalence: whilst young patients were often tormented by feelings of guilt, fears of hell, and physical pain, sickness could also be emotionally and spiritually uplifting, and invited much attention and love from parents. Drawing on a wide array of printed and archival sources, The Sick Child is of vital interest to scholars working in the interconnected fields of the history of medicine, childhood, parenthood, bodies, emotion, pain, death, religion, and gender.

Not all adolescents are sleep deprived: A study of rural populations

The objective of this study was to investigate the role of environmental factors in sleep duration among adolescents living in rural areas. A total of 1140 students (569 males), aged 10-19 years, and attending two schools in rural regions in southern Brazil, completed a questionnaire about their sleep habits. Demographic data were also obtained. Prevalence ratios (PR) were estimated for the cases of more than 9 h of sleep on weekdays. Sleep duration in adolescents with and without electric lighting at home was analyzed. Average sleep duration at night was 9.63 (1.64) h on school-going days and 10.14 (2.42) h on weekends. The prevalence of adolescents sleeping for more than 9 h at night on school-going days was 58.3%. Older adolescents showed a tendency to delay their sleep onset times, which is associated with a reduction of sleep duration. Adolescents without electric lighting at home slept longer on school-going days (P < 0.001) and on weekends (P = 0.013) when compared to those with electric lighting at home. From multivariate analysis, age (P < 0.001), school schedule (P = 0.007) and work (0.042) were factors affecting sleep duration. In contrast to the data previously reported for urban populations, we found a high prevalence of adolescents sleeping for more than 9 h on school nights. Data on populations living in less industrialized regions reinforce the idea that technological advances are associated with the negative impact of sleep phase delay in adolescents.

Cellular and molecular characterization of an embryonic cell line (BME26) from the tick Rhipicephalus (Boophilus) microplus

The cellular and molecular characteristics of a cell line (BME26) derived from embryos of the cattle tick Rhipicephalus (Boophilus) microplus were studied. The cells contained glycogen inclusions, numerous mitochondria, and vesicles with heterogeneous electron densities dispersed throughout the cytoplasm. Vesicles contained lipids and sequestered palladium meso-porphyrin (Pd-mP) and rhodamine-hemoglobin, suggesting their involvement in the autophagic and endocytic pathways. The cells phagocytosed yeast and expressed genes encoding the antimicrobial peptides (microplusin and defensin). A cDNA library was made and 898 unique mRNA sequences were obtained. Among them, 556 sequences were not significantly similar to any sequence found in public databases. Annotation using Gene Ontology revealed transcripts related to several different functional classes. We identified transcripts involved in immune response such as ferritin, serine proteases, protease inhibitors,. antimicrobial peptides, heat shock protein, glutathione S-transferase, peroxidase, and NADPH oxidase. BME26 cells transfected with a plasmid carrying a red fluorescent protein reporter gene (DsRed2) transiently expressed DsRed2 for up to 5 weeks. We conclude that BME26 can be used to experimentally analyze diverse biological processes that occur in R. (B.) microplus such as the innate immune response to tick-borne pathogens. (C) 2008 Elsevier Ltd. All rights reserved.

Inhaled linalool-induced sedation in mice

Linalool is a monoterpene often found as a major component of essential oils obtained from aromatic plant species., many of which are used in traditional medical systems as hypno-sedatives. Psychopharmacological evaluations of linalool (i.p. and i.c.v.) revealed marked sedative and anticonvulsant central effects in various mouse models. Considering this profile and alleged effects of inhaled lavender essential oil, the purpose of this study was to examine the sedative effects of inhaled linalool in mice. Mice were placed in an inhalation chamber during 60 min, in an atmosphere saturated with 1% or 3% linalool. Immediately after inhalation, animals were evaluated regarding locomotion, barbiturate-induced sleeping time, body temperature: and motor coordination (rota-rod test). The 1% and 3% linalool increased (p < 0.01) pentobarbital sleeping time and reduced (p<0.01) body temperature. The 3% linalool decreased (p<0.01) locomotion. Motor coordination was not affected. Hence, linalool inhaled for I h seems to induce sedation without significant impairment in motor abilities, a side effect shared by most psycholeptic drugs. (C) 2008 Elsevier GmbH. All rights reserved.

Beteendestudier och miljöberikning av gnagare

It is often challenging to create a new enrichment program for any animal. This is especially true with the additional challenge that I wanted to use only naturalistic enrichment, and I’m working with animals some of which are nocturnal. Even with a many hurdles, a little bit of enrichment can do a big difference and make a big difference in activity levels of the animals. Eskilstuna parkens zoo have a house called the MUSeum housing four kinds of rodents. Rodents are generally much more active at night and spend much of the day sleeping out of sight of the public. One of the goals of starting an enrichment program was to increase the animal’s activity throughout the day to provide an improved guest experience. Many of the guests would stop briefly at the exhibit only seeing the empty exhibit, unaware of that there were animals there. Before starting an enrichment program, I wanted to determine how the rodent was spending their time. By observing the animals’ behaviour for 15 minutes a day at various times throughout the day, for a total of 15 observations, I was able to construct an activity budget for their behaviour. The results obtained were, as expected, that the rodents spent a lot of time resting. By enrichment both with food and the temperature we were able to take the activity to another level, and several new behaviours were observed.

Omläggning av skiftgång

The digital printing market is changing faster now than before and the ability to adjust to newsituations has become more importat to a printing company. An efficient internal communicationis essential. At Elanders Digitaltryck a decision was made in august 2002 to look over the shiftworking system for the printer operators. In this paper, an investigation of the possibilities tochange the existing system to a better one was made.The project resultet in four different timetabels. The construction was based on theoretical studiesand an analysis of the current situation at the workplace. The analysis showed that a strong resistanseagainst a change of the working hours exists among the workers and that this should beconsidered before a decision is made. An analasys of the printers counters shows that they areused more efficient during shorter shift periods compared to the longer ones. A closeer look at theabcense due to sickness shows that it is relatively high but no connection between abcense andworking hours could be made.Working hours is a sensitive issue and should be treated with care. It is important that the workersare well informed and preferly involved in the development of a new timetable.

Friskfaktorer på en enhet : Identifiera & fortsatt bevara

Detta är en kvalitativ studie med syftet att inom en enhet på Stockholms Stad identifiera friskfaktorer och undersöka vad som krävs för att fortsatt bevara dessa. Vidare är syftet att undersöka vilket stöd som är nödvändigt för bevarandet samt HR-funktionens roll i detta avseende. Enheten är, sett till sjukfrånvaro, en välmående grupp som står inför förändringar inom marknaden och målsättning då de påverkas av det nyligen genomförda regeringsskiftet. Ett frågeverktyg användes för att framställa de åtta viktigaste dimensionerna av det attraktiva arbetet och en fördjupad diskussion kring dessa fördes sedan under en fokusgruppsintervju tillsammans med enhetens medarbetare. Resultatet visade att de viktigaste dimensionerna var bland annat arbetstid och relationer. Vidare påvisades att en balans mellan arbetsliv och privatliv är av stor vikt för medarbetarnas hälsa och välmående. För att fortsatt bevara det attraktiva i arbetet visade empirin att gruppens relationer och ledaren var nyckelfaktorer och att HR-funktionen, den personalstrategiska avdelningen, enbart bidrar med en administrativ och vägledande roll i frågan om stöd. Arbetets slutsatser innefattar att bevarandet av friskfaktorer kräver att tillvaron måste vara begriplig, hanterlig och meningsfull men även att medarbetarna behöver rimliga krav i relation till deras handlingsutrymme. En vidare slutsats är behovet av en förändring i ledarskapsbeteendet i kommande stadier då gruppen eventuellt kommer att hamna i en ny mognadsfas på grund förändrade omständigheter. Författarna drar även slutsatsen att friskfaktorer är till viss del individuellt beroende på livssituation men att balansen mellan arbetsliv och privatliv är betydande för de flesta. HR-funktionen, den personalstrategiska avdelningen, har en informativ och administrativ roll i frågan om stöd och författarna anser att det ligger en logik i denna roll. Sett till organisationens storlek är det lättare att vända psykosociala frågor till företagshälsovård eller en psykologgrupp och få det arbetsrättsliga stödet eller information från HR-funktionen.