Morbidity among nursing personnel and its association with working conditions and work organization

Introduction: Work organization patterns and working conditions experienced by nursing personnel in the hospital settings may be associated to increased morbidity among these health workers. Aim: To estimate the prevalence and factors associated with self-reported diseases among nursing personnel at the emergency hospital in Rio Branco/ State of Acre, Brazil. Methods: A cross-sectional study was conducted involving 272 participants who answered a questionnaire including sociodemographic characteristics, working conditions, lifestyles, work ability, and a fatigue perception scale. The self-reported diseases in the 12 months prior to data collection were considered the dependent variable. Results: A total of 85.7% of the participants reported one or more diseases in the past 12 months. Most prevalent diseases were: musculoskeletal diseases (37.1%), digestive diseases (28.7%), mental disorders (28.3%), work injuries (27.9%), and respiratory diseases (26.8%). The following significant variables remained in the final model: high work demands (OR 2.69), reported fatigue (OR 3.59), night work (OR 6.55) and being a technician or nursing assistant (OR 4.23). Conclusions: Variables related to working conditions and work organization were associated with the occurrence of reported diseases among nursing professionals. Health promotion measures at work require a comprehensive approach including the working conditions and the work organization.

Study of postures in sugarcane cutters in the Pontal of Paranapanema-SP, Brazil

The expansion of sugarcane monoculture in Brazil in the last decades has pointed out to the necessity of considering the question of sugarcane cutters occupational health. In this work we present a cross-sectional study aiming to examine the occupational posture of a group of sugarcane cutters, which work in a cane field located in the region of Pontal do Paranapanema-SP, Brazil. The study was made using the Ergonomic Analysis of Work - EAW methodology and the postural analysis method by Win-OWAS. Through the obtained records of postures, it was observed that during a workday the sugarcane cutters remain standing erect on two legs or in one leg 66% of the time and that their trunk remain tilted and in rotation, according to 63% of the positions categorized. It was also observed that the sugarcane cutter trunk performs repetitive and boundless movements during his routine of work, which can expose this individual to additional wear of their musculoskeletal functions. The activities in which the individual engages have favorable or adverse influence on his posture. The repetitive movements involved in specialized occupations are equivalent to repeated exercises, thus may be responsible for the excessive development of certain muscle groups. The study suggests that the postures adopted by sugarcane cutters can overload their musculoskeletal system and predispose the cutters to work-related musculoskeletal diseases.

Do blood components affect the production of reactive oxygen species (ROS) by equine synovial cells in vitro?

Brossi P.M., Baccarin R.Y.A. & Massoco C.O. 2012 Do blood components affect the production of reactive oxygen species (ROS) by equine synovial cells in vitro? Pesquisa Veterinaria Brasileira 32(12):1355-1360. Departamento de Clinica Medica, Faculdade de Medicina Veterinaria e Zootecnia, Universidade de Sao Paulo, Av. Prof. Dr. Orlando Marques de Paiva 87, Butanta, Sao Paulo, SP 5508-210, Brazil. E-mail: baccarin@ usp.br Blood-derived products are commonly administered to horses and humans to treat many musculoskeletal diseases, due to their potential antioxidant and anti-inflammatory effects. Nevertheless, antioxidant effects have never been shown upon horse synovial fluid cells in vitro. If proved, this could give a new perspective to justify the clinical application of blood-derived products. The aim of the present study was to investigate the antioxidant effects of two blood-derived products - plasma (unconditioned blood product - UBP) and a commercial blood preparation (conditioned blood product - CBP)(4) - upon stimulated equine synovial fluid cells. Healthy tarsocrural joints (60) were tapped to obtain synovial fluid cells; these cells were pooled, processed, stimulated with lipopolysaccharide (LPS) or phorbol 12-myristate 13-acetate (PMA), and evaluated by flow cytometry for the production of reactive oxygen species (ROS). Upon addition of any blood-derived product here used - UBP and CBP - there was a significant decrease in the oxidative burst of synovial fluid cells (P<0.05). There was no difference between UBP and CBP effects. In conclusion, treatment of stimulated equine synovial cells with either UBP or CBP efficiently restored their redox equilibrium.

Dist��rbios osteomusculares relacionados ao trabalho em profissionais de enfermagem: revis��o integrativa da literatura

OBJETIVO: Avaliar as evid��ncias sobre o adoecimento de trabalhadores de enfermagem pelos Dist��rbios Osteomusculares Relacionados ao Trabalho (DORT). M��TODOS: Revis��o integrativa da literatura utilizando as bases: Biblioteca Virtual em Sa��de (BVS), BVS Enfermagem, Scopus e Banco de Teses da Universidade de S��o Paulo (USP) obtendo-se 17 estudos. RESULTADOS: Evidenciou-se que os DORT acometem os profissionais de enfermagem e relacionam-se ��s condi����es inadequadas dos ambientes de trabalho, �� organiza����o e estrutura do trabalho. CONCLUS��O: �� necess��rio investir em programas preventivos, capacita����es, educa����o em sa��de, estrat��gias de interven����o e organiza����o dos servi��os existentes.

Natural history study of arthrogryposis multiplex congenita, amyoplasia type

Arthrogryposis or Arthrogrypsosis Multiplex Congenita (AMC) are terms used to describe the clinical finding of multiple congenital contractures. There are more than 300 distinct disorders associated with arthrogryposis. Amyoplasia is the most common type of arthrogryposis and is often referred to as the ���classic��� type. There is no known cause of amyoplasia and no risk factors have been identified. Moreover, there is no established diagnostic criteria, which has led to inconsistency and confusion in the medical literature. The purpose of this study was to describe the natural history of amyoplasia, to determine if there are any identifiable risk factors and develop a list of diagnostic criteria. A retrospective chart review of 59 children with arthrogryposis ascertained at the Shriners Hospitals for Children in Houston, Texas was performed and included the following information: prenatal, birth, and family histories, and phenotypic descriptions. Forty-four children were identified with amyoplasia and 15 children with other multiple congenital contractures and other anomalies (MCC) were used as a comparison group. With the exception of abnormal amniotic fluid levels during pregnancy, there were no significant demographic or prenatal risk factors identified. However, we found common features that discriminate amyoplasia from other types of arthrogryposis and developed a diagnostic checklist. This checklist can be used as diagnostic criteria for discriminating amyoplasia from isolated and multiple contracture conditions.

Image-based biomechanical assessment of vertebral body and intervertebral disc in the human lumbar spine

Life expectancy continuously increases but our society faces age-related conditions. Among musculoskeletal diseases, osteoporosis associated with risk of vertebral fracture and degenerative intervertebral disc (IVD) are painful pathologies responsible for tremendous healthcare costs. Hence, reliable diagnostic tools are necessary to plan a treatment or follow up its efficacy. Yet, radiographic and MRI techniques, respectively clinical standards for evaluation of bone strength and IVD degeneration, are unspecific and not objective. Increasingly used in biomedical engineering, CT-based finite element (FE) models constitute the state-of-art for vertebral strength prediction. However, as non-invasive biomechanical evaluation and personalised FE models of the IVD are not available, rigid boundary conditions (BCs) are applied on the FE models to avoid uncertainties of disc degeneration that might bias the predictions. Moreover, considering the impact of low back pain, the biomechanical status of the IVD is needed as a criterion for early disc degeneration. Thus, the first FE study focuses on two rigid BCs applied on the vertebral bodies during compression test of cadaver vertebral bodies, vertebral sections and PMMA embedding. The second FE study highlights the large influence of the intervertebral disc���s compliance on the vertebral strength, damage distribution and its initiation. The third study introduces a new protocol for normalisation of the IVD stiffness in compression, torsion and bending using MRI-based data to account for its morphology. In the last study, a new criterion (Otsu threshold) for disc degeneration based on quantitative MRI data (axial T2 map) is proposed. The results show that vertebral strength and damage distribution computed with rigid BCs are identical. Yet, large discrepancies in strength and damage localisation were observed when the vertebral bodies were loaded via IVDs. The normalisation protocol attenuated the effect of geometry on the IVD stiffnesses without complete suppression. Finally, the Otsu threshold computed in the posterior part of annulus fibrosus was related to the disc biomechanics and meet objectivity and simplicity required for a clinical application. In conclusion, the stiffness normalisation protocol necessary for consistent IVD comparisons and the relation found between degeneration, mechanical response of the IVD and Otsu threshold lead the way for non-invasive evaluation biomechanical status of the IVD. As the FE prediction of vertebral strength is largely influenced by the IVD conditions, this data could also improve the future FE models of osteoporotic vertebra.

Computer-Assisted Orthopedic Surgery: Current State and Future Perspective

Introduced about two decades ago, computer-assisted orthopedic surgery (CAOS) has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined.

Preval��ncia de les��es musculo-esquel��ticas em profissionais de artes musicais

Enquadramento: As les��es m��sculo-esquel��ticas relacionadas com o trabalho apresentam-se atualmente como um crescente flagelo e a profiss��o de m��sico �� uma atividade predisponente para a ocorr��ncia dessas les��es, exigindo uma aten����o especial dos profissionais de sa��de para identificar e controlar os fatores de risco. Objetivos: O presente estudo pretende identificar a preval��ncia das perturba����es m��sculo-esquel��ticas nos m��sicos profissionais praticantes de Cordofones beliscados e analisar a sua rela����o com as vari��veis sociodemogr��ficas, estado de sa��de e caracter��sticas da pr��tica instrumental. M��todos: Trata-se de um estudo n��o experimental, transversal, descritivo-correlacional e de car��ter quantitativo, que envolveu 70 m��sicos portugueses praticantes de cordofones beliscados, residentes em Viseu, Porto e Lisboa, com idades compreendidas entre 18 e 55 anos. Foi realizado com recurso ao uso de um question��rio que avalia as vari��veis sociodemogr��ficas, as cl��nicas e as relacionadas com a pr��tica musical e para avalia����o das perturba����es musculoesquel��ticas utiliz��mos o ���Question��rio N��rdico M��sculo-Esquel��tico���. Resultados: Dos m��sicos estudados 70,0% referem sentir perturba����es m��sculo-esquel��ticas como dor/formigueiro/dorm��ncia nos ��ltimos 12 meses, tendo estes ocorrido sobretudo nos punhos/m��os (68.6%), ombros (54.3%), pesco��o e regi��o lombar (44.3%). Observ��mos que s��o v��rios os fatores risco das perturba����es musculoesquel��ticas como a idade avan��ada, um ��ndice de Massa Corporal mais elevado, o consumo de bebidas alco��licas, n��o praticar atividade f��sica, o excesso de espet��culos, a postura adotada, instrumentos mais pesados e tocar sem pausas. Conclus��es: O nosso estudo refor��a a ideia de que as perturba����es m��sculo-esquel��ticas est��o presentes nos m��sicos portugueses e que a sua origem est�� relacionada com caracter��sticas individuais, estado de sa��de e exig��ncias da pr��tica instrumental. Cabe ent��o ao Enfermeiro de Reabilita����o criar estrat��gias preventivas, para evitar que os fatores de risco acrescidos causem ou aumentem as j�� instaladas les��es m��sculo-esquel��ticas nos m��sicos, promovendo uma carreira longa e saud��vel. Palavras-chave: M��sicos; Les��es musculoesquel��ticas; Fatores de risco; Enfermagem de Reabilita����o.

Condi����es de trabalho e sa��de ps��quica de servidores t��cnico-administrativos da UFRN

Unfavorable working conditions constitute one of the factors that may contribute to cause psychic suffering and behavioral disorders in workers. This research aimed to characterize the working conditions public servant technical- administrative , specifically the auxiliaries and assistants in administration of the Federal University of Rio Grande do Norte ��� UFRN, Natal, Brasil, as well to identify the incidence of psychic suffering in this group of public servants. As a strategy, we chose a case study of multi-method type, descriptive with quantitative and qualitative sequential steps. For this, it initially performed desk research by surveying epidemiological data for these public servants working in central campus, to identify the major diseases presented in the period from January 2011 to June 2014. Then, we proceeded to diagnostic step of the aspects related to work, by applying online and in loco of Working Conditions Survey (already validated by Borges et al., 2013a) in 11 sectors selected according to the following criteria: high number of workers public servants and major and minor percentage of absences for health care for ICD-F (according to records of Sector of Workers Health Care - DAS). In the treatment of the data the spreadsheet editor software Microsoft Office Excel and statistical SPSS Statistical Package for Social Sciences were used and made qualifying type of content analysis of open questions. Applied to this study 174 public servants and the results show a predominance of absenteeism due to mental or behavioral disorders (ICD F), musculoskeletal diseases (ICD M) and respiratory system (ICD J). Among the factors that were significant are the working hours (contractual and legal); Physical Effort (M = 2.59) and workspace (M = 2.58) - physical and material conditions; encouraging collaboration (M = 3.5) - processes and characteristics of the work; and participation (M = 1.78) - social-management environment. Therefore, it infers the existence of a relationship between these factors and some of the reasons for absenteeism reported by participants. It is suggested the expansion of this research with studies involving other professionals (including scholarship workers and contractors) and specific sectors.

Magnitude da morbidade relacionada ao trabalho no Rio Grande do Norte

Diseases and disorders related to work sets up an important public health problem in Brazil and worldwide. However, the reality of these diseases still constitutes a gap with regard to its characterization and epidemiological situation, especially in Brazil. In this context, this study aims to analyze the magnitude of morbidity related to work from the injuries and illnesses reported by Health the Diseases Notifiable of Health of the State Public River Health Department worker Reference Center Information System services Grande do Norte from 2007 to 2014. It is ecological study, quantitative cross-sectional study in which the analysis unit of the municipalities of Rio Grande do Norte. Data were collected from the state base of Diseases Notifiable Information System Centre of the Secretariat of State Workers' Health Reference Public Health of Rio Grande do Norte, between March and June 2015, after the approval of the Committee of Ethics in Research of the Federal University of Rio Grande do Norte, Opinion 014/2014. The population was represented by the universe of cases of diseases and disorders related to work that were reported and shut down the system from 2007 to 2014. Data were analyzed using descriptive and inferential statistics, presented in tables, graphs, charts and figures. For this, we used the Microsoft Excel 2007 and SPSS version 20.0. To check the significance level we opted for the application of the chi-square or Fisher tests. We adopted the significance level of p <0.05. Of the 10,161 cases of diseases related to the reported work, the biological work accidents had the highest percentage (52.84%) followed by serious occupational accidents (37.49%). For diseases, the highlights were musculoskeletal (4.82%), mental disorders (2.19%) and exogenous intoxication (1.97%). Among men, there was a predominance of major accidents (91.80%), mental disorders (70.00%) and exogenous poisoning (52.84%). Women were most affected by biological accidents (77.50%) and musculoskeletal diseases (64.10%). Among workers who have suffered injuries predominated mulatto (%), mean age of 35.86 years, low education (%) and workers in the formal sector (%). Among the accidents, biological (n = 5,369) accounted for 52.84% of cases occurred predominantly among nursing professionals (48.31%). The percutaneous exposure was the most frequent (73.05%) and the occurrence of circumstances was improper disposal of sharps (45.28%), the needle the most common agent (66.62%) and the organic material was blood (72.99%). Most injured workers were vaccinated against hepatitis B (68.13%), but no information as to the assessment of the vaccine response. In the course of the disease predominated ignored the situation with loss of monitoring of clinical follow-up (55.62%). There was also an increase in the notification of serious industrial accidents predominantly male (91.80%) workers aged 25-44 years (54.3%) and typical accidents (76.3%). The temporary disability was the most common outcome (55.53%) and hand the most affected part (33.00%); the mining and construction industry had the highest number of cases (25.1%) in registered employee (34.2%). The findings of this study show a positive result in relation to increased mandatory reporting of injuries and illnesses related to work together to health services that meet victimized workers, towards the occurrence of knowledge of these accidents for decision making in public plans and policies of health. However, the information system still needs improvement in both the coverage and the quality of the data to demonstrate with greater reliability the magnitude of events to support the planning of workers' health into shares in the state.

Determinantes das perturba����es musculoesquel��ticas nos trabalhadores de cuidados pessoais em resid��ncias de apoio ao idoso

Introdu����o: O enfermeiro especialista em reabilita����o �� o profissional com compet��ncias e conhecimentos para, ap��s o diagn��stico, implementar e monitorizar os resultados dos programas de redu����o do risco das perturba����es musculosquel��ticas relacionadas com o trabalho (PME), junto dos trabalhadores de cuidados pessoais em resid��ncias de apoio ao idoso, avaliando e introduzindo no processo de presta����o de cuidados os necess��rios ajustamentos, promovendo assim, pr��ticas mais seguras e eficazes. Assim, o presente estudo centrou-se em identificar os determinantes das PME nestes trabalhadores e suas repercuss��es na sa��de. M��todos: Estudo de natureza quantitativa, de tipologia transversal e descritivocorrelacional, com recurso a uma amostra n��o probabil��stica por conveni��ncia, constitu��da por 120 indiv��duos, na sua maioria do g��nero feminino (95,8%) e com uma m��dia de idades de 43,21 anos (Dp=10,812 anos). Como instrumento de colheita de dados utilizou-se o inqu��rito de sa��de e trabalho (INSAT), aferido para este dom��nio de investiga����o. Resultados: Estes cuidadores formais manifestam d��fices de sa��de com principal relev��ncia para os relacionados com a mobilidade f��sica e dor, quer pela exist��ncia de constrangimentos de natureza f��sica e biomec��nica, organizacional e psicossocial, bem como de natureza individual. Os problemas de sa��de identificados por estes trabalhadores, resultantes das condi����es e caracter��sticas do trabalho foram: dores de costas (90,8%), dores musculares e articulares (82,5%), varizes (64,2%), dores de cabe��a (49,2%) e ansiedade ou irritabilidade (47,5%). Ser do g��nero feminino, ter idade entre os 49-58 anos, ser vi��vo ou divorciado, ter doen��as cr��nicas, tomar medica����o e efetuar hor��rio diurno, revelaram-se como determinantes percursores das PME assim como, a n��vel laboral, as caracter��sticas e os constrangimentos organizacionais e relacionais relacionados com o esfor��o f��sico, a intensidade e tempo de trabalho, as exig��ncias emocionais, a insufici��ncia de autonomia e a m�� qualidade das rela����es sociais. Conclus��o: Estes resultados apontam para a necessidade de desenvolvimento de estrat��gias preventivas das PME neste grupo profissional, onde �� fundamental a interven����o do enfermeiro de reabilita����o na implementa����o de programas de promo����o da sa��de, gest��o do stresse e riscos psicossociais e forma����o profissional. Palavras-chave: Doen��as musculosquel��ticas; Enfermagem de Reabilita����o; Sa��de Ocupacional.

Prevalencia de morbilidad osteomuscular en una empresa de servicios de seguridad electr��nica en Bogot��, 2013

Introducci��n: actualmente los trastornos m��sculo esquel��ticos (TME) han sido reconocidos como la principal causa de morbilidad en el trabajo, dado el porcentaje de ausentismo laboral que representa, generando reducci��n en la productividad de las industrias. Una visi��n general de la prevalencia en TME puede conducir a m��todos de prevenci��n de morbilidad adecuados para cada tipo de proceso, y as�� proporcionar un ambiente m��s seguro y confortable. Objetivo: determinar la prevalencia de s��ntomas osteomusculares y su relaci��n con factores individuales y laborales en personal de una empresa dedicada a prestar servicio de seguridad electr��nica en Bogot��, en el 2013. M��todos: estudio de corte transversal, desarrollado a partir de fuentes de datos secundarios de una poblaci��n de 199 trabajadores, con informaci��n sociodemogr��fica y s��ntomas osteomusculares en los distintos roles laborales (administrativo, soporte y de campo) de una empresa de servicios en seguridad electr��nica. Se usaron m��todos estad��sticos para el c��lculo de proporciones, se estimaron las prevalencias osteomusculares globales, realizando comparaciones por rol laboral. La revisi��n de la asociaci��n entre factores sociodemogr��ficos y laborales con s��ntomas de TME se hizo a trav��s de la prueba Chi2 de asociaci��n o prueba exacta de Fisher. Resultados: Los segmentos que mostraron la mayor frecuencia en morbilidad de TME fueron espalda, cuello, mu��ecas y manos. Se encontr�� asociaci��n entre dolor de hombros y brazos con la edad, OR=0,54 (IC95%=0,30-0,95) y tiempo en el cargo, OR=1,855(IC 95%=1,043-3,297); entre dolor de cuello y edad OR=0,50 (IC95%=0,27-0,90) y entre dolor de mu��ecas y/o manos con tiempo en el cargo, OR=1,827(IC 95%=1,032-3,235). Conclusi��n: Se presenta morbilidad por TME en varios segmentos, derivados de factores (individuales y laborales), ratificando la importancia de hacer intervenciones integrales de control de riesgos para su prevenci��n.

Musculoskeletal Conditions Briefing

Musculoskeletal conditions (MSCs) are a group of diseases that affect the body&rsquo;s bones, joints, muscles and the tissues that connect them. Common MSCs include back pain, rheumatoid arthritis, osteoarthritis, osteoporosis, and spinal disorders. MSCs are the most common cause of severe long term pain and physical disability in developed countries. They significantly affect the psychosocial wellbeing of individuals as well as their families and carers. They are responsible for substantial costs to the health and social care system and the economy. They are a leading cause of absence from work and lost productivity at work. MSCs comprise a diverse group of conditions. Some have a specific medical diagnosis (eg rheumatoid arthritis) but others have no clear medical diagnosis (eg back pain). Risk factors for the development and progression of MSCs include age, sex, family history, obesity, physical inactivity, injury and biomechanical occupational health issues.

Musculoskeletal Conditions Briefing: Technical Documentation

Musculoskeletal conditions (MSCs) are a group of diseases that affect the body&rsquo;s bones, joints, muscles and the tissues that connect them. Common MSCs include back pain, rheumatoid arthritis, osteoarthritis, osteoporosis, and spinal disorders. MSCs are the most common cause of severe long term pain and physical disability in developed countries. They significantly affect the psychosocial wellbeing of individuals as well as their families and carers. They are responsible for substantial costs to the health and social care system and the economy. They are a leading cause of absence from work and lost productivity at work. MSCs comprise a diverse group of conditions. Some have a specific medical diagnosis (eg rheumatoid arthritis) but others have no clear medical diagnosis (eg back pain). Risk factors for the development and progression of MSCs include age, sex, family history, obesity, physical inactivity, injury and biomechanical occupational health issues. This document details the methods used to calculate the estimates and forecasts.