Andréa Maria Silveira

Factors related to sickness absenteeism among nursing personnel

OBJECTIVE To analyze short-term leaves among the healthcare staff of a university hospital. METHODS Study population included 965 nursing professionals active on 1 January 2000. Leaves up to 30 days in one year were analyzed. Sickness leaves (one-year aggregate), service demand, and diagnoses were described. Relative risk was estimated through multivariate analysis, using negative binomial distribution. RESULTS About 65% of workers generated 1,988 appointments, of which 68.6% lead to absence from work. The greatest demand occurred among nursing technicians, women, and statutory workers (OR=1.61; 1.47; 1.53 respectively). Over half the studied population (57.6%) had at least one absence. This corresponds to 87.8% of workers who had physician appointments. These workers generated a total 1,364 leaves of absence--1.41 per worker--and 5,279 workdays were missed. Multivariate analysis was carried out considering each gender separately. An effect was found only for work regime (RR=1.45 e RR=2.43) for both men and women. CONCLUSIONS A relationship exists between absenteeism and work regime. It is necessary to include other variables, such as time working for the company, shift, and number of children.

Análise das aposentadorias por incapacidade permanente entre os trabalhadores da Universidade Federal de Minas Gerais no período de 1966 a 1999

OBJECTIVE: The aim of the present study was to conduct a retrospective analysis of all retirement cases from permanent disability (related or not to work) of the staff members at the Universidade Federal de Minas Gerais (UFMG), from 1966 to 1999. METHODS: a historical series analyses to observational study was done. The considered variables included age, gender, diagnosis, occupation, date of disability leave and data of retirement. Results: It was evidenced from the 355 analysed cases, large variability in the yearly distribution, with minimum variability between the years of 1978/91 and maximum in 1999. From the total retirement cases, 56% were male and 44% female, with a mean age of 51 years. The most frequent diagnoses were schizophrenia (14%), arterial hypertension (13%) and back problems (9%). In relation to occupation, the mean rate of retirement for the teaching group (group 1) was 1.33/1000 workers/year and 1.86/1000 workers/year for the technical and general service workers (group 2). CONCLUSIONS: The findings from the present study associated with the population morbidity data will allow the Servico de Atencao a Saude do Trabalhador (SAST/Pampulha/UFMG), to better promote health programs in the workplace.

Respiratory effects from industrial talc exposure among former mining workers

OBJETIVO: Evaluar efectos respiratorios tardios de la inhalacion ocupacional de talco contaminado por asbesto. METODOS: Analisis de serie de casos de 29 extrabajadores de mineria de talco contaminado con asbestos provenientes de Carandai, sureste de Brasil, atendidos en el Centro de Referencia Estatal de Salud del Trabajador de Minas Gerais en 2004-2005. Los extrabajadores fueron sometidos a anamnesis clinico-ocupacional, radiografia de torax y espirometria. Fue creado un escore de exposicion que multiplicado por la duracion, origino un indice de exposicion acumulativa al talco. Para testar la asociacion del indice de exposicion acumulativa con la presencia de alteraciones radiologicas, sugestivas de neumoconiosis e/o alteraciones pleurales, fue ajustado un modelo de regresion logistica exacta. RESULTADOS: Todos los extrabajadores eran hombres, con promedio de edad de 48,2 anos. En las radiografias de torax fueron encontradas alteraciones pleurales en tres de ellos, opacidades parenquimatosas compatibles con neumoconiosis en uno y sospecha en seis. Alteraciones espirometricas ocurrieron en tres. La regresion logistica indico odds ratio de 1,059 (IC 95%:1,012;1,125) para el indice acumulado, es decir, cada unidad en el indice resulta en un aumento de 5,9% en el chance de presentar alteracion radiologica compatible o con sospecha de neumoconiosis. Con relacion a la mediana del tiempo estimado de latencia entre el inicio de la exposicion y el diagnostico de las placas pleurales, ocurrio diferencia significativa (p=0,013) entre los casos (27,0 anos) y no casos (14,3 anos). CONCLUSIONES: Los resultados muestran la necesidad de control clinico en los trabajadores que fueron expuestos a asbesto, particularmente debido a los efectos tardios de la exposicion a este mineral.

O contraditório direito à saúde de pessoas em privação de liberdade: o caso de uma unidade prisional de Minas Gerais

This paper aims to analyze the realization of the right to health of people deprived of liberty, by means of focus groups conducted with three subjects involved in the prison context: imprisoned people, prison officers, and health professionals in a male prison in Ribeirao das Neves, Minas Gerais, Brazil. The discussions were recorded, transcribed, and underwent discourse analysis. The right to health, understood as full access to good-quality health services, is put into question as an actual phenomenon, since, considering that public services are scrapped, this access is restricted to those who can pay for it. State neglect with regard to the right to health of imprisoned people is justified by the disciplinary role played by prison. Poor working conditions and moral judgment on the prisoner’s behavior indicate a refusal to recognize the legitimacy of his right to health. Although the Brazilian laws claim that health is a right of all and a duty of the State, we find out the lack of realization of this right both for imprisoned people and for the professionals working in the prison.

Homens, vítimas e autores de violência: a corrosão do espaço público e a perda da condição humana

Trata-se de estudo qualitativo, realizado no Municipio de Ribeirao das Neves-MG, com o objetivo de compreender o envolvimento dos homens com a violencia. A metodologia consistiu de grupos focais organizados segundo sexo, faixa etaria e regiao administrativa do Municipio, sendo, ao todo, trinta grupos, com 231 participantes, recrutados aleatoriamente. Para analisar, foi utilizado o metodo hermeneutico-dialetico e, a luz da teoria politica de Hannah Arendt, a violencia foi interpretada como dominacao que perpassa as relacoes humanas. Homens e mulheres foram identificados como possiveis autores e vitimas de violencia, o envolvimento de cada um sendo definido a partir de relacoes desiguais que estabelecem. Os numeros da violencia, assim como as explicacoes centradas em teorias biologicas, podem levar a conclusao prematura de que os homens sejam mais violentos do que as mulheres. A fundamentacao teorica e a contextualizacao mais profundas permitem clarear outras faces desse importante problema.

O ensino das relações trabalho-saúde-doença na escola médica: percepção dos alunos e proposta de aperfeiçoamento na UFMG

Dos medicos, independentemente da especialidade que exercem, sao requeridas competencias para lidar com as relacoes trabalho-saude-doenca, o que nao tem sido adequadamente contemplado no curso de graduacao. Buscando aperfeicoar o ensino desse conteudo, encontra-se em desenvolvimento, desde 2003, na Faculdade de Medicina da UFMG, com o apoio de duas bolsistas do Programa de Iniciacao a Docencia da Pro-Reitoria de Graduacao, uma proposta de avaliar o programa da disciplina Saude do Trabalhador, com enfase nas estrategias pedagogicas utilizadas e nos instrumentos de avaliacao do desempenho dos alunos. O trabalho foi implementado em etapas, iniciando-se com o reconhecimento da historia e estrutura da disciplina; revisao da literatura, enfocando os conceitos e estrategias de avaliacao aplicadas ao ensino medico e identificacao de experiencias desenvolvidas em outros centros. A seguir, foram preparados questionarios, denominados pre e pos-teste, para conhecer a percepcao e experiencia previa dos alunos quanto aos conteudos e atividades da disciplina. Os questionarios sao aplicados sistematicamente no inicio e final do semestre letivo, desde julho de 2003. Os resultados desse trabalho tem possibilitado melhor adequacao dos conteudos e metodologias desenvolvidas, de particular importância no contexto da reorientacao curricular da formacao medica.

Inclusão da pessoa com deficiência no mercado de trabalho em Belo Horizonte, Brasil: cenário e perspectiva

Even after the publication of Law 8213 in 1991, which established quotas for employing disabled persons, their inclusion in the workplace still presents a challenge for Brazilian society. In order to understand the main barriers that hamper this process a qualitative research study was conducted in the municipality of Belo Horizon-te. This study included interviews with important actors involved in the process of inclusion; and focus groups including disabled persons and members of their families. The main barriers encountered were: preconceived ideas and discrimination; family relationships; the Continuous Cash Benefit (BPC) program; the low level of qualifi-cation among disabled person; lack of access; and the unpreparedness of companies. It was concluded that drafting laws is not sufficient to guarantee inclusion in the labor market and that governments should implement public policies to assist in this process.

Impacto do Programa Fica Vivo na redução dos homicídios em comunidade de Belo Horizonte

OBJECTIVE To evaluate the impact of a homicide prevention program. METHODS A quasi-experimental study was performed using time series analysis of homicide incidence in the Morro das Pedras area in the city of Belo Horizonte, Southeastern Brazil, from 2002 to 2006. The number of homicides occurring in this location was compared to other violent and non-violent favelas and to other neighborhoods of the city, during each of the Program phases. To test the hypothesis that homicide reduction was caused by the actions implemented by the program, a statistical model was developed based on generalized linear models. RESULTS In the first six months a 69% reduction in the number of homicides was obtained. During the other Program periods, the effect on the reduction of homicides lessened, but the difference among coefficients compared to the initial period was not statistically significant. Even with full Program implementation, the effect continued to be similar to the previous periods, probably because the program was implemented in other violent favelas in the city. CONCLUSIONS The results suggest that the Staying Alive Program model can be an important alternative for the prevention of youth homicides in communities that have characteristics similar to the pilot program in Morro das Pedras.OBJETIVO: Avaliar o impacto de programa de prevencao de homicidios. METODOS: Com base nos dados do Programa Fica Vivo, de prevencao de homicidios, foi realizado um estudo quase experimental com analise de series temporais da ocorrencia de homicidios no aglomerado Morro das Pedras, em Belo Horizonte, MG, de 2002 a 2006. Comparou-se o numero de homicidios ocorridos nessa localidade com os de outras favelas violentas e nao violentas e outros bairros da cidade, em cada uma das fases do Programa. Para testar a hipotese de que a reducao dos homicidios resultou das acoes implementadas pelo Programa, foi elaborado um modelo estatistico baseado em modelos lineares generalizados. RESULTADOS: Nos primeiros seis meses obteve-se 69% de reducao no numero medio de homicidios. Nos periodos de refluxo e retomada parcial do Programa, o efeito de reducao dos homicidios diminuiu, mas a diferenca entre coeficientes com aquele do periodo inicial nao foi estatisticamente significante. Mesmo com a retomada integral do Programa, o efeito continuou similar aos dos periodos anteriores, provavelmente porque o Programa foi implantado em outras favelas violentas da cidade. CONCLUSOES: Os resultados apontam que o modelo do Programa Fica Vivo pode constituir uma importante alternativa para prevencao de homicidios contra jovens em comunidades que apresentem caracteristicas semelhantes as da experiencia piloto no Morro das Pedras.

Impact of the Staying Alive Program on the reduction of homicides in a community in Belo Horizonte

OBJECTIVE To evaluate the impact of a homicide prevention program. METHODS A quasi-experimental study was performed using time series analysis of homicide incidence in the Morro das Pedras area in the city of Belo Horizonte, Southeastern Brazil, from 2002 to 2006. The number of homicides occurring in this location was compared to other violent and non-violent favelas and to other neighborhoods of the city, during each of the Program phases. To test the hypothesis that homicide reduction was caused by the actions implemented by the program, a statistical model was developed based on generalized linear models. RESULTS In the first six months a 69% reduction in the number of homicides was obtained. During the other Program periods, the effect on the reduction of homicides lessened, but the difference among coefficients compared to the initial period was not statistically significant. Even with full Program implementation, the effect continued to be similar to the previous periods, probably because the program was implemented in other violent favelas in the city. CONCLUSIONS The results suggest that the Staying Alive Program model can be an important alternative for the prevention of youth homicides in communities that have characteristics similar to the pilot program in Morro das Pedras.OBJETIVO: Avaliar o impacto de programa de prevencao de homicidios. METODOS: Com base nos dados do Programa Fica Vivo, de prevencao de homicidios, foi realizado um estudo quase experimental com analise de series temporais da ocorrencia de homicidios no aglomerado Morro das Pedras, em Belo Horizonte, MG, de 2002 a 2006. Comparou-se o numero de homicidios ocorridos nessa localidade com os de outras favelas violentas e nao violentas e outros bairros da cidade, em cada uma das fases do Programa. Para testar a hipotese de que a reducao dos homicidios resultou das acoes implementadas pelo Programa, foi elaborado um modelo estatistico baseado em modelos lineares generalizados. RESULTADOS: Nos primeiros seis meses obteve-se 69% de reducao no numero medio de homicidios. Nos periodos de refluxo e retomada parcial do Programa, o efeito de reducao dos homicidios diminuiu, mas a diferenca entre coeficientes com aquele do periodo inicial nao foi estatisticamente significante. Mesmo com a retomada integral do Programa, o efeito continuou similar aos dos periodos anteriores, provavelmente porque o Programa foi implantado em outras favelas violentas da cidade. CONCLUSOES: Os resultados apontam que o modelo do Programa Fica Vivo pode constituir uma importante alternativa para prevencao de homicidios contra jovens em comunidades que apresentem caracteristicas semelhantes as da experiencia piloto no Morro das Pedras.

Propriedades psicométricas da Vulnerability to Abuse Screening Scale para rastreio de abuso contra idosos

ABSTRACT OBJECTIVE Adapt and evaluate the psychometric properties of the Vulnerability to Abuse Screening Scale to identify risk of domestic violence against older adults in Brazil. METHODS The instrument was adapted and validated in a sample of 151 older adults from a geriatric reference center in the municipality of Belo Horizonte, State of Minas Gerais, in 2014. We collected sociodemographic, clinical, and abuse-related information, and verified reliability by reproducibility in a sample of 55 older people, who underwent re-testing of the instrument seven days after the first application. Descriptive and comparative analyses were performed for all variables, with a significance level of 5%. The construct validity was analyzed by the principal components method with a tetrachoric correlation matrix, the reliability of the scale by the weighted Kappa (Kp) statistic, and the internal consistency by the Kuder-Richardson estimator formula 20 (KR-20). RESULTS The average age of the participants was 72.1 years (DP = 6.96; 95%CI 70.94–73.17), with a maximum of 92 years, and they were predominantly female (76.2%; 95%CI 69.82–83.03). When analyzing the relationship between the scores of the Vulnerability to Abuse Screening Scale, categorized by presence (score > 3) or absence (score < 3) of vulnerability to abuse, with clinical and health conditions, we found statistically significant differences for self-perception of health (p = 0.002), depressive symptoms (p = 0.000), and presence of rheumatism (p = 0.003). There were no statistically significant differences between sexes. The Vulnerability to Abuse Screening Scale acceptably evaluated validity in the transcultural adaptation process, demonstrating dimensionality coherent with the original proposal (four factors). In the internal consistency analysis, the instrument presented good results (KR-20 = 0.69) and the reliability via reproducibility was considered excellent for the global scale (Kp = 0.92). CONCLUSIONS The Vulnerability to Abuse Screening Scale proved to be a valid instrument with good psychometric capacity for screening domestic abuse against older adults in Brazil.