Professional Category Research Articles

Factors influencing the health-related quality of life among persons with lower limb amputation wearing a prosthesis

IntroductionLimb amputation is often an unavoidable process in many diseases and accidents, leading to several limitations in social, professional, and recreational activities.ObjectivesTo explore the perceptions of persons with lower limb amputation (PLLA) wearing a prosthesis regarding the health-related quality of life (HRQoL), and to examine the relationships between HRQoL, body image disturbance, and self-esteem.MethodsThe research sample consisted of 91 PLLA who were using a prosthesis. The data were collected through a questionnaire comprised of demographic information and the following scales: The Short Form Health Survey-12 (SF-12), the Amputee Body Image Scale (ABIS-R), and the Rosenberg scale (RSES), in order to assess HRQoL, body image disturbance, and self-esteem respectively. The SPSS statistical software (v.26) was used for the statistical analysis of the data.Results The mean SF-12 score of the participants was 70.31 (SD=16.74). The HRQoL was affected by the following sociodemographic factors: age, educational level, profession, income, marital status, and parenthood. It was also influenced by disability-related factors, such as amputation cause and years of prosthesis use. In particular, young participants reported a better level of HRQoL than the older participants (p<0.001). Participants with a higher education level presented better HRQoL than those with lower education level (p<0.001). Unemployed participants and students presented better HRQoL scores compared to all other professional categories (p=0.001). However, participants with lower incomes <10,000 € reported a lower level of HRQoL (p=0.028). Singles had the highest HRQoL score, while widowers had the lowest (p=0.001). Childfree participants experienced the highest level of HRQoL (p=0.001). Participants whose amputation resulted from an accident reported a better HRQoL compared to those who had an amputation due to Type 2 diabetes (p<0.001). As the years of prosthesis use increase, HRQoL decreases (p=0.001). Regarding the associations between HRQoL, body image disturbance, and self-esteem statistically significant relationships were recorded. More specifically, there is a significant positive relationship between RSES and SF-12 (p<0.001); as participants’ self-esteem increases, so does their HRQoL. Conversely, a statistically significant negative correlation emerged between SF-12 and ABIS-R (p<0.001); as HRQoL increases, body image disturbance decreases.ConclusionsThe aforementioned factors should be considered in the design and implementation of psychosocial interventions aimed at recovery. Qualitative studies are recommended to explore the lived experiences of PLLA in-depth.Disclosure of InterestNone Declared

A post-COVID-19 assessment of resilience of nurses and paramedical workers in municipal hospitals of urban Pune, India.

To assess the resilience of primary healthcare workers (HCWs) by determining the factors associated with developing resilience post-coronavirus disease 2019 (COVID-19). A cross-sectional study in selected municipal hospitals. Connor-Davidson Resilience Scale was used to assess the resilience of the 245 HCWs, including the nurses and paramedics working in Pune Municipal Corporation (PMC) hospitals in Pune City. Data were analysed using the Chi-square test, one-way analysis of variance (ANOVA), independent-samples t-test and correlational analysis using the Statistical Package for the Social Sciences (SPSS) version 28. The mean resilience score of the HCWs in PMC hospitals post-COVID-19 was 75.09 (±9.25). The score for hardiness, optimism, resourcefulness and purpose was 20.15 (±3.87), 21.22 (±3.39), 17.24 (±2.76) and 16.40 (±2.17), respectively. Seven factors were significantly associated with the resilience of nurses and paramedics, namely age (P < 0.001), work experience (P < 0.001), monthly income (P < 0.001), having faced financial problems during COVID-19 (P < 0.001), hospital setting (P < 0.05), marital status (P < 0.01) and professional category (P < 0.001). In addition, 60% of the participants reported mental health issues due to routine workloads such as irritation/anger, frustration and tension/worry, fatigue and work-related stress, and sadness and anxiety. Suggestions for improvement were mainly increasing human resources, proper management, skilled staff, improved facilities and funding, and cooperation among staff. The resilience of primary HCWs in Pune post-COVID-19 was higher than HCWs in other countries assessed during COVID-19. Further, resilience was found more among nurses than paramedics. Modifiable factors affecting resilience must be addressed to improve the resilience of HCWs to build everyday resilience and strengthen health systems for public health emergencies.

Barriers to medication error reporting in a federally qualified health center

ObjectiveTo explore the National Coordinating Council for Medication Error Reporting and Prevention Categories of Errors health professionals are most likely to report and characterize what barriers to medication error reporting influence decisions to report and the extent they do so at a large federally qualified health center (FQHC). DesignProspective, cross-sectional, survey. Setting and participantsA total of 161 medical professionals at a large FQHC clinic with a small pharmacy team. Outcome measuresSurvey responses to explore respondent understanding of medication error categories and the influence of barriers to medication error reporting on their decision to report. ResultsThirty-six (22.4%) respondents completed the survey. Nearly 40% of respondents would not report a near-miss error and were influenced by workplace/environmental barriers significantly more than those who would report. Regardless of reporting experience or patient-care role, assessed barrier categories influence the decision to report similarly. ConclusionNear-miss medication errors are inconsistently reported. Efforts to improve reporting should emphasize addressing workplace/environmental barriers.

An automated flowchart for the Modified Rankin Scale assessment: A multicenter inter-rater agreement analysis.

The Modified Rankin Scale (mRS) is a widely adopted scale for assessing stroke recovery. Despite limitations, the mRS has been adopted as primary outcome in most recent clinical acute stroke trials. Designed to be used by multidisciplinary clinical staff, the congruency of this scale is not consistent, which may lead to mistakes in clinical or research application. We aimed to develop and validate an interactive and automated digital tool for assessing the mRS-the iRankin. A panel of five board-certified and mRS-trained vascular neurologists developed an automated flowchart based on current mRS literature. Two international experts were consulted on content and provided feedback on the prototype platform. The platform contained five vignettes and five real video cases, representing mRS grades 0-5. For validation, we invited neurological staff from six comprehensive stroke centers to complete an online assessment. Participants were randomized into two equal groups usual practice versus iRankin. The participants were randomly allocated in pairs for the congruency analysis. Weighted kappa (kw) and proportions were used to describe agreement. A total of 59 professionals completed the assessment. The kw was dramatically improved among nurses, 0.76 (95% confidence interval (CI) = 0.55-0.97) × 0.30 (0.07-0.67), and among vascular neurologists, 0.87 (0.72-1) × 0.82 (0.66-0.98). In the accuracy analysis, after the standard mRS values for the vignettes and videos were determined by a panel of experts, and considering each correct answer as equivalent to 1 point on a scale of 0-15, it revealed a higher mean of 10.6 (±2.2) in the iRankin group and 8.2 (±2.3) points in the control group (p = 0.02). In an adjusted analysis, the iRankin adoption was independently associated with the score of congruencies between reported and standard scores (beta coefficient = 2.22, 95% CI = 0.64-3.81, p = 0.007). The iRankin adoption led to a substantial or near-perfect agreement in all analyzed professional categories. More trials are needed to generalize our findings. Our user-friendly and free platform is available at https://www.irankinscale.com/.

PROFESSIONAL GRAPHIC JUSTIFICATION OF TEST PROGRAMS FOR PROFESSIONALLY SIGNIFICANT QUALITIES ASSESSMENT OF FUTURE SPECIALISTS (ON THE EXAMPLE OF KH. DOSMUKHAMEDOV ATYRAU UNIVERSITY)

Professional education and development involve not only learning extensive theoretical knowledge but also applying it through practical skills, especially those involving motor abilities that are crucial to the profession. The current vocational education system integrates professional diagnostics most effectively when it incorporates methods from professionally oriented physical culture. This approach is key to developing the physical competence and readiness required for specialists to excel in their fields. This study aims to establish comprehensive testing programs to evaluate the conditioning qualities that are important for the professional development of students as they train to become specialists. The methodology used for this study involves a professional analysis of the university's specialty training programs. This includes categorizing professions into standard groups based on the core subject matter and defining broad professional categories with common features. A detailed professional structure was outlined for each faculty, and specialties were categorized by profession type: “H-H”; “H-S”; “H-T”; “H-N”; “H-AR”. On the basis of analysis of special features and conditions of learned types professional activity were created their generalized profiles (professiograms) with highlighting a block of professionally important qualities, properties and functions. Subsequently, for each typical group of professions were selected motor test tasks to assess the level of professionally important formation for these quality professions.

Assessing the individual effects of different job satisfaction facets on the job performance of qualified employees in the unique conditions of the construction industry

Job performance is crucial to success in the labor-intensive and competitive construction industry. Unlike previous studies, this research focused not only on the overall job satisfaction and job performance relationship but also provided enhanced insights into the relationship between employee satisfaction levels with different aspects of their jobs and the individual impacts of each of these on the employee’s overall job performance in a comprehensive manner by presenting the survey findings of 394 skilled laborers, engineers/architects, and managerial staff in the Turkish and North Cyprus construction markets. A further contribution of the current study is differentiating among various categories of construction professionals for potential approach variations in the analysis of the defined relationship. Both job satisfaction and job performance vary considerably based on different employee categories. The lowest job satisfaction and job performance were recorded by skilled laborers, while the greatest ones were recorded by engineers/architects, and there was a strong positive correlation between job satisfaction and performance across all respondent categories. Regression analysis findings revealed “workload conditions” as the only strong predictor of job performance existing in all three categories, indicating a need to reconsider the heavy workload tradition available in the construction industry. The distinct difference between the job satisfaction facets that predicted job performance in various employee categories was a noteworthy finding. This suggests that organizations may benefit from categorizing their employee groups, concentrating on each group’s distinct approach, and developing tailored strategies in response. Strikingly, numerous strong predictors of job performance identified in this research may be improved without significant investment, giving the organizations a competitive edge. This study provides a guide for construction organizations in identifying the key job satisfaction facets to prioritize while implementing tailored strategies to improve the job performance of three types of crucial construction professionals.

How Sharp Objects Injuries Impact our Healthcare Workers: Unveiling Perspective and Preventive Imperatives.

Introduction Sharp object injuries in the medical field present a considerable occupational hazard for healthcare workers (HCWs), encompassing a spectrum of consequences from immediate discomfort to enduring health consequences. These injuries may expose HCWs to potential infections. Despite efforts to control sharp object injuries in healthcare environments, they are present at every stage involving using or disposing of medical sharp instruments. In Jordan, limited research has focused on sharp object injuries, with most data included from studies concentrating on practicing nurses or nursing students. Consequently, further research is necessary to comprehend the causes behind the high sharp object injury rate and the insufficient knowledge of safety practices and preventive guidelines. Objectives This study was conducted to investigate the impact of sharp object injuries on HCWs, underlying causes,and potential consequences causes of needlestick injuries. To highlight perspective and preventive imperatives. Methods and patients This retrospective institutional-based cross-sectional chart analysis was conducted by reviewing all sharp object injuries report sheets and extracting data directly from these reports for analysis. The study encompassed all reported cases occurring between 2018 and 2023. All the participants' data handling was accomplished according to the Declaration of Helsinki (2013) and the Health Insurance Portability and Accountability (HIPAA) Acts. Results A total of 146 self-reported hospital workers were included in the study. Within the final cohort, 52.73% of the participants were male (77/146), with an average age at diagnosis of 38.6±7.87 years (ranging from 20 to 52 years). Conversely, females comprised 47.27% of the cohort population (69/146) and had an average age at diagnosis of 34.73±6.73 years (ranging from 19 to 47 years). The age group 20-29 years was the most prominent age group, statistical analysis of age and gender data revealed significant differences. The overall prevalence of sharp object injuries was 11.83%, indicating that a sizable portion of HCWs is at risk of exposure to bloodborne pathogens. Among the different professional categories, Physicians constituted the majority of sharp object injuries reported victims in 41 cases (28.08%), followed by nurses in 38 cases (26.02%).Statistical analysis of the profession's data revealed significant differences (P<0.001). Notably, sharp object injuries were most reported in wards. The leading procedures that caused sharp object injuries were identified as during needle recapping in 53 instances (36.30%), then followed by medical waste treatment in 32 cases (21.92%). The left hand was the most affected body part, reported in 83 cases (56.84%).All injured individuals reported the incident promptly. No seroconversions were documented within the reviewed cases during the study period. Conclusion Injuries caused by sharp objects persist as a significant danger for hospital employees, posing immediate harm and long-term health risks linked to bloodborne pathogens. The findings stress the continuous responsibility of healthcare institutions to prioritize staff safety by addressing the root causes of sharp object injuries and fostering reporting and prevention cultures. Underreporting reasons are diverse, encompassing factors like time constraints, fear of consequences, and the misconception of injury insignificance.

The impact of the COVID-19 pandemic on nursing home professionals: results of the RESICOVID project

ObjectivesThe situation caused by the COVID-19 pandemic has had an impact on the mental, physical, and social health of nursing home staff. The operations and protocols of long-term care facilities had to be adapted to a new, unforeseen, and unknown situation in which a devastating and highly contagious disease was causing large numbers of deaths. The aim of this study was to determine the cumulative impact of the COVID-19 pandemic on care, technical, coordinating-supervisory, and managerial staff working in nursing homes.MethodsCorrelation analysis and between-group comparisons were carried out to study the relationship between burnout scores, emotional balance, and organic and behavioral symptoms.ResultsThe results indicate high levels of burnout and psychological exhaustion. Management professionals displayed higher levels of organic and behavioral symptoms than other professional categories in the same care settings. Despite this negative symptomatology, most professionals showed a positive emotional balance.ConclusionThe need to develop intervention programs to improve the mental, physical, and occupational health of the staff in nursing homes, considering the needs of different professional categories, is emphasized.

Organizational stress and resilience. The role of external resources

Theoretical background. Military gendarmes represent a professional category frequently exposed to organizational and operational stress factors. In the face of potential stressful situations, threats, adversity or change, resilience is essential. As a protective factor against the negative effects of stressors, resilience ensures the military gendarmerie's ability to remain task-focused, productive and connected to the organization's missions. Public safety workers' perceptions of organizational structure and climate can directly affect resilience (Hart &amp; Cooper, 2001). It has been shown that transformational leadership can increase military resilience (Jayasingam et al., 2019) by positively reinterpreting stressful experiences as opportunities for personal growth and development (Bartone, 2012). Also, studies demonstrate the effectiveness of psychological training activities in the sense of increasing resilience (Arnetz et al., 2013). Methodology. The study was conducted on a number of 214 military personnel, who completed self-report questionnaires regarding organizational stress, resilience, the management style of the leader of the organization they belong to, and the perception of the effectiveness of the psychological training activity. Also, the mediating role of external resources, management style and the perception of the psychological training activity, in the relationship between organizational stress and the resilience of military gendarmes, was analyzed. Results. Organizational stress has a significant negative effect on resilience. Transformational management style, transactional management style and perceived effectiveness of psychological training activity are partial mediators of the relationship between organizational stress and resilience of military gendarmes. The results are of particular practical importance to commanders and mental health professionals working in military organizations.

Current knowledge of human Mpox viral infection among healthcare workers in Cameroon calls for capacity-strengthening for pandemic preparedness.

An increased incidence of human Monkeypox (Mpox) cases was recently observed worldwide, including in Cameroon. To ensure efficient preparedness and interventions in the health system, we sought to assess the knowledge of Mpox's transmission, prevention, and response among healthcare workers (HCWs) in Cameroon. A cross-sectional online survey was conducted among HCWs in Cameroon using 21-item questions adapted from the United States Centers for Disease Control and Prevention (US-CDC) standard questionnaire on Mpox. The overall knowledge of Mpox was assessed by cumulative score and categorized as excellent (≥80%, 17/21) or good (≥70%, ≥15/21) knowledge. The regression analysis was used to identify the predictors of Mpox knowledge. The survey enrolled 377 participants, but only responses from 342 participants were analyzed. Overall, 50.6% were female participants, and 59.6% aged 30 years or younger. The majority of the participants were medical doctors (50.3%); most worked in central-level hospitals (25.1%) and had 1-5 years of experience (70.7%). A total of up to 92.7% were aware of Mpox, with social media (58.7%) and radio/television (49.2%) as the main sources. The mean knowledge score was 14.0 ± 3.0 (4 to 20), with only 12.9% having excellent knowledge (≥80%) and 42.1% having good knowledge of Mpox. Younger age (26-30 years old) was associated with good knowledge, while workplace type was associated with excellent knowledge of Mpox (aOR [95% CI]: 4.01 [1.43-11.24]). Knowledge of treatment/management of Mpox was generally poor across the different professional categories. Knowledge of Mpox among HCWs is substandard across different professionals. Thus, for optimal preparedness and immediate interventions for Mpox and similar emerging pathogens, capacity-strengthening programs should be organized for HCWs while encouraging scientific literature and organizational social media websites.

Gender Equality in Architecture and Construction: An Assessment Framework at the Institutional and Sectoral Levels in Jordan

The issue of gender equality demands attention from governments, policymakers, and the community at large. It requires continuous redefinition due to its complex technical, professional, economic, and social dimensions, all aimed at empowering women to claim their position within society. Jordan is no exception to this, as women encounter numerous hurdles in accessing equal opportunities in the professional sphere despite their increasing levels of education. This underscores the necessity for a thorough examination of the factors influencing this discussion. This research is targeted at identifying and categorising relevant gender equality indicators within the architectural practice in Jordan, as part of the construction sector. This research adopts a quantitative approach, utilising the Delphi Technique and Analytical Hierarchy Process through engagement with experts from academia and practice to ensure appropriate sourcing, filtration, and rating of the most relevant indicators. It concludes with the identification of fifty-nine indicators grouped into the categories of Education, Employability, Enablement, Inclusion, Professionalism, Facilitation, and Support. This research reveals a higher emphasis on the practical aspects of gender equality by the participants, prioritising particular categories and indicators. The findings offer essential insights to effectively address such an important issue across the policy, economic, social, and professional levels.

Serum Prestin and Otolin-1 Levels in Pilots of Helicopter-Based Emergency Medical Services: Potential Markers for Ear Injury.

Occupational noise exposure is a major public health concern, impacting a large workforce worldwide. In this study, we sought to evaluate the serum concentrations of prestin, a cochlear protein that diminishes following noise exposure, and otolin-1, a protein secreted into the bloodstream subsequent to inner ear damage, among three diverse professional categories, each exposed to varying degrees of noise. Helicopter emergency medical service (HEMS) pilots and construction workers were considered high-risk groups due to their elevated exposure to occupational noise, whereas office workers were regarded as a low-risk group, reflecting their comparatively minimal noise exposure. The study sample included 60 males, encompassing helicopter pilots, construction laborers, and office workers (n=20, each). Recruitment occurred during standard occupational health visits, with all participants presenting normal clinical audiograms. Serum levels of prestin and otolin-1 were measured in duplicate using commercially available immunoassays and compared across the three professional categories. HEMS pilots had the lowest mean serum prestin level at 211±27 pg/mL, followed by construction workers at 234±29 pg/mL, and office workers at 269±42 pg/mL (p<0.001, one-way analysis of variance), with all inter-group differences statistically significant (p<0.05, Tukey'spost hoctests). For otolin-1, HEMS pilots showed the highest mean at 216±20 pg/mL, with construction workers at 196±22 pg/mL, and office workers at 181±20 pg/mL (p<0.001, one-way analysis of variance). Statistically significant differences were found between HEMS pilots and both other groups for otolin-1 levels (p<0.05, Tukey'spost hoctests), but not between construction workers and office workers. Serum concentrations of prestin and otolin-1 may differ among healthy individuals according to their occupational noise exposure and have the potential to act as indicators of subclinical inner ear injury. To substantiate these preliminary observations, incorporating exposure assessment, especially via direct measurements of noise and vibration exposure, would markedly improve the reliability of our findings.

Relationship between thyroid function changes with work-/night-shifts and history of thyroid pathology among health personnel

The study aim was to analyze the relationship between functional thyroid pathology and the exposure to work shifts / night shifts, and describe the most prevalent thyroid disorders based on the type of shift. Cross-sectional study performed in the emergency department of a hospital in Almeria (Spain). Relationships between thyroxine and thyrotropin levels (TSH) and work shifts, professional category and history of thyroid pathology were analyzed. The study included 133 workers; 80.5% female, average age was 46.11 years (38 - 65), and 52% were part of the nursing staff; thyroid disorders were more frequent in female participants. Most participants (81.2%) had rotating shifts schedules and 11.3% night shifts (12.1% female and 7.7% male). Thyroid alterations were found in 27% of the participants (usually elevated TSH levels and normal thyroxine levels), particularly in those doing night shifts (61.1%). TSH alterations were more frequent in individuals doing night shifts than in rotating shifts (53.3 vs 13.0%; p<0.001). Individuals working night shifts had mean TSH values in the normal range, although significantly higher than the individuals in the rest of the shifts; thyroxine levels were found to be similar. No thyroid disorders were found in day shift participants. Night shift and a history of thyroid pathology were independent predictors of thyroid disorders. Night shift schedules and history of thyroid disorders are more frequent in female, both related to the presence of thyroid disorders, indicating the need to include the evaluation of these disorders in health surveillance programs and analyze gender differences.

OLYMPUS-POPGEN: A synthetic population generation model to represent urban populations for assessing exposure to air quality.

With the new individual- and activity-based approaches to simulating exposure to air pollutants, exposure models must now provide synthetic populations that realistically reflect the demographic profiles of individuals in an urban territory. Demographic profiles condition the behavior of individuals in urban space (activities, mobility) and determine the resulting risks of exposure and environmental inequalities. In this context, there is a strong need to determine the relevance of the population modeling methods to reproduce the combinations of socio-demographic parameters in a population from the existing databases. The difficulty of accessing complete, high-resolution databases indeed proves to be very limiting for the ambitions of the different approaches. This work proposes to evaluate the potential of a statistical approach for the numerical modeling of synthetic populations, at the scale of dwellings and including the representation of coherent socio-demographic profiles. The approach is based on and validated against the existing open databases. The ambition is to be able to build upon such synthetic populations to produce a comprehensive assessment of the risk of environmental exposure that can be cross-referenced with lifestyles, indicators of social, professional or demographic category, and even health vulnerability data. The approach implemented here is based on the use of conditional probabilities to model the socio-demographic properties of individuals, via the deployment of a Monte Carlo Markov Chain (MCMC) simulation. Households are assigned to housing according to income and house price classes. The resulting population generation model was tested in the Paris region (Ile de France) for the year 2010, and applied to a population of almost 12 million individuals. The approach is based on the use of census and survey databases. Validation, carried out by comparison with regional census data, shows that the model accurately reproduces the demographic attributes of individuals (age, gender, professional category, income) as well as their combination, at both regional and sub-municipal levels. Notably, population distribution at the scale of the model buildings remains consistent with observed data patterns. The outcomes of this work demonstrate the ability of our approach to create, from public data, a coherent synthetic population with broad socio-demographic profiles. They give confidence for the use of this approach in an activity-based air quality exposure study, and thus for exploring the interrelations between social determinants and environmental risks. The non-specific nature of this work allows us to consider its extension to broader demographic profiles, including health indicators, and to different study regions.

SERVIÇO SOCIAL E SAÚDE: PERSPECTIVAS DE ATUAÇÃO NO CAMPO DE GESTÃO E PLANEJAMENTO.

The current problems involving the health field are read within the context of neoliberal policies which make access and implementation of the right to health unfeasible as proposed by the Health Reform and in accordance with the assumptions of the Unified Health System (SUS). Social Work, as a professional category aligned with the interests of the working class and in line with professional documents, especially its current Code of Ethics, identifies in the sphere of management and planning an appropriate space to contribute to the realization of the right to health. The work is developed based on a bibliographical analysis of existing materials and, through an analytical reading, promotes discussion about the possibilities for social workers to work in the field of health management and planning. As a result, we have to move away from traditional practices, characterized by their technicality and bureaucracy, and by opting for a democratic and strategic management concept, they enable, in this field, critical action that considers the real health needs of the population from a perspective of realizing the right to health.

SERVIÇO SOCIAL E SAÚDE: PERSPECTIVAS DE ATUAÇÃO NO CAMPO DE GESTÃO E PLANEJAMENTO.

The current problems involving the health field are read within the context of neoliberal policies which make access and implementation of the right to health unfeasible as proposed by the Health Reform and in accordance with the assumptions of the Unified Health System (SUS). Social Work, as a professional category aligned with the interests of the working class and in line with professional documents, especially its current Code of Ethics, identifies in the sphere of management and planning an appropriate space to contribute to the realization of the right to health. The work is developed based on a bibliographical analysis of existing materials and, through an analytical reading, promotes discussion about the possibilities for social workers to work in the field of health management and planning. As a result, we have to move away from traditional practices, characterized by their technicality and bureaucracy, and by opting for a democratic and strategic management concept, they enable, in this field, critical action that considers the real health needs of the population from a perspective of realizing the right to health.

The joy and pain of being a harm reduction worker: a qualitative study of the meanings about harm reduction in Brazil

BackgroundAlthough harm reduction is highlighted as an effective intervention for alcohol and drug use, a funding gap for harm reduction interventions has been identified, mainly in low- and middle-income countries. In these countries, tensions between abstinence and harm reduction models have impaired the shift from punitive practices to evidence-based interventions committed to guaranteeing the human rights of people who use drugs. Since 2015, the Brazilian government has adopted a more punitive and abstinence-focused drug policy that jeopardizes the care of people who use alcohol and other drugs and the comprehension of the harm reduction workers' perspective in relation to their practice. Therefore, this study aimed to comprehend the meanings constructed by Brazilian harm reduction workers regarding their practices with vulnerable populations amidst a context of political tension.MethodsWe conducted 15 in-depth semi-structured qualitative interviews with harm reduction workers employed in public health services for at least 6 months. Data were analyzed using thematic analysis.ResultsThe thematic axis "The joy and pain of being a harm reduction worker in Brazil" was constructed and divided into four major themes: (1) Invisibility of harm reduction work; (2) Black, poor, and people who use drugs: identification with the service users; (3) Between advocacy and profession: harm reduction as a political act; (4) Small achievements matter. Despite the perceived invisibility of harm reduction workers in the public health and alcohol and drug fields, valuing small achievements and advocacy were important resources to deal with political tension and punitive strategies in Brazil. The findings also highlight the important role of harm reduction workers due to their personal characteristics and understanding of drug use behavior, which bring the target audience closer to actions within the public health system.ConclusionThere is an urgent need to acknowledge harm reduction based on peer support as a professional category that deserves adequate financial support and workplace benefits. Additionally, expanding evidence-based harm reduction interventions and community-based voluntary drug use treatment centers should be prioritized by public policies to address the human rights violations experienced by people who use drugs.

Nurse coordinators and IPAs in Parkinson's expert centers: what are their roles?

The creation of Parkinson's expert centers (PEC) led to the emergence of new nurses, known as coordination nurses. And in 2018, the emergence of advanced practice nursing led to the creation of a new category of professionals, advanced practice nurses (APN). Nurses coordinators and APN play a major role in meeting the public health challenges posed by Parkinson's disease. They are the guarantors of the implementation of a personalized care pathway, the aim of which is to offer patients an optimized quality of life. They forge an indispensable link between the city's healthcare services and the PEC, collaborating with the many healthcare professionals who work with people suffering from Parkinson's disease.

National institute of hygiene, epidemiology and microbiology Adolescent violence exposure survey

A survey was prepared based on an instrument designed and validated for the study of exposure to violence in adolescents with the objective of exploring the variables of physical, psychological, sexual and neglect/abandonment violence in home, school and community settings., cyber violence is included. The survey will be completed anonymously by adolescents from Basic Secondary Education, Pre-University, Technical and Professional Education and Special Conduct Schools Categories 1 and 2 with prior authorization from parents and/or guardians.

A French classification to describe medical deserts: a multi-professional approach based on the first contact with the healthcare system

BackgroundIncreasing inequalities in accessibility to primary care has generated medical deserts. Identifying them is key to target the geographic areas where action is needed. An extensive definition of primary care has been promoted by the World Health Organization: a first level of contact with the health system, which involves the co-presence of different categories of health professionals alongside the general practitioner for the diagnosis and treatment of patients. Previous analyses have focused mainly on a single type of provider while this study proposes an integrated approach including various ones to define medical deserts in primary care.MethodOur empirical approach focuses on the first point of contact with the health system: general practitioners, proximity primary care providers (nurses, physiotherapists, pharmacies, laboratories, and radiologists), and emergency services. A multiple analysis approach was performed, to classify French municipalities using the information on the evolution and needs of health care accessibility, combining a principal component analysis and a hierarchical ascending classification.ResultsTwo clusters of medical deserts were identified with low accessibility to all healthcare professionals, socio-economic disadvantages, and a decrease in care supply. In other clusters, accessibility difficulties only concern a part of the health supply considered, which raises concern for the efficiency of primary care for optimal healthcare pathways. Even for clusters with better accessibility, issues were identified, such as a decrease and high needs of health care supply, revealing potential future difficulties.ConclusionThis work proposes a multi-professional and multi-dimensional approach to medical deserts based mainly on an extensive definition of primary care that shows the relevance of the co-presence of various healthcare professionals. The classification also makes it possible to identify areas with future problems of accessibility and its potential consequences. This framework could be easily applied to other countries according to their available data and their health systems’ specificities.