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We analysed whether immediate skin-to-skin contact between the healthy newborn and the mother after a caesarean section has a modulatory role on postpartum haemorrhage and uterine contraction. Unblinded, randomized clinical trial, simple random sampling, conducted in women undergoing caesarean sections. Of the population identified, the caesarean section total (N = 359), 23.2% (N = 83) met the inclusion criteria: scheduled caesarean section, accepting skin-to-skin contact, good level of consciousness. They were randomly allocated to the intervention group, skin-to-skin contact (N = 40), and to the control group, usual procedure (N = 40). There were three losses. Clinical variables: plasma haemoglobin, uterine contraction, breastfeeding, postoperative pain, were measured, and subjective variables: maternal satisfaction, comfort, comparison with previous caesarean section and newborn crying. Women with skin-to-skin contact had greater uterine contraction after caesarean section. The maternal plasma haemoglobin levels at discharge were significantly higher. It was associated with higher breastfeeding rate, satisfaction, comfort levels and with less maternal pain and less crying in the newborn.

Work-related violence against healthcare workers inflicted by healthcare users is a rising multidimensional phenomenon, a cause of concern among those who ensure the safety and health of these professionals. Although different studies indicate high percentages of attacks against healthcare workers, statistics from reports reveal much lower data. Underreporting of occupational violence against healthcare workers is a well-known fact reported in many studies. It is presented as a major obstacle when it comes to proposing adequate preventive measures, because the data on which to base these measures do not correspond to the true incidence of all the assaults that take place. Underreporting also makes it difficult to correctly assess the usefulness of preventive measures implemented. The following article looks at the latest studies carried out on the subject, presenting an overview of the factors accompanying these assaults, as well as the main reasons for this underreporting. It also highlights the lack in the literature of instruments designed to measure underreporting that have undergone a validation process. For all these reasons, this problem requires further study with validated tools to determine the reasons and circumstances that accompany and promote the underreporting of violence against healthcare workers. Knowing these reasons is a preliminary step in the fight against workplace violence and to measure the true magnitude of the problem, to provide the occupational health services with precise data and develop and assess the preventive measures implemented.

Resumen La agresion laboral a profesionales sanitarios por parte de los usuarios del sistema es un fenomeno multidimensional en alza, motivo de preocupacion para aquellos que velan por la seguridad y salud de dichos profesionales. Aunque diferentes estudios senalan altos porcentajes de personal sanitario agredido, las estadisticas de declaraciones realizadas revelan datos muy inferiores. La infradeclaracion de las agresiones laborales a sanitarios es un hecho conocido y referido en multitud de estudios y se presenta como un gran escollo a la hora de poder proponer medidas preventivas adecuadas, ya que las estadisticas en las que estas pueden basarse no corresponden a la verdadera casuistica de todas las agresiones que se producen. Asi mismo, dificulta el poder valorar correctamente la utilidad de las medidas preventivas adoptadas. El siguiente articulo hace un recorrido por los ultimos estudios realizados sobre el tema, presentando una panoramica general sobre los factores que acompanan a las agresiones, asi como de los motivos principales involucrados en que la infradeclaracion se produzca. Destaca, ademas, en la literatura, la falta de instrumentos que hayan sido sometidos a un proceso de validacion para medir esta infradeclaracion. Por todo ello, es necesario seguir investigando en esta problematica con herramientas validadas que permitan conocer los motivos y circunstancias que acompanan y fomentan la infradeclaracion de las agresiones a profesionales sanitarios. Conocer estos motivos es un paso previo para luchar contra la misma y poder conocer la verdadera magnitud del problema, de modo que los servicios de salud laboral puedan contar con datos precisos y desarrollar y evaluar medidas preventivas implementadas.

Giovana Signorelli Astolfi Cury,1 Debora Mayumi Takamune,1 Giedre Soares Prates Herrerias,1 Adriana Rivera-Sequeiros,2 Jaqueline Ribeiro de Barros,1 Julio Pinheiro Baima,1 Rogerio Saad-Hossne,1 Ligia Yukie Sassaki1 1São Paulo State University (Unesp), Medical School, Botucatu, Brazil; 2Department of Internal Medicine, San Juan de Dios del Aljarafe Hospital, Seville, SpainCorrespondence: Giovana Signorelli Astolfi Cury, Tel +5514 38801171, Fax +55 14 38801667, Email curygigi@gmail.comBackground: Inflammatory bowel diseases are chronic conditions characterized by incapacitating symptoms, which can compromise patient’s quality of life and social interaction. As social media use is continuously increasing and Facebook is one of the most accessed social media worldwide, this study aimed to evaluate the use of Facebook and identify clinical and psychological factors associated with addiction and compensatory use among patients.Methods: This case-control study enrolled 100 outpatients and 100 healthy individuals, who were classified into the patient and control groups, respectively. Facebook use was evaluated using the questionnaire Psycho-Social Aspects of Facebook Use (PSAFU). The IBD Questionnaire and the 36-Item Short-Form Health Survey (SF-36) were used to measure Health-related quality of life. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale; self-esteem, using the Rosenberg Self-Esteem scale.Results: The patient group included 54 patients with Crohn’s disease and 46 with ulcerative colitis. Facebook use was similar between the patient and control groups in all evaluated aspects (p=0.21). In the patient and the control groups, the compensatory use of Facebook was directly related to the symptoms of depression (patients: R = 0.22; p = 0.03; controls: R = 0.34; p = 0.0006) and inversely related to self-esteem scale (patients: R = − 0.27; p = 0.006; controls: R = − 0.37; p = 0.0001). Facebook addiction showed an inverse correlation with self-esteem (patients: R = − 0.32; p = 0.001; controls: R = − 0.24; p = 0.02) and quality of life (patients: IBDQ score, R = − 0.30; p = 0.003; controls: SF-36 score, R = − 0.29; p = 0.004).Conclusion: The use of Facebook was not different between study groups. Psychological aspects such as depression and low self-esteem were associated with the compensatory use of Facebook in both groups, which may be related to unsatisfactory personal aspects of social interaction.Keywords: Facebook, addiction, compensatory use, inflammatory bowel disease

To evaluate the effectiveness of telemedicine psychoeducational interventions (PIs) in adult patients on the clinical management of chronic non-oncological diseases compared with another therapeutic option or no treatment.Systematic review of randomized controlled trials.Six databases were searched between January 2011 and August 2021.A systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study selection, quality appraisal and data extraction were conducted independently by two reviewers. A third arbiter was available if discrepancies.A total of 719 articles were reviewed and 17 studies met the inclusion and quality criteria. The included studies related to smoking, chronic pain, obesity and mental illness. Most interventions were based on cognitive behavioural theory. Most of the included studies (12/17, 70.5%) showed improvements in health and significant reductions in anxiety, pain and depression with variable effect sizes. Patients reported a high satisfaction rate and indicated lectures or self-report writings as helpful in their recovery compared with more interactive items. Only financial incentives demonstrated greater adherence. A specific intervention format or complementary professional support was not associated with health outcomes.Telemedicine PIs are a safe and effective option for the clinical management of adults with chronic diseases. Future longitudinal studies are needed to assess the impact of these interventions on chronic physical and mental disease, evaluating the quality of life, morbidity and mortality.The results reinforce the telemedicine PIs with effects on clinical management similar to those of the face-to-face modality and can be carried out in a safe environment for patients at a lower cost to the health system. These conditions make them suitable for comprehensive care in the epidemiological COVID-19 context with the highest safety conditions for the patients and professionals.