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Stratégies d'accès à l'eau potable et aux infrastructures d'assainissement à Bamako (Mali)Traore, Hamadoun 20 September 2012 (has links)
Dans la plupart des pays en voie de développement, l'un des défis majeurs à révéler par les pouvoirs publics demeure la couverture des besoins des populations en services sociaux de base (Eau potable, Électricité, Infrastructure d'assainissement, etc.). A Bamako, les problématiques liées à ces services se posent avec beaucoup plus d'acuité que la ville connaît un des taux de croissance démographique et spatiale les plus importants du continent (3,5%) . Malheureusement, cet étalement n'a pu être accompagné par un développement proportionnel des infrastructures adéquates à cause de la faiblesse des ressources de l'Etat. Les difficultés énormes rencontrées par ces pays dans ce domaine ont amené la communauté internationale à initier les OMD. Au Mali, comme partout ailleurs, un impressionnant arsenal institutionnel et juridique a été mis en place à cet effet (PNAEP, Code de l'eau, PNE, PNA, etc.). Grâce à ce dispositif, même si beaucoup reste encore à faire dans le domaine de l'assainissement, les objectifs seront atteints dans le domaine de l'eau. Et pour une meilleure efficacité de la société de distribution de l'eau potable, l'Etat malien a ouvert son capital aux investisseurs privés. Après une expérience de 5 années de partenariat public-privé, marquée par un environnement économique mondial difficile et un contexte sociopolitique complexe, le bilan est diversement apprécié. Bamako et plusieurs autres centres urbains restent partiellement privés d'eau potable. Pour pallier cette présence insuffisante de l'Etat, aussi bien dans le domaine de l'eau potable que de l'assainissement liquide, des initiatives locales se sont développées à travers toute la ville de Bamako. / In the majority of developing countries, one of the major challenges the authorities have to take up is to provide the populations' basic social services needs (drinking water, electricity, cleaning-up infrastructure, etc.). In Bamako, the set of problems linked to these services comes with more severity, as the city has one of the most significant population and spatial growth rate of the African continent (3.5%)1. Unfortunately, this spreading out of Bamako did not go with a proportional development of adequate infrastructures, due to the weakness of the resources the State has. The huge difficulties encountered by these countries in this field led the international community to initiate the Millennium Development Goals (MDGs). In Mali, like everywhere else, an impressive array of institutional instruments and legal arsenal has been enacted for this purpose (the National Drinking Water Access Plan, the Water Code, the National Environmental Policy, the National Sanitation Policy, etc.). Through this mechanism, the goals will be achieved in the area of water, though there is still much to be done in the area of sanitation. In order to ensure a better effectiveness of the drinking water supply company, the Malian government has even opened it up to private investors. After an experience of 5 year public-private partnership, characterized by a tough global economic environment and a complex socio-political context, assessments of the results achieved vary greatly. Bamako and many other urban centers partially remain without drinking water.
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La microassurance / MicroinsuranceEkue, Ayih Roba 16 December 2016 (has links)
L’Organisation des Nations Unies a décrété l’année 2005 « année du microcrédit », dans l’espoir de réduire la pauvreté dans le monde, conformément aux huit objectifs du millénaire pour le développement (OMD). Présenté comme un précieux instrument de lutte contre la pauvreté, ce système créé par le Docteur Muhammad YUNUS prix Nobel de la Paix 2006 et fondateur de la Grameen Bank au Bangladesh, s’est propagé à travers le monde et notamment dans les pays en développement. Il permet d’offrir des petits prêts à des populations pauvres exclues du système financier afin de développer des activités génératrices de revenus et d’épargner. Plus connu sous le nom de la microfinance, ce terme désigne aujourd’hui, le microcrédit, l’épargne, le transfert d’argent et l’assurance. En effet, l’accès aux prêts n’excluait pas les autres risques, car le décès, la maladie, l’invalidité et les dommages aux biens fragilisaient aussi ces populations, révélant leur besoin d’assurance et il est évident que la prise de conscience de leur état de pauvreté, suscite la réduction de leur vulnérabilité. Une logique sous-tend l’offre par le biais de la « microassurance » dont le champ sémantique et opérationnel relève des compétences des assureurs qui en se lançant sur ce marché, doivent faire face à de nombreux défis car la microassurance s’inscrit dans des contextes bien spécifiques. Entre innovations et traditions, la démarche sera conçue dans le cadre d'une politique intégrée avec les Etats, acteurs traditionnels du développement, institutions de microfinance, organisations non gouvernementales et bailleurs de fonds internationaux, dont l'appui était essentiel. En dix ans, la microassurance a connu une croissance extraordinaire. Mais malgré les efforts accomplis, le bilan montre qu’il reste encore du chemin à faire. / The United Nations declared 2005 as the « Year of Microcrédit », in the hopes of reducing the level of world poverty, as part of the eight main objectives of the millennium development goals " OMD ". Presented as a valuable tool against poverty, this system created by Doctor Muhammad Yunus, 2006 Nobel Peace Price, and founder of the Grameen Bank in Bangladesh, is used throughout the world and most notably in developing countries.It allows " small loans " to impoverished populations which are excluded from financial systems so that they can develop activities that generate income as well as offer them the opportunity to save. More known as " microfinance", this term refers today, microcredit, savings, money transfer and insurance.Indeed, access to loans does not exclude other risks such as death, sickness, invalidity, as well as potential damages to capital goods. These numerous risks show their absolute need for insurance and it is obvious that awareness of their poverty will reduce their vulnerability.A development logic behind the offer through the " microinsurance " whose semantics and operational field within the competence of insurers embark on this market have to overcome a number of challenges as the field of " microinsurance " are in very specific and often difficult contexts.Between innovative and traditional, the approach will be integrated policy with the states, the traditional development actors, microfinance institutions, ONGs, international donors, whose support was essential.In ten years, " microinsurance " has experienced a extraordinary growing. But despite the progress that has been made, the resume shows that there is still much work to do.
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Droit international et développement durable en Afrique : le bilan mitigé des OMD et des partenariats pour le développement / International law and sustainable development : the mixed record of the MDGs and partnerships for developmentKeita, Diene 03 March 2014 (has links)
L'ensemble des pays d'Afrique s'accorde sur le fait que le développement humain est une aspiration fondamentale des peuples de la région et des gouvernements qui les représentent. Ainsi ont-ils tous adopté la Déclaration du Millénaire. Cependant les avancées d'une manière générale ont été en deçà des attentes. Entre 1990 et 2000, les pays africains n'ont atteint en moyenne que 10% des objectifs du Millénaire, au lieu des 40% nécessaires pour être sur la bonne voie. L'analyse globale du suivi des OMD montre que 4 pays ont atteint un certain nombre de cibles spécifiques et que plus d'un tiers des pays de la sous-région pourrait atteindre les principaux objectifs notamment dans les domaines de scolarisation, de la nutrition, et de l'accès à l'eau potable. Les autres pays par contre pourraient connaître de réelles difficultés à relever les défis sans un soutien effectif et durable de la communauté internationale. Malgré le bilan mitigé des accords de partenariats, de nombreux spécialistes estiment que l'atteinte des OMD en Afrique ne peut s'envisager sans des partenariats internationaux. D'où la nécessité de conserver le sens du réalisme c'est-à-dire de solliciter le concours financier, technologique et intellectuel que peuvent apporter les pays industrialisés, en particulier ceux de l'Union Européenne et des États-Unis d'Amérique, et déplacer la charge de la mise en œuvre du développement durable des États vers les citoyens et ce au travers la consécration des partenariats «publics-privés» et « États/Sociétés civiles». / All African countries agree that human development is a fundamental aspiration of the peoples of the region and the governments that represent them. So they all adopted the Millennium Declaration. However, overall progress has been below expectations. Between 1990 and 2000, African countries averaged only 10 per cent of the Millennium Development Goals, instead of the 40 per cent required to be on the right track. The global analysis of MDG monitoring shows that 4 countries have reached a number of specific targets and that more than one third of the countries of the subregion could reach the main objectives, particularly in the areas of schooling, nutrition, and access to clean water. Other countries, on the other hand, could face real difficulties in meeting the challenges without effective and lasting support from the international community. Despite the mixed record of partnership agreements, many experts believe that achieving the MDGs in Africa cannot be achieved without international partnerships. Hence the need to maintain the sense of realism that is to ask for the financial, technological and intellectual assistance that can bring the industrialized countries, especially those of the European Union and the United States of America , and to shift the burden of implementing the sustainable development of states towards the citizens through the dedication of "public-private" partnerships and "states / civil societies".
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Restoring Consistency in Ontological Multidimensional Data Models via Weighted RepairsHaque, Enamul January 2020 (has links)
This can be considered as a multidisciplinary research where ideas from Operations Research, Data Science and Logic came together to solve an inconsistency handling problem in a special type of ontology. / High data quality is a prerequisite for accurate data analysis. However, data inconsistencies
often arise in real data, leading to untrusted decision making downstream in the data
analysis pipeline. In this research, we study the problem of inconsistency detection and
repair of the Ontology Multi-dimensional Data Model (OMD). We propose a framework
of data quality assessment, and repair for the OMD. We formally define a weight-based
repair-by-deletion semantics, and present an automatic weight generation mechanism
that considers multiple input criteria. Our methods are rooted in multi-criteria decision
making that consider the correlation, contrast, and conflict that may exist among
multiple criteria, and is often needed in the data cleaning domain. After weight generation
we present a dynamic programming based Min-Sum algorithm to identify minimal
weight solution. We then apply evolutionary optimization techniques and demonstrate
improved performance using medical datasets, making it realizable in practice. / Thesis / Master of Computer Science (MCS) / Accurate data analysis requires high quality data as input. In this research, we study inconsistency in an ontology known as Ontology Multi-dimensional Data (OMD) Model and propose algorithms to repair them based on their automatically generated relative weights. We proposed two techniques to restore consistency, one provides optimal results but takes longer time compared to the other one, which produces sub-optimal results but fast enough for practical purposes, shown with experiments on datasets.
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Impacto na qualidade de vida de um programa educacional para prevenção de distúrbios osteomusculares relacionados ao trabalho (LERDORT)Santos, Antonio Cardoso dos January 2009 (has links)
Introdução: Os Distúrbios Osteomusculares Relacionados ao Trabalho (LERDORT) são um grande problema em saúde pública e frequentemente são causas de incapacidade temporária ou permanente. LERDORT constitui uma síndrome que se manifesta por patologias diversas: sinovites, tenossinovites, neurites, síndrome miofascial, epicondilites, tendinites, bursites, que acometem principalmente os membros superiores, coluna, mas também os membros inferiores. São de etiologia multifatorial: ergonômicas, organizacionais, individuais, psicossociais. Sua incidência é variável dependendo das populações de risco e da acurácia dos registros. Essas patologias têm diagnóstico difícil, onde os sintomas não condizem com os exames clínicos, e têm uma grande variabilidade de tratamentos, que em geral são de eficácia restrita, o que justifica a busca de intervenções de caráter preventivo. Os programas educacionais em saúde têm sido relatados como uma das estratégias de prevenção de LERDORT. Portanto a busca de uma intervenção educacional para prevenção primária de LERDORT, com potencial impacto na qualidade de vida do trabalhador e na produtividade no trabalho, parece ser uma alternativa interessante, e a sua eficácia medida por instrumentos validados mostra-se como um desfecho confiável a ser obtido no estudo. Objetivo: Testar o impacto de um programa educacional para prevenção de distúrbios osteomusculares relacionados ao trabalho (LERDORT) na qualidade de vida de trabalhadores. Métodos: Realizou-se um ensaio clínico aberto onde 101 funcionários de uma empresa de comércio de aços foram randomizados em dois grupos. O grupo intervenção foi submetido a um programa educacional para prevenção de LERDORT de 6 semanas, com encontros de 1 hora, na empresa, com no máximo 25 participantes, onde abordou-se de forma interativa de dinâmica de grupo a multifatoriedade de causas, biomecânica, ergonomia, cuidados posturais, e exercícios específicos. O grupo controle, com a mesma dinâmica e frequência recebeu um programa de orientação geral em saúde sobre: nutrição, obesidade, sono, higiene e prevenção de doenças, manejo de stress, mudanças de estilo de vida, e dicas para uma vida segura e saudável, que de forma objetiva e suscinta também era abordado no grupo intervenção. Os desfechos avaliados foram as variações nos escores de qualidade de vida medidos pelo Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), sendo o principal desfecho o domínio “capacidade funcional” e as variações na capacidade para o trabalho avaliadas pelo Work Limitation Questionnaire (WLQ). Resultados: Cinquenta sujeitos randomizados foram alocados para o grupo intervenção e 51 para o grupo controle, sendo que 6 sujeitos saíram do estudo antes de receber qualquer intervenção. Após 5 semanas não observamos diferenças na variação dos escores do SF-36 e WLQ entre o grupo intervenção e o grupo controle, assim como não houve diferença após 26 semanas. Mas a análise intragrupos demonstrou, na semana 26, uma melhora significativa de alguns domínios do SF-36. No grupo intervenção, houve diferença nos domínios dor, estado geral de saúde, vitalidade, aspectos mentais e resumos dos componentes físicos e mentais, e no grupo controle, nos domínios dor, aspectos sociais e resumo dos componentes mentais. No mesmo período de 26 semanas houve melhora do domínio “demanda de produção” do WLQ no grupo controle. Não houve diferença na análise estratificada por trabalhadores de escritório ou da produção. Conclusão: Não há evidência de que um programa educacional específico para prevenção de LERDORT, aplicado no local de trabalho, leve à melhora em curto prazo na qualidade de vida ou produtividade no trabalho, quando comparado com um programa educacional de orientação geral em saúde. Ambos os programas levaram a melhoras em vários domínios do SF-36 e WLQ, mas não no domínio “capacidade funcional”. / Background: Occupational Musculoskeletal Disorders (OMD) represent a major problem in public health and frequently cause of temporary or permanent work incapacity. OMD is defined as a syndrome that includes many diseases: sinovites, tenossinovites, neuritis, tendonitis, miofascial syndrome, bursitis, and that can involve the upper extremity, back, and also the lower extremity. OMD is mutilfactorial, including ergonomic, organizational, individual, psychological and social factors. The incidence is variable according to risk population and the accuracy of the data. Diagnosis of OMD is difficult because many symptoms do not correspond to findings in the clinical examination, and there were several types of treatment with restricted effectiveness. Thus research on preventive interventions is needed. Health educational programs had been reported as a preventive strategy in OMD. Therefore search for an educational intervention aimed to primary prevention in OMD, with impact in quality of life and work productivity, using outcomes measured by validated tools, represent and important unmet need. Objectives: To evaluate the impact in Quality of Life of a specific educational program for prevention of occupational musculoskeletal disorders. Methods: We conducted a randomized controlled trial with 101 clerical and production workers of a steel trading company. The intervention group underwent 6 weekly sessions of specific orientation about prevention of OMD. The 1 hour sessions occurred at the worksite, with up to 25 subjects, utilizing a group dynamic to discuss the mutilfactorial aspects of OMD: biomechanic, ergonomic, postures care, and specific exercises. The control group received an educational program in general health, including themes such as nutrition, avoiding obesity, sleep, hygiene, prevention of diseases, reducing stress, changing lifestyle, and tips for a safe and healthy life. These issues were also debated in the intervention group in a summary way. The outcomes were evaluated by Medical Outcomes Study 36- Item Short Form (SF-36), been the main outcomes the physical functioning domain, and the Work Limitation Questionnaire (WLQ). Results: Fifty subjects were randomized to intervention group and 51 to control group. Six subjects were withdrawn before any intervention. After 5 weeks and 26 weeks no significant differences was shown in the primary outcomes. However, within group analyses showed statistically significant improvement in bodily pain, general health, vitality, mental health, PCS (Physical Component Summary), and MCS (Mental Component Summary) in the intervention group. The control group presented statistically significant improvement in bodily pain, social functioning, MCS, and output demands in WLQ. No difference was shown in the stratified analyses of clerical and production workers. Conclusion: No evidence was shown that a specific educational program for prevention of OMD at the worksite improved life quality or work productivity in a short time, when compared with an educational program in general health. Both programs improved several domains of SF-36 and WLQ, but not in physical functioning.
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Impacto na qualidade de vida de um programa educacional para prevenção de distúrbios osteomusculares relacionados ao trabalho (LERDORT)Santos, Antonio Cardoso dos January 2009 (has links)
Introdução: Os Distúrbios Osteomusculares Relacionados ao Trabalho (LERDORT) são um grande problema em saúde pública e frequentemente são causas de incapacidade temporária ou permanente. LERDORT constitui uma síndrome que se manifesta por patologias diversas: sinovites, tenossinovites, neurites, síndrome miofascial, epicondilites, tendinites, bursites, que acometem principalmente os membros superiores, coluna, mas também os membros inferiores. São de etiologia multifatorial: ergonômicas, organizacionais, individuais, psicossociais. Sua incidência é variável dependendo das populações de risco e da acurácia dos registros. Essas patologias têm diagnóstico difícil, onde os sintomas não condizem com os exames clínicos, e têm uma grande variabilidade de tratamentos, que em geral são de eficácia restrita, o que justifica a busca de intervenções de caráter preventivo. Os programas educacionais em saúde têm sido relatados como uma das estratégias de prevenção de LERDORT. Portanto a busca de uma intervenção educacional para prevenção primária de LERDORT, com potencial impacto na qualidade de vida do trabalhador e na produtividade no trabalho, parece ser uma alternativa interessante, e a sua eficácia medida por instrumentos validados mostra-se como um desfecho confiável a ser obtido no estudo. Objetivo: Testar o impacto de um programa educacional para prevenção de distúrbios osteomusculares relacionados ao trabalho (LERDORT) na qualidade de vida de trabalhadores. Métodos: Realizou-se um ensaio clínico aberto onde 101 funcionários de uma empresa de comércio de aços foram randomizados em dois grupos. O grupo intervenção foi submetido a um programa educacional para prevenção de LERDORT de 6 semanas, com encontros de 1 hora, na empresa, com no máximo 25 participantes, onde abordou-se de forma interativa de dinâmica de grupo a multifatoriedade de causas, biomecânica, ergonomia, cuidados posturais, e exercícios específicos. O grupo controle, com a mesma dinâmica e frequência recebeu um programa de orientação geral em saúde sobre: nutrição, obesidade, sono, higiene e prevenção de doenças, manejo de stress, mudanças de estilo de vida, e dicas para uma vida segura e saudável, que de forma objetiva e suscinta também era abordado no grupo intervenção. Os desfechos avaliados foram as variações nos escores de qualidade de vida medidos pelo Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), sendo o principal desfecho o domínio “capacidade funcional” e as variações na capacidade para o trabalho avaliadas pelo Work Limitation Questionnaire (WLQ). Resultados: Cinquenta sujeitos randomizados foram alocados para o grupo intervenção e 51 para o grupo controle, sendo que 6 sujeitos saíram do estudo antes de receber qualquer intervenção. Após 5 semanas não observamos diferenças na variação dos escores do SF-36 e WLQ entre o grupo intervenção e o grupo controle, assim como não houve diferença após 26 semanas. Mas a análise intragrupos demonstrou, na semana 26, uma melhora significativa de alguns domínios do SF-36. No grupo intervenção, houve diferença nos domínios dor, estado geral de saúde, vitalidade, aspectos mentais e resumos dos componentes físicos e mentais, e no grupo controle, nos domínios dor, aspectos sociais e resumo dos componentes mentais. No mesmo período de 26 semanas houve melhora do domínio “demanda de produção” do WLQ no grupo controle. Não houve diferença na análise estratificada por trabalhadores de escritório ou da produção. Conclusão: Não há evidência de que um programa educacional específico para prevenção de LERDORT, aplicado no local de trabalho, leve à melhora em curto prazo na qualidade de vida ou produtividade no trabalho, quando comparado com um programa educacional de orientação geral em saúde. Ambos os programas levaram a melhoras em vários domínios do SF-36 e WLQ, mas não no domínio “capacidade funcional”. / Background: Occupational Musculoskeletal Disorders (OMD) represent a major problem in public health and frequently cause of temporary or permanent work incapacity. OMD is defined as a syndrome that includes many diseases: sinovites, tenossinovites, neuritis, tendonitis, miofascial syndrome, bursitis, and that can involve the upper extremity, back, and also the lower extremity. OMD is mutilfactorial, including ergonomic, organizational, individual, psychological and social factors. The incidence is variable according to risk population and the accuracy of the data. Diagnosis of OMD is difficult because many symptoms do not correspond to findings in the clinical examination, and there were several types of treatment with restricted effectiveness. Thus research on preventive interventions is needed. Health educational programs had been reported as a preventive strategy in OMD. Therefore search for an educational intervention aimed to primary prevention in OMD, with impact in quality of life and work productivity, using outcomes measured by validated tools, represent and important unmet need. Objectives: To evaluate the impact in Quality of Life of a specific educational program for prevention of occupational musculoskeletal disorders. Methods: We conducted a randomized controlled trial with 101 clerical and production workers of a steel trading company. The intervention group underwent 6 weekly sessions of specific orientation about prevention of OMD. The 1 hour sessions occurred at the worksite, with up to 25 subjects, utilizing a group dynamic to discuss the mutilfactorial aspects of OMD: biomechanic, ergonomic, postures care, and specific exercises. The control group received an educational program in general health, including themes such as nutrition, avoiding obesity, sleep, hygiene, prevention of diseases, reducing stress, changing lifestyle, and tips for a safe and healthy life. These issues were also debated in the intervention group in a summary way. The outcomes were evaluated by Medical Outcomes Study 36- Item Short Form (SF-36), been the main outcomes the physical functioning domain, and the Work Limitation Questionnaire (WLQ). Results: Fifty subjects were randomized to intervention group and 51 to control group. Six subjects were withdrawn before any intervention. After 5 weeks and 26 weeks no significant differences was shown in the primary outcomes. However, within group analyses showed statistically significant improvement in bodily pain, general health, vitality, mental health, PCS (Physical Component Summary), and MCS (Mental Component Summary) in the intervention group. The control group presented statistically significant improvement in bodily pain, social functioning, MCS, and output demands in WLQ. No difference was shown in the stratified analyses of clerical and production workers. Conclusion: No evidence was shown that a specific educational program for prevention of OMD at the worksite improved life quality or work productivity in a short time, when compared with an educational program in general health. Both programs improved several domains of SF-36 and WLQ, but not in physical functioning.
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Impacto na qualidade de vida de um programa educacional para prevenção de distúrbios osteomusculares relacionados ao trabalho (LERDORT)Santos, Antonio Cardoso dos January 2009 (has links)
Introdução: Os Distúrbios Osteomusculares Relacionados ao Trabalho (LERDORT) são um grande problema em saúde pública e frequentemente são causas de incapacidade temporária ou permanente. LERDORT constitui uma síndrome que se manifesta por patologias diversas: sinovites, tenossinovites, neurites, síndrome miofascial, epicondilites, tendinites, bursites, que acometem principalmente os membros superiores, coluna, mas também os membros inferiores. São de etiologia multifatorial: ergonômicas, organizacionais, individuais, psicossociais. Sua incidência é variável dependendo das populações de risco e da acurácia dos registros. Essas patologias têm diagnóstico difícil, onde os sintomas não condizem com os exames clínicos, e têm uma grande variabilidade de tratamentos, que em geral são de eficácia restrita, o que justifica a busca de intervenções de caráter preventivo. Os programas educacionais em saúde têm sido relatados como uma das estratégias de prevenção de LERDORT. Portanto a busca de uma intervenção educacional para prevenção primária de LERDORT, com potencial impacto na qualidade de vida do trabalhador e na produtividade no trabalho, parece ser uma alternativa interessante, e a sua eficácia medida por instrumentos validados mostra-se como um desfecho confiável a ser obtido no estudo. Objetivo: Testar o impacto de um programa educacional para prevenção de distúrbios osteomusculares relacionados ao trabalho (LERDORT) na qualidade de vida de trabalhadores. Métodos: Realizou-se um ensaio clínico aberto onde 101 funcionários de uma empresa de comércio de aços foram randomizados em dois grupos. O grupo intervenção foi submetido a um programa educacional para prevenção de LERDORT de 6 semanas, com encontros de 1 hora, na empresa, com no máximo 25 participantes, onde abordou-se de forma interativa de dinâmica de grupo a multifatoriedade de causas, biomecânica, ergonomia, cuidados posturais, e exercícios específicos. O grupo controle, com a mesma dinâmica e frequência recebeu um programa de orientação geral em saúde sobre: nutrição, obesidade, sono, higiene e prevenção de doenças, manejo de stress, mudanças de estilo de vida, e dicas para uma vida segura e saudável, que de forma objetiva e suscinta também era abordado no grupo intervenção. Os desfechos avaliados foram as variações nos escores de qualidade de vida medidos pelo Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), sendo o principal desfecho o domínio “capacidade funcional” e as variações na capacidade para o trabalho avaliadas pelo Work Limitation Questionnaire (WLQ). Resultados: Cinquenta sujeitos randomizados foram alocados para o grupo intervenção e 51 para o grupo controle, sendo que 6 sujeitos saíram do estudo antes de receber qualquer intervenção. Após 5 semanas não observamos diferenças na variação dos escores do SF-36 e WLQ entre o grupo intervenção e o grupo controle, assim como não houve diferença após 26 semanas. Mas a análise intragrupos demonstrou, na semana 26, uma melhora significativa de alguns domínios do SF-36. No grupo intervenção, houve diferença nos domínios dor, estado geral de saúde, vitalidade, aspectos mentais e resumos dos componentes físicos e mentais, e no grupo controle, nos domínios dor, aspectos sociais e resumo dos componentes mentais. No mesmo período de 26 semanas houve melhora do domínio “demanda de produção” do WLQ no grupo controle. Não houve diferença na análise estratificada por trabalhadores de escritório ou da produção. Conclusão: Não há evidência de que um programa educacional específico para prevenção de LERDORT, aplicado no local de trabalho, leve à melhora em curto prazo na qualidade de vida ou produtividade no trabalho, quando comparado com um programa educacional de orientação geral em saúde. Ambos os programas levaram a melhoras em vários domínios do SF-36 e WLQ, mas não no domínio “capacidade funcional”. / Background: Occupational Musculoskeletal Disorders (OMD) represent a major problem in public health and frequently cause of temporary or permanent work incapacity. OMD is defined as a syndrome that includes many diseases: sinovites, tenossinovites, neuritis, tendonitis, miofascial syndrome, bursitis, and that can involve the upper extremity, back, and also the lower extremity. OMD is mutilfactorial, including ergonomic, organizational, individual, psychological and social factors. The incidence is variable according to risk population and the accuracy of the data. Diagnosis of OMD is difficult because many symptoms do not correspond to findings in the clinical examination, and there were several types of treatment with restricted effectiveness. Thus research on preventive interventions is needed. Health educational programs had been reported as a preventive strategy in OMD. Therefore search for an educational intervention aimed to primary prevention in OMD, with impact in quality of life and work productivity, using outcomes measured by validated tools, represent and important unmet need. Objectives: To evaluate the impact in Quality of Life of a specific educational program for prevention of occupational musculoskeletal disorders. Methods: We conducted a randomized controlled trial with 101 clerical and production workers of a steel trading company. The intervention group underwent 6 weekly sessions of specific orientation about prevention of OMD. The 1 hour sessions occurred at the worksite, with up to 25 subjects, utilizing a group dynamic to discuss the mutilfactorial aspects of OMD: biomechanic, ergonomic, postures care, and specific exercises. The control group received an educational program in general health, including themes such as nutrition, avoiding obesity, sleep, hygiene, prevention of diseases, reducing stress, changing lifestyle, and tips for a safe and healthy life. These issues were also debated in the intervention group in a summary way. The outcomes were evaluated by Medical Outcomes Study 36- Item Short Form (SF-36), been the main outcomes the physical functioning domain, and the Work Limitation Questionnaire (WLQ). Results: Fifty subjects were randomized to intervention group and 51 to control group. Six subjects were withdrawn before any intervention. After 5 weeks and 26 weeks no significant differences was shown in the primary outcomes. However, within group analyses showed statistically significant improvement in bodily pain, general health, vitality, mental health, PCS (Physical Component Summary), and MCS (Mental Component Summary) in the intervention group. The control group presented statistically significant improvement in bodily pain, social functioning, MCS, and output demands in WLQ. No difference was shown in the stratified analyses of clerical and production workers. Conclusion: No evidence was shown that a specific educational program for prevention of OMD at the worksite improved life quality or work productivity in a short time, when compared with an educational program in general health. Both programs improved several domains of SF-36 and WLQ, but not in physical functioning.
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