High job strain and low job control among medical residents were associated with several indicators of lowered heart rate variability. Thus, analysis of heart rate variability may be an informative marker for evaluating the physiological impacts of workplace stressors.

BackgroundGiven that dengue disease is growing and may progress to dengue hemorrhagic fever (DHF), data on economic cost and disease burden are important. However, data for Mexico are limited.Methodology/Principal findingsBurden of dengue fever (DF) and DHF in Mexico was assessed using official databases for epidemiological information, disabilities weights from Shepard et al, the reported number of cases and deaths, and costs. Overall costs of dengue were summed from direct medical costs to the health system, cost of dengue to the patient (out-of-pocket expenses [medical and non-medical], indirect costs [loss of earnings, patient and/or caregiver]), and other government expenditures on prevention/surveillance. The first three components, calculated as costs per case by a micro-costing approach (PAATI; program, actions, activities, tasks, inputs), were scaled up to overall cost using epidemiology data from official databases. PAATI was used to calculate cost of vector control and prevention, education, and epidemiological surveillance, based on an expert consensus and normative construction of an ideal scenario.Disability-adjusted life years (DALYs) for Mexico in 2016 were calculated to be 2283.46 (1.87 per 100,000 inhabitants). Overall economic impact of dengue in Mexico for 2012 was US$144 million, of which US$44 million corresponded to direct medical costs and US$5 million to the costs from the patient’s perspective. The estimated cost of prevention/surveillance was calculated with information provided by federal government to be US$95 million. The overall economic impact of DF and DHF showed an increase in 2013 to US$161 million and a decrease to US$133, US$131 and US$130 million in 2014, 2015 and 2016, respectively.Conclusions/SignificanceThe medical and economic impact of dengue were in agreement with other international studies, and highlight the need to include governmental expenditure for prevention/surveillance in overall cost analyses given the high economic impact of these, increasing the necessity to evaluate its effectiveness.

Similar to previous studies, exclusive breastfeeding was found to have great importance, since this practice protects the child's health and allows for a better development, despite unfavorable social and economic conditions. In particular, it seems that the protection conferred by breastfeeding is stronger when home conditions are poor, but this same condition presents an intervention opportunity, particularly the assurance of potable water provision for the infant when breastfeeding is not an option.

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Objective. To assess the impact of occupational exposure to noise, as well as its relationship with other factors that can induce hearing loss. Material and methods. In January and February 1997, we conducted sonometry and dosimetry tests in a cement factory, as well as audiometric test in 85 cement workers, to identify sources of noise and evaluate the effect to noise exposure and other factors, of the prevalence of occupational hearing loss. Statistical analysis was conducted using measures of central tendency, bivariate analysis and polynominal regression models. Results. High noise levels were found in the crushing, crude milling, and cement milling sites. The highest individual dose corresponded to the packer job post. Fifty-five per cent of the study population presented some degree of hearing loss due to noise exposure. The cement processing area with the highest percentage of damaged workers was calcination. Conclusions. Our results show that noise is a serious risk factor in particular sites of cement factories, and also that an elevated number of hearing loss cases are due to occupational noise exposure in this industry; Our findings underscore the need for designing and implementing hearing protection programs, to assure the health and safety of cement workers.