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This study aims to compare the mastery of competencies in assisting the LGBT+ population of Brazilian health professionals. Data collection occurred in a face-to-face and virtual manner, in the first semester of 2018. The health professionals answered a socio-demographic and functional questionnaire, in addition to the questionnaire Measurement of Training Needs for Health Care for the LGBT+ Public. The data was analyzed using Mann-Whitney and Chi-square tests. The project research was submitted to and approved by the IMED Research Ethics Committee (CAAE 69116917.6.0000.5319). The sample (n= 380) was made up mostly of psychologists (42.3%), female (81%), heterosexual (73.2%), aged between 26 and 35 years (36%), Catholic (41%), living in the south region (36.9%), and working in the profession for ten years or more (34.3%). Skills gaps on the LGBT+ theme was identified, especially in topics such as "approach to the patient's sexuality," "interference of religious beliefs in care," "care with the genitalia and breast of the trans individual," among others. Professionals trained in psychology and non-heterosexuals had a greater mastery of the theme than the others. The fragmentation of knowledge and skills hinders the full and equal access to the health system, and continued educational actions are recommended.

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BACKGROUND: Nursing professionals are on the front line of health systems in Brazil as well as worldwide. Studies on the work ability of nursing professionals are especially relevant as care demands increase and health care workforce shortages are expected. As the population of Brazil ages, the need for nursing care will increase. OBJECTIVE: To identify levels and predictors of work ability among Brazilian nursing professionals. METHODS: A cross-sectional study with 267 nursing professionals (72 nurses and 195 nursing technicians and nursing auxiliary) from public emergency and urgent care units was conducted. Measures included the following: Work Ability Index; Questionnaire of Socio-demographics, Lifestyle and Work and Health Aspects; and Violence at Work questionnaire. Generalized linear regression and Poisson models were used for data analysis. RESULTS: The mean work ability was 40.4 (range: 22 to 49). Almost 79.6% (n = 211) of participants reported good or excellent work ability, and 20.4% (n = 54) reported moderate or poor work ability. Better perceptions of health and job satisfaction, absence of health issues (past 15 days), lower stress levels, and having a partner were associated with better work ability. Victims of workplace violence were less likely to have good or excellent work ability than non-victims (prevalence ratio = 0.80; 95% CI 0.72 to 0.90). Professionals with cumulative experiences of workplace violence were less likely to report better work ability. CONCLUSIONS: The prevalence of good or excellent work ability was 79.6%. Our findings indicate that the following factors are predictors of work ability: self-reported perception of health, health issues in the last 15 days, workplace violence, job satisfaction, stress, and marital status.

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Introduction: Factors associated with the mining environment can contribute to work accidents and reduced caution at work, which may affect the quality of life and work capacity of miners. Objectives: To evaluate if fatigue influences quality of life and work capacity in miners with silicosis. Methods: This was a cross-sectional study conducted in the Northern Region of the state of Rio Grande do Sul, Brazil. Sociodemographic data and data on fatigue, work capacity, and quality of life were collected during the second half of 2017 and first half of 2018. Results: All participants were men. Mean participant age was 52.6 (± 7.2) years, and most (70.4%) of them did not finish elementary school. The strongest correlations were found between the physical, overall, and total fatigue domains and the World Health Organization Quality of Life - BREF and between the total and mental fatigue domains and the Work Ability Index. Strong correlations were also found between overall and total fatigue and the total St. George's Respiratory Questionnaire score. Conclusions: Silicosis and physical workload have a negative impact on respiratory quality of life and perception of fatigue among miners.

Introdução: Fatores associados ao ambiente de mineração podem contribuir para acidentes e menor autocuidado no trabalho, podendo afetar a qualidade de vida e a capacidade para o trabalho. Objetivos: Avaliar se a fadiga influencia a qualidade de vida e a capacidade para o trabalho dos trabalhadores de mineração com silicose. Métodos: Trata-se de estudo transversal, desenvolvido no norte do Rio Grande do Sul, Brasil. Foram coletados dados so cio demográficos, de fadiga, da capacidade para o trabalho e de qualidade de vida. A coleta de dados ocorreu durante o segundo semestre de 2017 e o primeiro semestre de 2018. Resultados: Todos os participantes eram homens. A idade média dos participantes foi de 52,6 (± 7,2) anos, e a maioria (70,4%) não concluiu o ensino fundamental. Os melhores coeficientes de correlação foram alcançados entre os domínios de fadiga física, geral e total e o questionário de Qualidade de Vida da Organização Mundial da Saúde-BREF e entre os domínios totais e fadiga mental e o Índice de Capacidade para o Trabalho. Correlações fortes também foram alcançadas entre a fadiga geral e total e o escore total do Questionário de Qualidade de Vida Respiratória do Hospital São Jorge. Conclusões: A silicose e a carga de trabalho física têm influência negativa na qualidade de vida respiratória e na percepção de fadiga dos trabalhadores de mineração.

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Every human being has the right to safe, dignified and harm-free care in health institutions. High fidelity simulation has been used in teaching for the training and continuing education of health professionals to promote quality, safe and humanized patient care. Elaborating scenarios is an important phase to provide a simulation-based experience, and is relevant in the teaching-learning process. The objective of this study was to validate the content and applicability of the High Fidelity Simulation Scenario Planning and Development Form and its Operational Manual. The form could be used to development of scenarios to medicine, nursing, physiotherapy and as well as other specialties in the healthcare. This was a methodological validation study of the form and its manual content by experts in simulation and its feasibility, conducted in two phases: Phase 1: eight experts were selected using the "snowball" sampling technique to validate the content measured by the content validity index; Phase 2 (test): the form and its operational manual validated by the experts were made available to 28 participants in order to elaborate scenarios for the feasibility assessment and participation in the focus group. All items in the form and in the operational manual reached a content validity index above 0.80. The total content validity index was 0.98. The evaluation of the usability of the instruments carried out by the participants reached a percentage above 96.43% in all alternatives except for the item "It was easy to use the form to build your scenario" (75%). Eight participants were present in the focus group. Focus group discussions were categorized into completeness, practicality and usefulness according to comments and suggestions. The form and its operational manual proved to be valid instruments.

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Resumo Introdução A enfermagem é uma profissão predominantemente feminina que tem como centralidade o cuidado em saúde. A literatura aponta que essa categoria profissional vivencia as situações de violências interpessoais, a violência urbana/social, os sofrimentos face às desigualdades sociais, além das precárias condições de trabalho. Objetivo Analisar as condições de trabalho e as violências vividas por profissionais de nível médio-técnicos/as em enfermagem na área hospitalar que realizam o trabalho de cuidado. Método Pesquisa com abordagem qualitativa que utilizou o referencial dos estudos do care, que considera a divisão sexual do trabalho. Foram entrevistados dois homens e sete mulheres de um hospital público da região Sudeste do Brasil. Foi utilizado um roteiro semiestruturado para a coleta dos depoimentos orais com subsídios da história oral. Resultados Havia quatro trabalhadores/as terceirizados/as e cinco servidores/as públicos/as. Em relação às condições de trabalho, foram identificados: terceirização do trabalho na área pública; diminuição do número de trabalhadores/as para o cuidado em saúde; casos de acidentes de trabalho (doenças e acidentes com materiais perfurocortantes), sofrimento e emoções dos/as profissionais diante das condições de vida da população atendida; violências urbana e social que influenciam a saúde e a subjetividade dos/as profissionais; vivências de conflitos, ameaças e agressões entre a equipe e as pessoas atendidas pelas profissionais. Conclusão É preciso aprofundamento teórico e metodológico para compreender as condições de trabalho, as violências e as emoções nas especificidades de uma profissão predominantemente feminina.

Abstract Background Nursing is a predominantly female profession that focuses on health care. The literature reports that this professional category experiences situations of interpersonal violence, urban/social violence, suffering in the face of social inequalities, in addition to precarious working conditions. Objetive To analyse the working conditions and the violence experienced by the medium level technician´s professional in nursering concerning the hospitalar area that do the care work. Method Research with qualitative approach, that utilized references of the care studies that consider the Sexual Division of Labour (SDL). Seven women and two men of the public hospital in the south region in Brazil were interviewed. A semi-structured itinerary was used for the oral testimony collections with subsidies of the oral history. Results Four workers were outsourced by the public service and five were public officer. In relation to the working conditions, it could be identified: outsourcing in the public service; decrease of the number of workers for health care; accidents at work (diseases and accidents with cutting materials); suffering and the emotions of the professionals in face of the living conditions of the population served by this public service; the urban and social violence that influences the health and the subjectivity of the professionals; and the violence and the relationships with the people served by them (conflicts, threats and aggressions). Conclusion It is necessary to intensify the theoretical and methodological characteristics in order to understand the working conditions, the violence and the emotions in the specificities of a predominantly female profession.

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BACKGROUND: Artisanal and small-scale mining (ASM) are an important source of employment in southern Brazil. Mining workers are frequently exposed to unhealthy work conditions which increase the risk of occupational diseases. In this study, we assessed the association of sociodemographic factors and the occupational history of artisanal mining workers with the risk of adverse respiratory outcomes. METHODS: The study was conducted with 258 artisanal mining workers in southern Brazil, who were exposed to dust (mainly crystalline silica) in their work. Information on sociodemographic variables and occupational histories was collected between 2017 and 2018. To estimate the worker's exposure to inhalable dust we use the Advanced REACH (Registration, Evaluation, and Authorization of Chemicals) Tool (ART). RESULTS: Study participants were all men, with an average age of 40 years. Median crude dust exposure estimated by ART was 13.2 mg/m³ and median crude crystalline silica exposure was 1.6 mg/m3 . The prevalence ratio (PR) for self-reported silicosis was 3.08 (95% confidence interval, 1.39-7.17) in workers with 20 years or more of mining work. Factors associated with silicosis were age, pack-years of tobacco use, and body mass index. Smokers were over twice as likely to report respiratory symptoms. CONCLUSIONS: Our findings indicate that a high prevalence of silicosis and other associated diseases in mining workers is associated with both unhealthy work environment conditions and the health profile of workers. This study is an important step for understanding health outcomes from work in ASM.

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OBJECTIVE: To evaluate which type of diet is most effective for weight loss. METHODS: Relevant studies for this type of review were identified from March to May 2018 by several sources, in the electronic databases PubMed, CINAHL, Scielo, SCOPUS, Web of Science, BVS Portal, EMBASE and Cochrane Library. For gray literature, Open Green and Base search and hand search repositories, which is a free search for materials that address the subject were searched. RESULTS: The selected publications totaled 537, of which 104 were from the electronic databases and 433 records identified through other databases. After the removal of duplicates, 113 titles and abstracts and 37 complete texts were selected, after reading the articles in full, 14 articles were selected for inclusion in this review. Out of the 14 articles analyzed, relevant results were presented for a diet rich in fruits and vegetables; oleaginous, especially nuts; a Mediterranean diet was noted in three studies; dietary guidelines based on guides was mentioned in two studies and a high-protein diet was cited four times. CONCLUSION: The most effective diet for weight loss was the high fiber diet, although it contributes with small percentage value.

OBJETIVO: evaluar qué tipo de dieta es la más efectiva para perder peso. MÉTODOS: los estudios relevantes para este tipo de revisión fueron identificados de marzo a mayo de 2018 por varias fuentes, en las bases de datos electrónicas PubMed, CINAHL, Scielo, SCOPUS, Web of Science, BVS Portal, EMBASE y Cochrane Library en la literatura gris Open Creen y Base de búsqueda y repositorios de búsqueda manual, que es una búsqueda gratuita de materiales que tratan el tema. RESULTADOS: Las publicaciones seleccionadas totalizaron 537, de las cuales 104 eran de las bases de datos electrónicas y 433 registros identificados a través de otras bases de datos. Después de la eliminación de los artículos duplicados, se seleccionaron 113 títulos y resúmenes y 37 textos completos; después de leer los artículos completos, se seleccionaron 14 artículos para su inclusión en esta revisión. De los 14 artículos analizados se presentaron resultados relevantes para una dieta rica en frutas y verduras; oleaginoso, especialmente los frutos secos; Dieta mediterránea en tres estudios; Pautas dietéticas basadas en guías dietéticas, presentes en dos estudios y dieta hiperproteica, citadas cuatro veces. CONCLUSIÓN: la dieta más efectiva para perder peso es la dieta alta en fibra, aunque contribuye con un pequeño valor porcentual.

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Analisando-se as tendências globais de crescimento populacional e o envelhecimento da população, que implica no aparecimento de doenças crônicas, além das doenças e acidentes em geral (relacionados ou não ao trabalho), observa-se crescente necessidade de implementação dos serviços de reabilitação no mundo. A reabilitação envolve três aspectos: reabilitação médica, profissional e social. Este estudo teve por objetivo identificar e apresentar a produção de conhecimento dos processos de reabilitação profissional em diversos países, bem como identificar estratégias para a reintegração ao trabalho de pessoas com restrições decorrentes de doenças ou acidentes em geral, por meio da reabilitação profissional durante os últimos 30 anos. Foi realizada uma revisão integrativa em portais de pesquisa em saúde ­ Biblioteca Virtual em Saúde ­ Biblioteca Virtual em Medicina (BVS-BIREME), PubMed ­, bases de dados ­ Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Web of Science, Sociological abstracts, Education Resources Information Center (ERIC) ­ e banco de dados (SCOPUS). No total, 1.109 publicações foram identificadas. Após avaliação metodológica, 12 foram consideradas elegíveis e incluídas. Os estudos avaliaram novas abordagens e a implementação de programas existentes, novos projetos/programas e medidas educacionais para trabalhadores em licença médica. A maioria considerou a multidisciplinaridade, a abordagem educacional complementar, a intervenção precoce e a possibilidade de ajustes no ambiente de trabalho. As publicações sobre novos projetos foram relacionadas a programas de retenção no emprego e retorno ao trabalho para trabalhadores desempregados e temporários. Há um pequeno número de estudos descrevendo programas de reabilitação ocupacional e dificuldades em avaliar sua eficácia. A produção científica ainda é discreta quando comparada à necessidade relacionada a esse tema na atualidade.

Analysis of population growth trends and aging­which is associated with occurrence of chronic diseases, in addition to (work-related or not) diseases and accidents in general­points to an increasing need to implement rehabilitation services worldwide. Rehabilitation comprises three aspects: medical, vocational and social. The aim of the present study was to describe the state of the art in vocational rehabilitation approaches in several countries, as well as vocational rehabilitation-based return-to-work strategies for individuals with restrictions due to diseases and accidents in general developed in the past 30 years. We performed an integrative review of studies located in databases Virtual Health Library-Regional Library of Medicine (VHL-BIREME), PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Web of Science, Sociological Abstracts, Education Resources Information Center (ERIC) and SCOPUS. A total of 1,109 studies were initially retrieved, of which 12 were considered eligible on methodological assessment and included for review. The selected studies analyzed new approaches and the implementation of existing programs, new programs/projects, and educational measures for workers on sick leave. Most programs had multidisciplinary nature and included complementary educational approaches, early intervention, and possibility of workplace adjustments. The studies on new projects consisted in job retention and return-to-work programs for unemployed or temporary workers. The number of studies which describe occupational rehabilitation programs is small and evaluating their efficacy is difficult. Scientific research on this subject is still scarce vis-à-vis the current demands.

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Analysis of population growth trends and aging-which is associated with occurrence of chronic diseases, in addition to (work-related or not) diseases and accidents in general-points to an increasing need to implement rehabilitation services worldwide. Rehabilitation comprises three aspects: medical, vocational and social. The aim of the present study was to describe the state of the art in vocational rehabilitation approaches in several countries, as well as vocational rehabilitation-based return-to-work strategies for individuals with restrictions due to diseases and accidents in general developed in the past 30 years. We performed an integrative review of studies located in databases Virtual Health Library-Regional Library of Medicine (VHL-BIREME), PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Web of Science, Sociological Abstracts, Education Resources Information Center (ERIC) and SCOPUS. A total of 1,109 studies were initially retrieved, of which 12 were considered eligible on methodological assessment and included for review. The selected studies analyzed new approaches and the implementation of existing programs, new programs/projects, and educational measures for workers on sick leave. Most programs had multidisciplinary nature and included complementary educational approaches, early intervention, and possibility of workplace adjustments. The studies on new projects consisted in job retention and return-to-work programs for unemployed or temporary workers. The number of studies which describe occupational rehabilitation programs is small and evaluating their efficacy is difficult. Scientific research on this subject is still scarce vis-à-vis the current demands.

Analisando-se as tendências globais de crescimento populacional e o envelhecimento da população, que implica no aparecimento de doenças crônicas, além das doenças e acidentes em geral (relacionados ou não ao trabalho), observa-se crescente necessidade de implementação dos serviços de reabilitação no mundo. A reabilitação envolve três aspectos: reabilitação médica, profissional e social. Este estudo teve por objetivo identificar e apresentar a produção de conhecimento dos processos de reabilitação profissional em diversos países, bem como identificar estratégias para a reintegração ao trabalho de pessoas com restrições decorrentes de doenças ou acidentes em geral, por meio da reabilitação profissional durante os últimos 30 anos. Foi realizada uma revisão integrativa em portais de pesquisa em saúde ­ Biblioteca Virtual em Saúde ­ Biblioteca Virtual em Medicina (BVS-BIREME), PubMed ­, bases de dados ­ Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Web of Science, Sociological abstracts, Education Resources Information Center (ERIC) ­ e banco de dados (SCOPUS). No total, 1.109 publicações foram identificadas. Após avaliação metodológica, 12 foram consideradas elegíveis e incluídas. Os estudos avaliaram novas abordagens e a implementação de programas existentes, novos projetos/programas e medidas educacionais para trabalhadores em licença médica. A maioria considerou a multidisciplinaridade, a abordagem educacional complementar, a intervenção precoce e a possibilidade de ajustes no ambiente de trabalho. As publicações sobre novos projetos foram relacionadas a programas de retenção no emprego e retorno ao trabalho para trabalhadores desempregados e temporários. Há um pequeno número de estudos descrevendo programas de reabilitação ocupacional e dificuldades em avaliar sua eficácia. A produção científica ainda é discreta quando comparada à necessidade relacionada a esse tema na atualidade.

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RESUMO Estudo de reflexão sobre as orientações nutricionais que são realizadas a população e que, na maior parte do mundo, enfatiza o consumo de frutas, verduras e legumes em maior quantidade em relação a alimentos industrializados, que por conterem maior quantidade de açúcar, sódio, e calorias aumentam o ganho de peso. No entanto, quando se lê a respeito das formas de cultivo dos alimentos in natura e sobre a qualidade dos alimentos cárneos e pescados, que são orientados para o consumo da população, surge à dúvida se há coerência entre a orientação e o consumo, uma vez que há relatos da contaminação desses alimentos por resíduos de agrotóxicos, contaminação do solo, da água e que não tem tido o devido destaque pelos órgãos estatais. Qual deveria ser a conduta perante a realidade que se apresenta? Uma perspectiva viável é a conscientização da população, que deve exigir melhores condições dos alimentos consumidos, além de resgatar práticas mais saudáveis como o cultivo de hortas orgânicas caseiras e adquirir o mínimo possível, alimentos industrializados. Longe de polemizar, esta reflexão visa incentivar uma visão crítica aos profissionais de saúde sobre seu papel na prevenção de doenças, e exigir alimentos mais saudáveis para o consumo humano.(AU)

ABSTRACT Reflection study on the nutritional guidelines given to the population, which, in most parts of the world, emphasize on the consumption of fruits, vegetables and legumes over industrialized foods, which contain more sugar, sodium and calories, and increase body weight. However, when one reads about the ways of cultivating fresh food and about the quality of meat and fish products destined for consumption, the question arises as to whether there is coherence between said guidance and consumption, given that there are reports of contamination of these foods by pesticide residues, as well as soil and water contamination, a topic scarcely addressed by state entities. What should be done to face this reality? A viable perspective is to raise awareness in the population, which should demand better quality foods, in addition to returning to healthier practices such as the cultivation of home-grown organic gardens and acquiring as few industrialized foods as possible. Far from causing controversy, this reflection aims to encourage a critical view in health professionals on their role in disease prevention and the demand for healthier foods for human consumption.(AU)

RESUMEN Estudio de reflexión sobre las orientaciones nutricionales que se dan a la población y que, en la mayor parte del mundo, enfatizan el consumo de frutas, verduras y legumbres antes que los alimentos industrializados, que por contener mayor cantidad de azúcar, sodio y calorías, aumentan peso corporal. Sin embargo, cuando se lee acerca de las formas de cultivo de los alimentos frescos y sobre la calidad de los alimentos cárnicos y pescados, destinados al consumo de la población, surge la duda de si hay coherencia entre la orientación y el consumo, dado que hay relatos de contaminación de esos alimentos por residuos de pesticidas, contaminación del suelo, del agua, poco atendido por los órganos estatales. ¿Cuál debería ser la conducta ante la realidad que se presenta? Una perspectiva viable es la concientización de la población, que debe exigir mejores condiciones de los alimentos consumidos, además de rescatar prácticas más saludables como el cultivo de huertos orgánicos caseros y adquirir el mínimo posible, de alimentos industrializados. Lejos de polemizar, esta reflexión pretende incentivar una visión crítica a de los profesionales de la salud sobre su papel en la prevención de enfermedades, y exigir alimentos más saludables para el consumo humano.(AU)

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Reflection study on the nutritional guidelines given to the population, which, in most parts of the world, emphasize on the consumption of fruits, vegetables and legumes over industrialized foods, which contain more sugar, sodium and calories, and increase body weight. However, when one reads about the ways of cultivating fresh food and about the quality of meat and fish products destined for consumption, the question arises as to whether there is coherence between said guidance and consumption, given that there are reports of contamination of these foods by pesticide residues, as well as soil and water contamination, a topic scarcely addressed by state entities. What should be done to face this reality? A viable perspective is to raise awareness in the population, which should demand better quality foods, in addition to returning to healthier practices such as the cultivation of home-grown organic gardens and acquiring as few industrialized foods as possible. Far from causing controversy, this reflection aims to encourage a critical view in health professionals on their role in disease prevention and the demand for healthier foods for human consumption.

Estudo de reflexão sobre as orientações nutricionais que são realizadas a população e que, na maior parte do mundo, enfatiza o consumo de frutas, verduras e legumes em maior quantidade em relação a alimentos industrializados, que por conterem maior quantidade de açúcar, sódio, e calorias aumentam o ganho de peso. No entanto, quando se lê a respeito das formas de cultivo dos alimentos in natura e sobre a qualidade dos alimentos cárneos e pescados, que são orientados para o consumo da população, surge à dúvida se há coerência entre a orientação e o consumo, uma vez que há relatos da contaminação desses alimentos por resíduos de agrotóxicos, contaminação do solo, da água e que não tem tido o devido destaque pelos órgãos estatais. Qual deveria ser a conduta perante a realidade que se apresenta? Uma perspectiva viável é a conscientização da população, que deve exigir melhores condições dos alimentos consumidos, além de resgatar práticas mais saudáveis como o cultivo de hortas orgânicas caseiras e adquirir o mínimo possível, alimentos industrializados. Longe de polemizar, esta reflexão visa incentivar uma visão crítica aos profissionais de saúde sobre seu papel na prevenção de doenças, e exigir alimentos mais saudáveis para o consumo humano.

Estudio de reflexión sobre las orientaciones nutricionales que se dan a la población y que, en la mayor parte del mundo, enfatizan el consumo de frutas, verduras y legumbres antes que los alimentos industrializados, que por contener mayor cantidad de azúcar, sodio y calorías, aumentan peso corporal. Sin embargo, cuando se lee acerca de las formas de cultivo de los alimentos frescos y sobre la calidad de los alimentos cárnicos y pescados, destinados al consumo de la población, surge la duda de si hay coherencia entre la orientación y el consumo, dado que hay relatos de contaminación de esos alimentos por residuos de pesticidas, contaminación del suelo, del agua, poco atendido por los órganos estatales. ¿Cuál debería ser la conducta ante la realidad que se presenta? Una perspectiva viable es la concientización de la población, que debe exigir mejores condiciones de los alimentos consumidos, además de rescatar prácticas más saludables como el cultivo de huertos orgánicos caseros y adquirir el mínimo posible, de alimentos industrializados. Lejos de polemizar, esta reflexión pretende incentivar una visión crítica a de los profesionales de la salud sobre su papel en la prevención de enfermedades, y exigir alimentos más saludables para el consumo humano.

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In this article, we review the literature on the current advances in targeted therapies for metastatic gastric cancer aimed at improving patient care. We conclude that the key to guiding targeted therapy is individual biomarkers, which are not completely elucidated. HER2 overexpression is the only predictive biomarker currently in use. Furthermore, it is necessary to understand that gastric tumors are heterogeneous; therefore, is impossible to evaluate a novel biological compound without evaluating personal biomarkers. The selection of patients who are able to receive each treatment is paramount for improving advanced gastric cancer survival and reducing unnecessary costs.

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A terceirização foi uma das formas de enxugamento dos serviços públicos. Estudamos o Departamento de Parques e Jardins de uma Prefeitura do Estado de São Paulo a partir de percepções da substituição da mão de obra efetiva por terceirizados. Objetivou-se analisar o departamento a fim de conhecer sua estrutura, organização, os trabalhadores e os possíveis impactos da terceirização. Trata-se de uma pesquisa de abordagem qualitativa, com entrevistas semiestruturadas considerando as trajetórias de vida, histórias ocupacionais dos trabalhadores e observações nos locais de trabalho. Observamos três distintas categorias de trabalhadores; os efetivos, os terceirizados e os reeducandos, abrigando no interior da categoria ?efetivos? ao menos duas ?classes?, uma valorizada e outra pouco valorizada. As histórias de vida dos efetivos indicaram possibilidades da construção de algum patrimônio e filhos com acesso aos estudos, devidos ao emprego público. Terceirizados e reeducandos realizavam tarefas menos qualificadas, com jornadas mais longas e salários bem mais baixos. Concluimos que a terceirização é uma forma de precarização do trabalho, levando a uma precarização de suas vidas; o serviço público estável atuou como uma forma de inclusão e de cidadania.

Outsourcing was one way of downsizing public services. We study the department of Parks and Gardens of a municipality of São Paulo state from the perceptions of replacing effective workers by outsourced workers. The objective of this article was to analyze this department to know its structure, organization, employees and the possible impacts of outsourcing. This is a qualitative study with semi-structured interviews considering workers life trajectories and occupational stories, as well as observations in the workplace. We observed three distinct categories of workers: effective, outsourced and reeducation, considering two classes in the effective category: one of prized workers and one of undervalued workers. The effectives life stories indicates possibilities of building some equity and children with access to education, due to public jobs. Outsourced and reeducation workers had less qualified tasks, with longer working hours and minor remuneration. We conclude that outsourcing is a form of precarious work, leading to the precarization of their lives; stable public service served as a form of inclusion and citizenship.

La tercerización fue una de las formas de reducción de personal de los servicios públicos. Estudiamos el Departamento de Parques y Jardines de la Municipalidad, en la ciudad de São Paulo, a partir de percepciones de la sustitución de mano de obra efectiva por tercerizados. Este estudio tuvo como objetivo analizar el departamento con el fin de conocer su estructura, organización, trabajadores y los posibles impactos de la tercerización. Se trata de un estudio cualitativo, con entrevistas semiestruturadas teniendo en cuenta las experiencias de vida, historias profesionales de los trabajadores y observaciones en los lugares de trabajo. Se observaron a tres categorías diferentes de trabajadores: los efectivos, los tercerizados y los reeducandos, y incluimos dentro de la categoría efectivos por lo menos dos clases, una valorada y otra poco valorada. Las historias de vida de los efectivos indicaron posibilidades de construcción de un cierto patrimonio y el acceso de los hijos a los estudios, debido al empleo público. Reeducandos y tercerizados realizaban tareas menos cualificadas, con jornadas más largas y salarios más bajos. Se concluyó que la tercerización es una forma de trabajo precario, que lleva a la precarización de sus vidas, y el servicio público estable actuó como una forma de inclusión y ciudadanía.

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This is a cross-sectional study conducted with 258 teachers from nine state schools in two municipalities of São Paulo state with the purpose of assessing their work ability. A questionnaire with socio-demographic and health/work conditions data and the Work Ability Index (WAI) was performed. Most teachers were females, 41.9 yr old on average (SD 9.4), and with an undergraduate degree (95.7%). The work ability was considered good for 42.6% and moderate/low for 35.3%. In linear regressions models, which used the two domain model, the significant variables for a decrease in WAI were: individual perception of a worsening in the health situation (p<0001), having children (p=0.0003 / p=0.0001), difficulty in sleeping well at night (p=0.0009 / p=0.0014), history of physical pain in the previous six months (p<0.0001 / p<0.0001), being a teacher with a contract (p=0.0007) and working as a teacher for a longer time. (p=0.0183). Public investments on the work conditions of teachers are important to recover and to maintain their work ability.

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Nursing personnel is essential in hospital, health centers and enterprises and is the large work force in health system. A cross-sectional study was conducted in a large city in two public hospitals and five health centre with the objective of to evaluate the work ability and health aspects of nursing staff. The sample was composed by 570 workers. The Work Ability Index - WAI and a questionnaire with socio-demographic, health and life style data was applied. The majority of workers was women (83%), married (50.4%), and was working in night shift work (65.6%); 61.4% was auxiliary nursing, 22.3% was registered nurses (RN). The average age was 38.9 years (SD 7.8) and the Body Mass Index mean was 25.8 (SD 5.3). Only 17.2% referred to practice at least 150 minutes of physical exercise five times per week or more. 26.8% had a second job. The work ability mean was 39.3 (SD 5.3) points. Age had a negative correlation with WAI (p=0.0052). Public hospital and health centre workers had poor work ability score when compared with workers from another branches. Public policies related to workplace health promotion need to be implemented in public hospital and health centre to improve the work ability.

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