COVID-19: como se proteger e conter a propagação no trabalho?

The pandemic caused by COVID-19 is a major health challenge and has required the work process to be considered in the design and implementation of strategies to cope with it. The reduction of risks inherent to work, through hygiene and biosafety protocols is a constitutional right. In this sense, this booklet aims to disseminate guidelines related to biosafety practices in the field of occupational health with the adequacy of the environment and conducts for the gradual resumption of face-to-face activities in a pandemic period. This material is the result of an extension project entitled "Good Biosafety Practices and Occupational Health in Education with the advent of COVID-19: how to protect and contain the spread?", Which has contributed to the dissemination of information aimed at the reduction of damage to workers' health and psychosocial impacts. Considering Collective Health as a multi and transdisciplinary area, it has contributed to the education sector through health education strategies, aiming at adapting the conduct at work involving the different segments of workers.A pandemia causada pela COVID-19 é um grande desafio para a saúde e tem exigido que o processo de trabalho seja considerado na elaboração e implantação de estratégias para o seu enfrentamento. A redução dos riscos inerentes ao trabalho, por meio de protocolos de higiene e biossegurança é um direito constitucional. Nesse sentido, esta cartilha tem como objetivo divulgar orientações relacionadas às práticas de biossegurança no campo da saúde do trabalhador com a adequação do ambiente e de condutas para a retomada gradual das atividades presenciais em período de pandemia. Este material é resultado de um projeto de extensão intitulado "Boas Práticas de Biossegurança e a Saúde do Trabalhador na Educação com o advento da COVID-19: como se proteger e conter a propagação?", que tem contribuído para a disseminação de informações que visem à diminuição de danos à saúde do trabalhador e de impactos psicossociais. Considerando a Saúde Coletiva como uma área multi e transdisciplinar, ela tem contribuído para o setor da educação por meio de estratégias de educação em saúde, visando adequações das condutas no trabalho envolvendo os diferentes segmentos de trabalhadores

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author