CONTRADIÇÕES DA GARANTIA DO EMPREGO: UMA ANÁLISE SOBRE AS RELAÇÕES DE GÊNERO ESTABELECIDAS ENTRE MULHERES E SEU TRABALHO NA ENFERMAGEM

This study investigated the conceptions of female nurses about the imbrications between gender attributions and aspects of the organization of their work, in the context of the precariousness of the global work and employment relationships.  This study was conducted at a public maternity hospital located in São Paulo – Brazil and was based on a qualitative approach. Data was gathered by ethnography and 10 in-depth interviews. The data collection was organized into two kinds of databases: ‘Field Journals’ and ‘Interviews Database’, which were analyzed by  ‘Triangulation Method’ according to the conceptual framework of hermeneutical referential. Female nurses were in charge to provide financially for the family since they had the ‘stable job’ at the house (being public servants) whereas their partners worked under contract. Those women had to conciliate the shift work with housework and motherhood. Their resting time was reduced, mainly the night workers and they complained about social loss related to the shift schedule. Thus, despite having the guarantee of employment, the burden of the precarious global labor market that subjugates their partners fell on these women's shoulders  and  had negative impacts on their physical and mental health.Neste estudo investigaram-se as concepções de trabalhadoras da enfermagem de uma maternidade pública paulistana sobre as consequências dos imbricamentos entre atribuições de gênero e a precarização das relações de trabalho. Foi utilizada metodologia qualitativa, com observações etnográficas e entrevistas em profundidade, produzindo ‘Diários de Campo’ e ‘Banco de Narrativas’, analisados pela técnica de triangulação de métodos, sob referencial hermenêutico-filosófico. As trabalhadoras explicitaram ocupar a posição de ‘chefe de família’, com responsabilidade de provimento do lar. Elas eram detentoras do vínculo de trabalho seguro (funcionárias públicas) e ganhavam mais que seus parceiros: eles eram celetistas ou tinham contrato informal de trabalho. Elas relataram a necessidade de conciliação dos turnos de trabalho com tarefas domésticas e cuidado dos filhos. O tempo para descanso era reduzido, principalmente para as do turno noturno, e todas referiram perdas sociais por causa dos plantões. Apesar de possuírem a garantia do emprego, o ônus das relações precarizadas do mercado de trabalho brasileiro a que estavam submetidos seus parceiros recaiam sobre essas mulheres, com impactos negativos para sua saúde física e mental

Equity, diversity and working hours: Challenges and solutions

Submitted by Sandra Infurna ([email protected]) on 2019-10-03T12:34:12Z No. of bitstreams: 1 LuciaRotenberg_IOC_2004.pdf: 35119 bytes, checksum: 9a09dd69a4317ac97c84faaaeefe1eb4 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2019-10-03T12:45:49Z (GMT) No. of bitstreams: 1 LuciaRotenberg_IOC_2004.pdf: 35119 bytes, checksum: 9a09dd69a4317ac97c84faaaeefe1eb4 (MD5)Made available in DSpace on 2019-10-03T12:45:49Z (GMT). No. of bitstreams: 1 LuciaRotenberg_IOC_2004.pdf: 35119 bytes, checksum: 9a09dd69a4317ac97c84faaaeefe1eb4 (MD5) Previous issue date: 2004University of Sydney. Sydney, Australia.Universidade de São Paulo. São Paulo, SP, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Universidade de São Paulo. São Paulo, SP, Brasil.This special issue is devoted to a refereed and edited selection of papers presented at the XVIth International Symposium on Night and Shiftwork held in Santos, Brazil, in November 2003. The journal Chronobiology International has also an issue (volume 21, n. 6, 2004) dedicated to that Symposium. Held every two years, these symposia are organised under the auspices of the Working Time Society and the Scientific Committee on Shiftwork of the International Commission on Occupational Health (http://time.iguw.tuwien.ac.at/index.htm)

Fatores associados à capacidade para o trabalho e percepção de fadiga em trabalhadores de enfermagem da Amazônia ocidental Factors associated with work ability and perception of fatigue among nursing personnel from Amazonia

OBJETIVO: Analisar os fatores associados à capacidade inadequada para o trabalho e à percepção de fadiga entre os profissionais de enfermagem. MÉTODO: Estudo transversal desenvolvido com 272 trabalhadores em um hospital de urgência e emergência de Rio Branco/Acre. A coleta de dados ocorreu por meio dos seguintes instrumentos: questionário sobre dados sociodemográficos, condições de trabalho e estilo de vida; Índice de Capacidade para o Trabalho - ICT; e Questionário de Percepção de Fadiga. Para análise dos fatores associados à capacidade inadequada para o trabalho e à percepção de fadiga elevada foi utilizada a regressão de Poisson bivariada e múltipla. RESULTADOS: A prevalência de capacidade inadequada para o trabalho foi de 40,8%, tendo como fatores associados: sexo feminino (RP = 1,84; IC95% 1,06 - 3,18); referir outro vínculo empregatício (RP = 1,71; 1,25 - 2,35); número de funcionários insuficiente (RP = 1,96; 1,10 - 3,47); tarefas repetitivas e monótonas (RP = 1,84; 1,24 - 2,72); três ou mais morbidades sem diagnóstico médico (RP = 1,48; 1,06 - 2,06); fadiga elevada (RP = 2,37; 1,81 - 3,12). A prevalência de fadiga elevada foi de 25,7% e os fatores associados foram: tarefas repetitivas e monótonas (RP = 1,74; 1,00 - 3,03); referir de três a cinco morbidades com diagnóstico médico (RP = 1,98; 1,00 - 3,11) e seis ou mais morbidades (RP = 3,79; 2,04 - 7,03), segundo a auto-avaliação do profissional. CONCLUSÕES: O estudo evidencia que grande parte população estudada apresenta capacidade inadequada para o trabalho e níveis elevados de fadiga, apontando para a necessidade de intervenções no plano individual (condições de vida) e no ambiente de trabalho, principalmente no que tange aos aspectos organizacionais.<br>OBJECTIVE: To analyze factors associated with inadequate work ability and perceived fatigue among nursing professionals. METHODS: A cross-sectional study was conducted involving 272 nursing personnel at an emergency hospital in Rio Branco/State of Acre, Brazil. Data collection was performed using the following instruments: questionnaire on sociodemographic data, working conditions and life styles; the Work Ability Index - WAI, and a questionnaire on perceived fatigue. Bivariate and multiple Poisson regression was used in the analysis of factors associated with work ability and perceived fatigue. RESULTS: The prevalence of inadequate work ability was 40.8% and presented the following associated factors: female sex (RP = 1.84; 95% CI 1.06 - 3.18); refering: other job commitment (RP = 1.71; 1.25 - 2.35); understaffing (RP = 1.96; 1.10 - 3.47); repetitive and monotonous tasks (RP = 1.84; 1.24 - 2.72); reporting three or more clinically undiagnosed morbidities (RP = 1.48; 1.06 - 2.06); excessive reported fatigue (RP = 2.37; 1.81 - 3.12). The prevalence of severe fatigue was 25.7% and the associated factors were: repetitive and monotonous tasks (RP = 1.74; 1.00 - 3.03); reporting three to five clinically-diagnosed morbidities (RP = 1.98; 1.00 - 3.11) and six or more self-reported morbidities (RP = 3.79; 2.04 - 7.03). CONCLUSIONS: The study revealed that most of the studied population showed reduced work ability and high levels of fatigue. These results point toward the need for interventions on an individual level (such as life conditions) and workplace improvements, looking jointly at the organizational aspects and work environment, particularly organizational aspects

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research