Cumprimento das normas ISO 14001 e ISO 22000 por serviços de alimentação

Objetivo Avaliar, em estabelecimentos produtores de refeições, a segurança de alimentos e a preocupação ambiental de acordo com o cumprimento das normas ABNT ISO 22000 e 14001 por meio de dois checklists. Métodos O presente estudo exploratório e descritivo foi realizado em restaurantes a la carte do Distrito Federal. Foram elaborados dois check-lists para representar os requisitos das normas ISO 22000 e 14001. Determinaram-se estatisticamente 37 unidades produtoras de refeições participantes, que foram sorteadas aleatoriamente dentre as presentes na lista da Associação de Bares e Restaurantes. Os resultados dos checklists foram analisados de acordo com os critérios de pontuação da Resolução ANVISA nº 275/2002. Resultados Cinco unidades possuíam nutricionista como responsável técnico e foram as que obtiveram maior conformidade no check-list da ISO. Nenhuma das unidades atingiu mais de 50% dos requerimentos das ISO 14001 e 22000, o que mostra a falta de preocupação com as questões ambientais e o não cumprimento da legislação vigente sobre coleta seletiva de lixo. Conclusão As unidades pesquisadas não possuem uma produção de refeições segura, conforme estabelecido nas normas de referência, e não se dedicam a diminuir o impacto ambiental gerado por seus resíduos poluentes. As unidades que têm um nutricionista apresentaram-se em melhores condições de produzir alimentos seguros para a população.Objective The objective of this study was to assess food service environmental and food safety management systems according to two checklists based on ABNT ISO 22000 and 14001. Methods This exploratory and descriptive study investigated a-la-carte food services of the Federal District, Brazil. Two checklists were developed to investigate ISO 14001 and 22000 compliance. A total of 37 food services were selected from the list of the Brazilian Association of Bars and Restaurants by simple random sampling. Checklist results were analyzed according to ANVISA resolution nº 275/2002. Results Only five food services employed dietitians to supervise meal production. These establishments achieved the highest ISO compliance. However, no establishment had more than 50% ISO 14001 or 22000 compliance. Restaurants showed little concern for the environment and disobeyed waste disposal laws by not separating recyclables from non-recyclables. Conclusion The study food services do not have safe meal production systems, evidenced by non-conformity with the reference standards. Additionally, they do not attempt to reduce the environmental impact of their wastes. Food services supervised by dietitians are better prepared to produce safe foods

Incidence and risk factors for tuberculosis in people living with HIV: cohort from HIV referral health centers in Recife, Brazil.

OBJECTIVE: To identify the incidence of and risk factors for tuberculosis in people living with HIV (PLHIV). DESIGN: Observational, prospective cohort study. METHODS: A total of 2069 HIV-infected patients was observed between July 2007 and December 2010. The Kaplan-Meier method was used to estimate the probability of survival free of tuberculosis, and Cox regression analysis to identify risk factors associated with the development of tuberculosis. RESULTS: Survival free of tuberculosis (TB) was 91%. The incidence rate of tuberculosis was 2.8 per 100 persons/years. Incidence of tuberculosis was higher when subjects had CD4 cell count <200 cells/mm(3); were not on antiretroviral therapy; in those who had, a body mass index <18.5 kg/m(2), anemia (or were not tested for it), were illiterate or referred previous tuberculosis treatment at entry into the cohort. Those not treated for latent TB infection had a much higher risk (HR = 7.9) of tuberculosis than those with a negative tuberculin skin test (TST). Having a TST≥5 mm but not being treated for latent TB infection increased the risk of incident tuberculosis even in those with a history of previous tuberculosis. CONCLUSIONS: Preventive actions to reduce the risk of TB in people living with HIV should include an appropriate HAART and treatment for latent TB infection in those with TST≥5 mm. The actions towards enabling rigorous implementation of treatment of latent TB infection and targeting of PLHIV drug users both at the individual and in public health level can reduce substantially the incidence of TB in PLHIV

GWAS in Breast Cancer

Breast cancer is the most diagnosed cancer in women, and the second cause of cancer-related deaths among women worldwide. It is expected that more than 240,000 new cases and 40,450 deaths related to the disease will occur in 2016. It is well known that inherited genetic variants are drivers for breast cancer development. There are many mechanisms through which germline genetic variation affects prognosis, such as BRCA1 and BRCA2 genes, which account for approximately 20% of the increased hereditary risks. Therefore, it is evident that the genetic pathways that underlie cancer development are complex in which networks of multiple alleles confer disease susceptibility and risks. Global analyses through genome-wide association studies (GWAS) have revealed several loci across the genome are associated with the breast cancer. This chapter compiles all breast GWAS released since 2007, year of the first article published in this area, and discuss the future directions of this field. Currently, hundreds of genetic markers are linked to breast cancer, and understanding the underlying mechanisms of these variants might lead to the discover of biomarkers and targets for therapy in patients

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Avaliação da adequação de unidades produtoras de refeições do Distrito Federal quanto às normas ABNT ISO 14001:2004 e 22000:2006

Monografia (especialização)—Universidade de Brasília, Centro de Excelência em Turismo, 2008.Objetivo: Avaliar em estabelecimentos produtores de refeições o Sistema de Gestão de Segurança de Alimentos e o Sistema de Gestão Ambiental de acordo com o cumprimento das normas ABNT ISO 22000:2006 e 14001:2004. Métodos: Nesta pesquisa foi realizado um estudo de natureza exploratório descritivo em unidades com a modalidade de serviço a Lá carte do Distrito Federal. Foram elaborados dois check-lists a partir das normas ISO 22000 e 14001. A amostra foi estabelecida a partir da Lista de Associados da Associação Brasileira de Bares e Restaurantes. Através de um estudo estatístico determinou-se 37 unidades participantes que foram sorteadas aleatoriamente. Os resultados dos check-lists foram analisados de acordo com os critérios de pontuação da Resolução da ANVISA RDC nº 275, de 21 de outubro de 2002. Resultados: Cinco unidades possuíam nutricionista como responsável técnico. Essas foram as que obtiveram melhor classificação de conformidade no check-list-01 em relação aos requisitos gerais do SGSA e da responsabilidade da direção. Entretanto, 100% das unidades apresentarem-se no grupo 3 de conformidade em relação ao cumprimento do check-list-01. Em relação ao check-list-02, também se observou que 100% das unidades estão no grupo 3 de conformidade para o check-list-02, notando-se a falta de preocupação dessas unidades com as questões de impacto ambiental e o não cumprimento da legislação vigente sobre coleta seletiva de lixo. Conclusão: As unidades pesquisadas não possuem uma produção de refeições segura e tampouco se dedicam a diminuir o impacto ambiental gerado por seus resíduos poluentes. As unidades que têm um nutricionista apresentaram-se em melhores condições de produzir alimentos seguros para a população. Entretanto, o instrumento utilizado (ISOs) é mais complexo para ser implementado do que a própria legislação nacional, resultando em muitas não-conformidades e, conseqüentemente, a classificação das unidades no grupo 3 de conformidade.Objective: Classify a sample of 37 food services located in the Federal District (Brasília, Brazil), acording to their fulfillment of essential requisites contained in two forms created from two norms published by ISO 22000:2006 and ISO 14001:2004, in order to evaluate the Food Security Management System and the Environmental Management System. Methods: This research is a descritive and exploratory study accomplished on a Lá carte food services from the Federal District (Brasília, Brazil). Two forms were drawn up in subject blocks from the ISO 22000:2006 and the ISSO 14001:2004. The food services sample came from the List of Brazilians Restaurants and Bars Association. For the sample calculation, a statistic study was made and it resulted in 37 food services aleatory assorted. The forms result were analyzed according to the punctuation of the Brazil’s Sanitary Surveillance National Agency 275 directive, from october 21st of 2002. Results: Only five food services have nutritionists as the responsible for the meals production. These food services got the best classification for the subjetct block A and block B of form-01. However, all the establishments were classified on group 3 of ISO\ud 22000:2006’s assentments. For the form-02, all establishments were classified on group 3 of assentments to the ISO 14001:2004, pointing out the lack of concern to the environment. Conclusion: The results indicate that the establishments researched don’t have a safe meal production, nevertheless the concern with it’s environment impact. The establishments with a nutritionist as a responsible for the meal production show the best results from the food safety aspect. However, the instrument (ISO) used in this study is more complex than the Sanitary Surveillance National Agency 275 directive. Therefore, all the establishments result on group 3 of ISO 22000:2006’s and ISO 14001:2004 assentments

Frequencies and bivariate analysis of the association between demographic, socioeconomic and lifestyle factors with the development of tuberculosis in people living with HIV, Recife, 2010.

<p>Frequencies and bivariate analysis of the association between demographic, socioeconomic and lifestyle factors with the development of tuberculosis in people living with HIV, Recife, 2010.</p