Perfil dos catadores do lixão da estrutural – DF : uma abordagem a luz da economia da saúde

Trabalho de Conclusão de Curso (graduação)—Universidade de Brasília, Faculdade de Ceilândia, Curso de Graduação em Saúde Coletiva, 2018.Os catadores de lixo constituem trabalhadores informais cuja subsistência vem de aterros ou lixões, o que implica um modo peculiar de vida com repercussões sociais e de saúde. O estudo objetivou descrever o perfil socioeconômico e demográfico dos catadores do Lixão da Estrutural – DF, além de analisar que ações estão sendo tomadas com relação à proteção social desses trabalhadores no âmbito da economia da saúde em virtude da implementação do aterro sanitário, previsto pela Lei 12.305/10 que prevê a erradicação dos lixões de todo território nacional. Trata-se de um estudo de caráter descritivo, com uma abordagem censitária. Foi feita uma análise secundária dos dados abordando aspectos sociodemográficos e econômicos relacionados aos catadores do lixão da estrutural como sexo, idade, estado civil, escolaridade, número de filhos, renda per capita média, horas de trabalho, tempo de catação e contribuição social. Esses dados foram submetidos a uma análise estatística mediante verificação de frequência simples, valor absoluto e média através do programa Excel For Windows (2013). As representações dos catadores configuram-se em duas matrizes simbólicas, as quais mostram a vinculação do lixo à imagem do catador, que vivencia estigma e exclusão social; além disso, essas matrizes mostram a dualidade exclusão/inclusão e os dilemas entre necessidade de sustento e enfrentamento dos riscos. Conclui-se que os catadores refletem os impactos sociais e econômicos que sofrem por trabalhar no lixo em condições degradantes e insalubres, por isso, necessitam de ações protetivas e governamentais inclusivas.The garbage pickers are casual workers that subsisting on scavenging in landfills what it implies a peculiar way of life with social repercussions and health. HIs study made a comparison of socioeconomic, demographic profiles of Structural City Dump - DF, beyond analyzing that actions are being taken about the social protection of these workers in the scope of the economy of the health in virtue of the implementation of it fill. foreseen for Law 12,305/10 that it foresees the eradication of the dumps of all domestic territory. One is about a study of descriptive character, with a tax boarding. A secondary analysis of the data was made approaching socioeconomic and demographic aspects related to the garbage pickers of the Structural City Dump as the sex, age, been civil, number of children, average per capita income, working hours, time of picked garbage and social contribution. These data were submitted to a statistical analysis by simple frequency verification, absolute and average values through the program Excel For Windows (2013). The representations of the collectors are configured in two symbolic matrices, which show the entailing of the garbage to the image of the collector, that lives deeply stigma, and social exclusion; moreover, these matrices show to the exclusion/inclusion and the quandaries between sustenance necessity and confrontation of the risks. It is concluded that the collectors reflect the social and economic impacts they suffer from working in the garbage in degrading and unhealthy conditions, so they need inclusive and protective governmental actions

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)