Inclusão social pelo trabalho: percepções da primeira experiência de emprego em jovens de baixa renda / Social inclusion through work: perceptions of the first employment experience in low income young people / Inclusión social a través del trabajo: percepciones de la primera experiencia laboral en jóvenes de bajos ingresos

OBJETIVO: Este estudo teve como objetivo propor um modelo cognitivo/explicativo que represente as mudanças que podem ser incorporadas à vida de jovens de baixa renda, a partir de sua primeira experiência de emprego formal. MÉTODO: A amostra do estudo foi composta por 25 jovens beneficiários do Programa Primeiro Emprego/BA, que participaram de grupos focais on-line. Para a análise, as falas foram inicialmente categorizadas por meio da análise de conteúdo temática e, em seguida, visando uma sistematização e o estabelecimento de uma relação entre as categorias adotadas, foi utilizada a técnica do mapeamento cognitivo. RESULTADOS: A partir da análise das falas dos jovens, foram identificados 29 núcleos de sentidos, distribuídos em torno da tríade indivíduo- trabalho-sociedade. Entre as mudanças pessoais percebidas, destacam-se a valorização e o crescimento pessoal, assim como questões financeiras. Nas mudanças laborais, o aumento da empregabilidade como resultado da maior qualificação profissional e das novas habilidades técnicas adquiridas foi amplamente citado. Por fim, no que diz respeito às mudanças sociais, a percepção de alteração do status social ficou evidente. A maioria das mudanças observadas foram positivas e indicaram um aumento na qualidade de vida dos jovens de baixa renda. CONCLUSÃO: Conclui-se, portanto, que para uma modificação dos padrões de reprodução da força de trabalho juvenil, baseados na precarização e na subalternidade, é necessária uma transformação da realidade laboral dos seus atores.

OBJECTIVE: This study aimed to propose a cognitive/explanatory model that represents the changes that can be incorporated into the lives of low-income young people, from their first experience of formal employment. METHOD: The study sample consisted of 25 young beneficiaries of the First Employment Program/ BA, who participated in online focus groups. For the analysis, the speeches were initially categorized through thematic content analysis and, then, aiming at systematization and the establishment of a relationship between the adopted categories, the cognitive mapping technique was used. RESULTS: Based on the analysis of the young people's statements, 29 nuclei of meanings were identified, and distributed around the individual-work-society triad. Among the perceived personal changes, valorization and personal growth stand out, as well as financial issues. In terms of job changes, the increase in employability as a result of higher professional qualifications and new technical skills acquired was widely cited. Finally, with regard to social changes, the perception of change in social status was evident. Most of the changes observed were positive and indicated an increase in the quality of life of low-income youth. CONCLUSION: It is concluded, therefore, that for a change in the system, a transformation of the work reality of its actors is necessary.

OBJETIVO: Este estudio tuvo como objetivo proponer un modelo cognitivo/explicativo que represente los cambios que pueden incorporarse en la vida de jóvenes de bajos ingresos, a partir de su primera experiencia de empleo formal. MÉTODO: La muestra del estudio estuvo compuesta por 25 jóvenes beneficiarios del Programa Primeiro Emprego/BA, que participaron de grupos focales en línea. Para el análisis, los enunciados fueron inicialmente categorizados a través del análisis de contenido temático y luego, con el objetivo de sistematizar y establecer una relación entre las categorías adoptadas se utilizó la técnica del mapeo cognitivo. RESULTADOS: A partir del análisis de los enunciados de los jóvenes, se identificaron 29 centros de significado, distribuidos en torno a la tríada individuo-trabajo-sociedad. Entre los cambios personales percibidos se destacan la apreciación y el crecimiento personal, así como las cuestiones financieras. En los cambios laborales se citó ampliamente el aumento de la empleabilidad como consecuencia de una mayor cualificación profesional y de nuevas competencias técnicas adquiridas. Finalmente, en lo que respecta a los cambios sociales, se hizo evidente la percepción de cambios en el estatus social. La mayoría de los cambios observados fueron positivos e indicaron un aumento en la calidad de vida de los jóvenes de bajos ingresos. CONCLUSIÓN: Se concluye, por tanto, que para modificar los patrones de reproducción de la fuerza laboral juvenil, basados en la precariedad y la subalternidad, es necesaria una transformación de la realidad laboral de sus actores.

Efectividad del modelo Individual Placement and Support en el trastorno mental grave: revisión sistemática / Effectiveness of the Individual Placement and Support model in severe mental disorder: a systematic review / Efetividade do modelo Individual Placement and Support em transtorno mental grave: uma revisão sistemática

Resumen Introducción El empleo es uno de los principales determinantes del estado general de salud. Para las personas que padecen un trastorno mental grave obtener un empleo supone un punto crucial en su recuperación por lo que la búsqueda, adquisición y mantenimiento de un empleo son objetivos fundamentales para las intervenciones de terapia ocupacional en esta población. Objetivos Conocer los resultados de las intervenciones de terapia ocupacional basadas en el modelo Individual Placement and Support sobre la inserción laboral y la calidad de vida de personas con trastorno mental grave. Método Se empleó la declaración PRISMA según los criterios establecidos por Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Las búsquedas se realizaron en las bases de datos: PubMed, Web of Science, Scopus y Cochrane. El riesgo de sesgo se evaluó con la herramienta Review Manager Web. El protocolo de revisión se registró en PROSPERO: CRD42023418778. Resultados Se incluyeron 12 estudios. El rango de edad de los participantes oscila entre los 18 y 53 años, predominando el género masculino. Los resultados vocacionales demuestran que la tasa de empleo fue al menos un 20% mayor en el grupo de apoyo individualizado al empleo que en el grupo control. No se encontraron hallazgos concluyentes para los resultados no vocacionales. Conclusión Los resultados sugieren que este modelo es efectivo en la inserción laboral de las personas con trastorno mental grave. Son necesarios futuros estudios con mayor rigor metodológico para confirmar la eficacia de este modelo en las variables no vocacionales.

Abstract Introduction Employment is one of the main determinants of general health status. For people suffering from serious mental disorders, obtaining a job is a crucial point in their recovery, which is why finding, acquiring, and maintaining a job are fundamental objectives for occupational therapy interventions with this population. Objective Find out the results of occupational therapy interventions based on the Individual Placement and Support model in the labor market insertion and quality of life of people with severe mental disorders. Method A review was conducted according to the criteria established by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Searches were carried out in the following databases: PubMed, Web of Science, Scopus, and Cochrane. Risk of bias was assessed using the Review Manager Web tool. The review protocol was registered at PROSPERO: CRD42023418778. Results Twelve studies were included. Participants ranged in age from 18 to 53 years, with predominance of males. Vocational results show that the employment rate was at least 20% higher in the individualized employment support group than in the control group. No conclusive findings were found for non-vocational outcomes. Conclusion The results suggest that this model is effective in the employability of people with severe mental disorders. Future studies with greater methodological rigor are needed to confirm the effectiveness of this model in non-professional variables.

Resumo Introdução O trabalho é um dos principais determinantes do estado geral de saúde. Para pessoas que sofrem de transtorno mental grave, conseguir um emprego é um ponto crucial em sua recuperação, razão pela qual encontrar, adquirir e manter um emprego são objetivos fundamentais para intervenções de terapia ocupacional nessa população. Objetivo Conhecer os resultados das intervenções de terapia ocupacional baseadas no modelo Individual Placement and Support sobre a inserção no mercado de trabalho e a qualidade de vida de pessoas com transtorno mental grave. Método Uma revisão foi conduzida de acordo com os critérios estabelecidos pelo Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). As buscas foram realizadas nos seguintes bancos de dados: PubMed, Web of Science, Scopus e Cochrane. O risco de viés foi avaliado usando a ferramenta Review Manager Web. O protocolo de revisão foi registrado no PROSPERO: CRD42023418778. Resultados Doze estudos foram incluídos. A idade dos participantes variou de 18 a 53 anos, com predominância do sexo masculino. Os resultados vocacionais demostram que a taxa de emprego foi pelo menos 20% maior no grupo de apoio individualizado ao emprego do que no grupo controle. Não foram encontrados achados conclusivos para os resultados não vocacionais. Conclusão : Os resultados sugerem que esse modelo é eficaz na integração ocupacional de pessoas com transtorno mental grave. São necessários estudos futuros com maior rigor metodológico para confirmar a eficácia desse modelo em variáveis não profissionais.

Quality of Life and Financial Impacts of Permanent Colostomy for Rectal Cancer

Abstract Introduction Returning to work is an important cancer recovery milestone. Permanent colostomy can be required for rectal cancer treatment and can significantly impact well-being. We aimed to evaluate the impact of permanent colostomy on health-related quality of life and return to work in patients with rectal cancer. Methods This was a retrospective cohort study on 23 employed patients receiving curative surgery for rectal cancer requiring permanent colostomy. Demographic and health-related quality-of-life questionnaires (the Colostomy Impact Score (CIS), the EORTC Quality of Life Questionnaire (QLQ)-C30, and the EORTC QLQ-CR29) were posted to eligible patients. Results On average, patients (10 female, 13 male, mean age 61.8 years) were 5.0 ± 3.5 years post-surgery. At the time of questioning, 73.9% had returned to work (21.7% changed their type of work), while 17.4% never returned to work. Of those that returned to work, 11.8% returned within 1 month of surgery, while 23.5% had not returned after 12 months. Comparison of CIS between patients that returned to the same work (14.6 ± 0.93), changed their work (13.0 ± 0.74), and did not return to work (14.3 ± 2.3) revealed no significant differences (p = 0.36). CIS did not correlate with days worked on return, or time to return to work (p > 0.05). Conclusion Returning to work following rectal cancer treatment with permanent colostomy is challenging, with 17.4% never returning to work. Of those who returned to work, 23.5% required more than 12 months. This was not associated with CIS in our study.

¡Ey parce! Estoy buscando camello: Cómo las redes de los contactos sociales definen la situación laboral de jóvenes en sectores populares y marginados de Cali

La búsqueda de empleo usando los contactos sociales a pesar de ser una práctica común, en ocasiones no genera los resultados esperados. Con el objetivo de comprobar lo anterior; en este documento se configuran las redes de contactos sociales de un grupo de jóvenes que viven en contextos de marginalidad y violencia de las comunas 1, 14, 16, 18 y 20 de Cali que participaron en el programa denominado Tratamiento Integral a Pandillas - Jóvenes Sin Fronteras (TIP-JSF), un proceso de intervención psicosocial desde una perspectiva integral que promovía la inclusión social. Las redes de contactos sociales halladas a través de una encuesta se caracterizan por ser pequeñas y cerradas, aumentando la probabilidad de que quienes las conforman, presenten el mismo estado laboral: desempleo o informalidad laboral. Es clave, entonces, que las/os jóvenes amplíen sus contactos para que los vinculen con otros que les puedan brindar información de mejores vacantes laborales.

The search for employment using social contacts, despite being a common practice, sometimes does not generate the expected results. In order to verify the above, this paper describes the social contact networks of a group of young people living in contexts of marginality and violence in Cali's communes 1, 14, 16, 18 and 20 who participated in the program called Integral Treatment for Gangs - Youth Without Borders (TIP-JSF), a process of psychosocial intervention from an integral perspective that promoted social inclusion. The social networks found through a survey are characterized by being small and closed, increasing the likelihood that those who make up these networks have the same employment status: unemployment or informal employment. It is essential for young people to expand their contacts and link them with other contacts that can provide them with information on better job vacancies.

A busca de emprego usando contatos sociais, apesar de ser uma prática comum, às vezes não gera os resultados esperados. Para verificar isso, este artigo descreve as redes de contatos sociais de um grupo de jovens que vivem em contextos de marginalidade e violência nas comunas 1, 14, 16, 18 e 20 de Cali e que participaram do programa chamado Tratamento Integral para Gangues - Jovens Sem Fronteiras (TIP-JSF), um processo de intervenção psicossocial de uma perspectiva holística que promoveu a inclusão social. As redes sociais encontradas por meio de uma pesquisa são caracterizadas por serem pequenas e fechadas, aumentando a probabilidade de que aqueles que as formam tenham a mesma situação de emprego: desemprego ou emprego informal. É fundamental, portanto, que os jovens ampliem seus contatos para conectá-los a outras pessoas que possam lhes fornecer informações sobre melhores vagas de emprego.

Descripción de las medidas laborales adoptadas ante la pandemia Covid-19 en Colombia: características y alcance

Con la declaratoria de la emergencia sanitaria ante la pandemia mundial por Covid-19, el gobierno empezó a implementar una serie de medidas para mitigar el riesgo de contagio, con grandes consecuencias en el sector económico, especialmente en materia laboral. Este artículo describe la normatividad laboral expedida durante el año 2020, realizando una caracterización frente a su alcance y actores afectados. Para ello, se utilizó una metodología cualitativa mediante análisis documental, con la normatividad nacional como unidad de análisis principal, e investigaciones sobre medidas laborales a nivel internacional como fuentes comparativas. Los resultados del análisis permiten llegar a un mapa conceptual representado por la normatividad en las categorías de protección laboral y fiscal, de la que se derivan clasificación por actores/beneficiarios y un comparativo con las principales medidas en las principales regiones del mundo, identificando que las medidas no alcanzaron la efectividad esperada dadas las altas tasas de desempleo e informalidad que se mantienen desde el año 2020 a la fecha.

With the declaration of a health emergency in the face of the global Covid-19 pandemic, the government began to implement a series of measures to mitigate the risk of contagion, with significant consequences in the economic sector especially in labor matters. This article describes the labor regulations issued during the year 2020, characterizing their scope and affected actors. For this, a qualitative methodology was used through documentary analysis, with national regulations as the main unit of analysis, and research on labor measures at the international level as comparative sources. The results of the analysis allow us to arrive at a conceptual map represented by the regulations in the categories of labor and fiscal protection, from which classification by actors/beneficiaries and a comparison with the main measures in the central regions of the world are derived, identifying that the measures did not reach the expected effectiveness given the high rates of unemployment and informality that have been maintained since 2020 to date.

Com a declaração de emergência sanitária face à pandemia global por Covid-19, o Governo passou a implementar um conjunto de medidas para mitigar o risco de contágio, com grandes consequências no setor económico, sobretudo em matéria laboral. Este artigo descreve os regulamentos trabalhistas emitidos durante o ano de 2020, fazendo uma caracterização quanto ao seu alcance e atores afetados. Para isso, utilizou-se uma metodologia qualitativa por meio da análise documental, tendo como principal unidade de análise as normativas nacionais, e a pesquisa sobre medidas trabalhistas em nível internacional como fontes comparativas. Os resultados da análise permitem chegar a um mapa conceitual representado pelas regulamentações nas categorias de proteção trabalhista e fiscal, do qual deriva a classificação por atores/beneficiários e uma comparação com as principais medidas nas principais regiões do mundo, identificando que as medidas não atingiram a efetividade esperada dados os altos índices de desemprego e informalidade que se mantêm desde 2020 até o momento.

Condicionantes para la participación laboral de las personas con discapacidad por lesión medular atendidas en un instituto especializado de rehabilitación

Objetivo : Determinar los factores condicionantes para la participación laboral de las personas con discapacidad por lesión medular de un instituto especializado de rehabilitación. Material y métodos : Estudio observacional, retrospectivo y relacional; se incluyeron 224 pacientes con lesión medular del Departamento de Investigación, Docencia, y Atención en Ayuda al Tratamiento del Servicio de Rehabilitación Profesional que fueron atendidos en el periodo 2016 al 2019. Se recolectaron variables clínicas, sociodemográficas y contextuales; y la actividad económica antes y después de la lesión. Resultados : El 65 % de pacientes fueron del sexo masculino, de edad media de 38,61 ± 13,33; según el nivel de lesión medular el 85,3% de pacientes tenía paraplejia, el 62,5% con grado de lesión en la escala ASIA A; el tiempo de evolución fue de más de 1 año 30,4%, estado civil soltero 52,2%, de procedencia Lima y provincias el 51,3%, con grado de instrucción de secundaria 50,9%, nivel socioeconómico de pobreza extrema en 61%. Se encontró diferencia significativa entre la participación laboral antes de la LM y el sexo (p<0,01) y la condición laboral (p<0,0069). La participación laboral después de la LM tuvo una diferencia significativa con el nivel socioeconómico (p<0.005) y el grado de lesión en la escala ASIA (p<0,014). El análisis de regresión logística mostró que el único factor asociado con la participación laboral fue el tiempo transcurrido de la lesión medular (p=0,039; OR=19,9). Conclusiones : Los pacientes con LM con menores ingresos económicos ubicados en grupos de pobreza pobre extremo y no extremo tuvieron mayor participación laboral; así como los que tuvieron un mayor grado de lesión en la escala ASIA. Asimismo, el único factor predictor de la participación laboral fue el tiempo transcurrido desde la lesión.

SUMMARY Objective : To determine the conditioning factors for labor participation in persons with disability due to spine lesions attended at a specialized rehabilitation center. Methods : A retrospective observational study was carried out at the Departamento de Investigación, Docencia, y Atención en Ayuda al Tratamiento del Servicio de Rehabilitación Profesional from 2016 to 2019, 224 patients were evaluated. Clinical, sociodemographic and contextual variables were collected as well as economic activity before and after the trauma. Results : 65% of patients were males; mean age was 38.61 ± 13.33; 85.3% had paraplegia and 63.5% had a lesion grade A on the ASIA scale; duration of illness was higher than one year in 30.4%; 52.2% were single; 51.3% come from provinces of Peru; 50.9% had secondary school level and 61% lived in extreme poverty. A significative difference for labor participation was found between sex (p<0.01) and labor condition (p<0.014) before the spinal lesion. Labor participation after the spinal lesion correlated with socioeconomic level (p<0.005) and the degree of the lesion based on the ASIA scale (p<0.014). The logistic regression analysis found that only duration of illness correlated with labor participation (p=0.039; OR=19.9). Conclusions : Patients with spinal lesions who lived in extreme poverty had higher labor participation as well as those with higher scores in the ASIA scale. The only predicting factor for labor participation was duration of illness.

Sentidos y significados atribuidos al autoempleo por cuatro profesionistas de la psicología en el contexto mexicano

La flexibilización y precarización estructural del trabajo han llevado, entre otros trabajadores, a un grupo de profesionistas de la psicología a identificar en el autoempleo una forma viable para desempeñarse en la actualidad. Esta experiencia ha representado para ellos una actividad performática que los reta a reinventarse continuamente para adaptarse a los cambios del mercado laboral y que trasforma los sentidos y significados que atribuyen al autoempleo. Con el objetivo de conocer y comprender esos sentidos y significados atribuidos al autoempleo, por medio de un estudio cualitativo de las narrativas y asociaciones de tres psicólogas y un psicólogo autoempleados en México se realizó este estudio. Los resultados develan las experiencias de autoempleo como articulación entre nuevas libertades y dependencias, que significan el trabajo para las y los participantes y desmitifican algunas retóricas del autoempleo. Concluimos que es urgente que las políticas laborales y educativas correspondan a estas realidades actuales del ejercicio libre de las profesiones, no sólo de la psicología.

The flexibilization and structural precariousness of work have led, among other workers, a group of psychology professionals to identify self-employment as a viable way of working in today's world. This experience has represented for them a performative activity, challenging them to reinvent continually themselves in order to adapt to changes in the labor market and transforming the sense and meanings they attribute to self-employment. With the objective to know and understand the sense and meaning attributed to work, the narratives and associations of four self-employed psychologists in Mexico were analyzed through a qualitative study. The results disclose the experiences of self-employment as an articulation between new freedoms and dependencies, which signify work for the participants and demystify some self-employment rhetoric. There is an urgent need for labor and educational policies to adjust to the actual realities of free professionals' practice, not only in the field of psychology.

A flexibilidade e a precariedade estrutural do trabalho levaram, entre outros trabalhadores, um grupo de profissionais da psicologia a identificar no trabalho autônomo uma forma viável de atuar na atualidade. Esta experiência tem representado para eles uma atividade de desempenho que os desafia a reinventar-se continuamente para se adaptar às mudanças do mercado de trabalho e que transforma os sentidos e significados que atribuem ao trabalho por conta própria. Este estudo foi realizado com o objetivo de conhecer e compreender esses sentidos e significados atribuídos ao trabalho autônomo, através de um estudo qualitativo das narrativas e associações de três psicólogos e psicólogos autônomos no México. Os resultados revelam as vivências do trabalho autônomo como articulação entre novas liberdades e dependências, que significam trabalho para os participantes e desmistificam algumas retóricas do trabalho autônomo. Concluímos que é urgente que as políticas laborais e educativas correspondam a estas realidades atuais do livre exercício das profissões, não só da psicologia.

Representações e Práticas Sociais em Disputa: O Trabalho Doméstico Remunerado Segundo Relatos em Rede Social / Representations and Social Practices in Dispute: Paid Domestic Work According to Social Network Reports / Representaciones y Prácticas Sociales en Disputa: Trabajo Doméstico Remunerado Según Relatos en Red Social

Este estudo documental objetivou analisar as representações sociais sobre o trabalho doméstico remunerado compartilhadas na página do Facebook "Eu, Empregada Doméstica" e as práticas sociais delas decorrentes. Para tanto, foram coletados 276 relatos, que compuseram o corpus submetido a uma Classificação Hierárquica Descendente no software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaire (IRaMuTeQ). Os resultados indicaram a existência de cinco classes, denominadas: "Perspectivas", "Trajetórias", "Regras da Cozinha", "Relações de Trabalho" e "Tarefas". As análises demonstraram haver um dissenso representacional, caracterizado pelo confronto de uma perspectiva negativa sobre a profissão, em que as regras, as tarefas e as relações interpessoais estabelecidas eram marcadas por práticas de violência, e outra de caráter positivo, que consistia na afirmação identitária e na busca de uma realidade distinta da vivenciada enquanto trabalhadora doméstica. Concluiu-se, então, que os relatos divulgados retratam a disputa entre representações sociais hegemônicas, associadas ao cotidiano de trabalho, e representações sociais de oposição, manifestadas nas denúncias expostas pelas profissionais na rede social, sinalizando a presença de um movimento, em espaço digital, que visa transformar a realidade ainda negativa da profissão.

This documentary study aimed to analyse the social representations about paid domestic work shared on Facebook page "Eu, Empregada Doméstica" and the social practices arising from them. For this purpose, 276 reports were collected, which comprised the corpus submitted to a Descending Hierarchical Classification in the software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaire (IRaMuTeQ). The results indicated the existence of five classes, named: "Perspectives", "Trajectories", "Kitchen Rules", "Labor Relations" and "Tasks". The analysis demonstrated that there was a representational dissent, characterized by the confrontation of a negative perspective about the profession, in which the rules, tasks and interpersonal relationships established were marked by practices of violence, and another of a positive character, which consisted of the identity affirmation and in search of a different reality from that experienced as a domestic worker. It was concluded that the reports published portray the dispute between hegemonic social representations, associated with daily work, and opposition social representations, manifested in the denunciations exposed by professionals on social network, signalling the presence of a movement, in digital space, which aims to transform the still negative reality of the profession.

El presente estudio documental tuvo como objetivo analizar las representaciones sociales acerca del trabajo doméstico remunerado, compartidas en la página del Facebook: "Eu, Empregada Doméstica" y sus prácticas sociales decurrentes. Fueron colectados 276 relatos, que compusieron el corpus sometido a una Clasificación Jerárquica Descendente en el software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaire (IRaMuTeQ). Los resultados indicaron la existencia de cinco clases: "Perspectivas", "Trayectorias", "Reglas de la cocina", "Relaciones de Trabajo" y "Tareas". Los análisis demostraron haber un disenso representacional, caracterizado por el confronto de una perspectiva negativa sobre la profesión, en que las reglas, las tareas y las relaciones interpersonales establecidas eran marcadas por prácticas de violencia; y otra de carácter positivo, que consistía en la afirmación identitaria y la búsqueda de una realidad distinta vivida mientras trabajadoras domésticas. Se concluye, entonces, que los relatos divulgados retratan la disputa entre las representaciones sociales hegemónicas, asociadas al cotidiano de trabajo; y representaciones sociales de oposición, manifestadas en las denuncias expuestas por las profesionales en la red social, apuntando la presencia de un movimiento, en espacio digital, que objetiva transformar la realidad aún negativa de la profesión.

A complexidade do trabalho precário na Atenção Psicossocial Territorial: reflexão crítica sobre o contexto brasileiro / The complexity of precarious work in Territorial Psychosocial Care: critical reflection on the Brazilian context

RESUMO Este artigo propõe compreender, na perspectiva da Teoria da Complexidade, e por meio da reflexão teórica crítica, a precarização do trabalho enquanto realidade no mercado brasileiro do trabalho público da saúde e sua influência nos resultados de uma política pública baseada no paradigma teórico/ prático da Atenção Psicossocial Territorial. Traça uma possibilidade de problematização sobre o tema central, por meio dos princípios: sistêmico, hologramático, círculo retroativo, recursivo, autonomia/ independência, dialógico e o da reintrodução do conhecimento em todo conhecimento, propostos por Edgar Morin, diante das discussões e dos estudos realizados pelo Grupo de Pesquisa Vida e Trabalho sobre a precarização do trabalho e a saúde mental em campo concreto. Essa reflexão propõe-se a ser fonte de reconhecimento para os atores, sobre as causas reais da precarização, que derivam do modo de exploração do trabalho em saúde em estreitamente próprio da aplicação do receituário neoliberal em estados burocráticos autoritários situados na periferia do capitalismo dependente. A reflexão permitiu a compreensão do todo e das partes que constituem o problema, reconhecendo as causas reais da precarização, ao contrário da culpabilização dos trabalhadores da saúde mental, diante das condições insalubres, da jornada de trabalho e da insegurança sobre os direitos sociais e direitos trabalhistas.

ABSTRACT This article proposes to understand, from the perspective of Complexity Theory, and through critical theoretical reflection, the precarization of work as a reality in the Brazilian public health work market, and its influence on the results of a public policy based on the theoretical/practical paradigm of Territorial Psychosocial Care. It outlines a possibility of problematizing the central theme, through the principles: systemic, hologrammatic, retroactive circle, recursive, autonomy/independence, dialogic, and the reintroduction of knowledge in all knowledge, proposed by Edgar Morin, in view of the discussions and studies carried out by the Life and Work Research Group on the precariousness of work and mental health in a concrete field. This reflection is intended to be a source of recognition for actors on the real causes of precariousness, which derive from the way in which health work is exploited, which is closely related to the application of neoliberal prescriptions in authoritarian bureaucratic states located on the periphery of dependent capitalism. The reflection allowed the understanding of the whole and the parts that constitute the problem, recognizing the real causes of precariousness, which blame mental health workers, in the face of unhealthy conditions, working hours, and insecurity about social rights and labor rights.

Análise da empregabilidade de enfermeiros formados em uma instituição de ensino superior pública do interior / Analysis of the employability of nurses who graduated in a public higher education institution in the countryside / Análisis de la empleabilidad de enfermeras formadas en una institución pública de educación superior en el interior

Objetivo: Analisar a empregabilidade de enfermeiros formados em um campus do interior do Brasil. Métodos: Estudo transversal, realizado com 144 egressos de quatro turmas de um curso de enfermagem, na cidade de Floriano, Piauí. A coleta de dados foi realizada no segundo semestre de 2016, via Google Forms. Foram investigadas variáveis socioeconômicas, relacionadas à empregabilidade e ao grau de satisfação com a profissão. Resultados: 61 pessoas participaram do estudo e taxa de empregabilidade em torno dos 75%. O principal campo de atuação profissional foi na atenção hospitalar. Dentre os motivos para o desemprego, prevaleceu a falta de concursos públicos (33%) e a pouca oferta de emprego na região (25%). Conclusão: Os achados permitiram compreender as dificuldades enfrentadas pelos egressos no que diz respeito a inserção no mercado de trabalho, destacando a importância da qualificação profissional e o estímulo na ampliação de habilidades e competências na área de enfermagem. (AU)

Objective: To analyze the employability of nurses trained on campus in the interior of Brazil. Methods: A cross-sectional study was carried out with 144 graduates from four classes of a nursing course in the city of Floriano, Piauí. Data collection was carried out in the second half of 2016, via Google Forms. Socioeconomic variables related to employability and the degree of satisfaction with the profession were investigated. Results: 61 people participated in the study and the employability rate around 75%. The main field of professional activity was in hospital care. Among the reasons for unemployment, the lack of public examinations (33%) and the low job offer in the region (25%) prevailed. Conclusion: The findings allowed us to understand the difficulties faced by graduates about insertion in the labor market, highlighting the importance of professional qualification and the encouragement to expand skills and competencies in the field of nursing. (AU)

Objetivo: Analizar la empleabilidad de enfermeras formadas en un campus del interior de Brasil. Métodos: Estudio transversal realizado con 144 egresados de cuatro clases de un curso de enfermería en la ciudad de Floriano, Piauí. La recolección de datos se realizó en el segundo semestre de 2016, a través de Google Forms. Se investigaron variables socioeconómicas relacionadas con la empleabilidad y el grado de satisfacción con la profesión. Resultados: 61 personas participaron en el estudio y la tasa de empleabilidad ronda el 75%. El principal campo de actividad profesional fue la atención hospitalaria. Entre los motivos del desempleo, predominaron la falta de exámenes públicos (33%) y la baja oferta laboral en la región (25%). Conclusion: Los hallazgos permitieron comprender las dificultades que enfrentan los egresados con respecto a la inserción en el mercado laboral, destacando la importancia de la calificación profesional y el estímulo para expandir habilidades y competencias en el campo de la enfermería. (AU)

Working Beyond Retirement Age: A Systematic Review

@#Introduction: Population ageing brings along various crucial implications, with working beyond retirement age is one of the economics implications of ageing. Realizing the increasing demand and concern to accommodate older adults into the workforce, this review was conducted to develop better understanding on the factors associated with post-retirement employment among older adults aged 50 years and older. Methods: Using Scopus, ScienceDirect and PubMed databases, related articles between January 2017 and June 2021 were thoroughly searched using combination of keywords and screened according to the predetermined eligibility criteria. Post-retirement employment was defined as employment of older adults aged 50 years old and above beyond retirement age or re-employment of retired older adults, either from compulsory or voluntary retirement. All observational, qualitative, mixed methods and experimental studies were included in the screening process. The Crowe Critical Appraisal Tool (CCAT) was used to assess the quality of included articles. Results: A total of 12 articles included for review, with seven articles rated as high-quality. The review had successfully identified 10 factors associated with working beyond retirement age among older adults. Having good health status and being male gender were the commonest factors influencing the decision to work beyond retirement age, followed by level of education, financial commitment/ reasons, and work characteristics. Conclusion: The findings of this review provide a crucial insight and foundation towards addressing the unique needs of older workers in the employment policy.

Analysis of labor relationship in the diagnosis of occupational diseases / 中国职业医学

Unclear labor relationship is the most common challenging issue in occupational disease diagnosis. At present, there are three main errors in the understanding regarding labor relationship in the process of occupational disease diagnosis. Firstly, labor relationship does not need to be considered in occupational disease diagnosis. Secondly, labor relationship must exist in order to initiate the occupational disease diagnosis procedure. Lastly, there is an overreach in handling labor relationship issues beyond one's authority. Labor relationship is the basic and antecedent problem which cannot be avoided in occupational diseases diagnosis. While officially, labor relationship issue should be considered in occupational disease diagnosis, they are not a necessary condition. The occupational diseases diagnosis requires actual labor and employment relations. If the workers with actual labor-relation are suspected to have health injuries caused by occupational hazards in the workplace, they are eligible for occupational diseases diagnosis. But it is not the responsibility of health department to judge the labor relationship. When a dispute arises between a worker and an employer regarding labor relationship, the resolution of the relevant dispute shall be submitted to the human resources and social services department or the labor and personnel arbitration committee, or submitted to the court for adjudication according to law. In the process of occupational disease diagnosis, the two reasonable disposal procedures for verifying actual labor and employment relationship involve workers submitting evidence of their labor relationship with the employer, and the employer's verification. If the employer disputes the labor relationship as presented by the worker, the occupational disease diagnosis institution should inform the worker to apply for labor dispute arbitration. However, it is important to note that arbitration or mediation documents from the court cannot be used as evidence in occupational disease diagnosis.

Survey on satisfaction and employment intention of general practice residents in Shanxi province / 中华全科医师杂志

Objective:To survey the satisfaction and employment intention of general practice residents (GPRs) in Shanxi Province.Methods:A cross-sectional questionnaire survey was conducted in May 2021 among GPRs in Shanxi Province through the residency training information management platform. The questionnaire included general demographic information, clinical competency and independent practice ability, the status of the training base, their satisfaction with the training, career prospects and employment intention. The survey results were analyzed.Results:A total of 452 questionnaires were distributed, and 434 valid ones were recovered with an effective recovery rate of 96.02%. The age of respondents was (27.4±4.6) years, there were 155 GPRs (35.71%) enrolled in 2018, 131 GPRs (30.18%) in 2019, and 148 GPRs (34.10%) in 2020. A total of 286 GPRs (65.9%) thought that they were able to independently complete some procedures such as abdominal puncture, lumbar puncture, chest puncture, and bone puncture, and the proportion of GPRs who were able to complete the above procedures increased with the training time (49.3%(73/148), 70.2%(92/131), and 78.1%(121/155) in 2020, 2019, and 2018 batches, respectively, χ2=29.39, P<0.001); 372 respondents (85.7%) thought that they were able to independently receive patients with common diseases and make preliminary diagnosis and treatment, while there was no significant difference in the proportion of GPRs enrolled in 2020, 2019, and 2018 ( χ2=3.35, P=0.188); 425 GPRs (97.9%) expressed that the base arranged rotation according to the training syllabus; 390 GPRs (89.9%) thought that the proportion of knowledge and skill assessment in the final examination was appropriate. The survey showed that 70 GPRs (16.1%) thought that the number of cases and types of diseases in the teaching base fully met the requirements of the training program, 144 GPRs (33.2%) thought that mostly met the requirements, 197 GPRs (45.4%) thought that basically met the requirements, 22 GPRs (5.1%) thought that most of them did not meet the requirements, and 1 GPR (0.2%) thought that completely did not meet the requirements. Most of the respondents (368 (84.8%)) reported that they received guidance from clinical instructors for medical record writing; 174 (40.1%) and 172 (39.6%) GPRs were very satisfied or satisfied with general practice teachers and teaching base instructors; 207 GPRs (47.7%) were satisfied with accommodation (or subsidies), while 38 GPRs (8.3%) were very dissatisfied; 203 GPRs (46.8%) were satisfied with basic salary and benefit, while 35 GPRs (8.1%) were very dissatisfied. For general practice as the career, 88 GPRs (20.3%) liked it very much, 255 GPRs (58.8%) liked it, 67 GPRs (15.4%) did not like it very much, and 24 GPRs (5.5%) disliked it. For the prospects of general practice, 108 GPRs (24.9%) considered it very optimistic, 219 GPRs (50.5%) considered it relatively optimistic, 92 GPRs (21.2%) considered it not very optimistic, and 15 GPRs (3.5%) considered it very pessimistic. Regarding employment intentions, 174 GPRs (40.1%) intended to choose municipal hospitals, 170 GPRs (39.2%) to choose county level hospitals, only 9 GPRs (2.1%) to choose village clinics. Conclusions:The survey indicates that for GPRs the most dissatisfied aspects are the salary and benefit, as well as the living conditions during their training; after completing the contract, most GPRs hope to work in hospitals at county and above levels.

Research on Employment Quality Evaluation Index System of Medical Students based on Analytic Hierarchy Process / 中华医学教育探索杂志

Objective:To construct medical students' employment quality evaluation index system based on analytic hierarchy process (AHP), for providing basis to scientific and objective evaluation of medical students' employment quality.Methods:Two rounds of consultation with 21 experts were conducted to construct medical students' employment quality index and evaluation standard by Delphi method, and the weight of each index and evaluation standard determined by AHP. Excel 2007 and SPSS 21.0 were used to analyze the results of expert consultation. The enumeration data were expressed as frequency and percentage. The mean and coefficient of variation were used to describe the importance scores of experts on indicators at all levels. The positive coefficient, authority coefficient and coordination degree of experts were calculated, and the Kendall coordination coefficient ( W) test was carried out. Yaahp 6.0 is used to analyze the pairwise comparison matrix in the analytic hierarchy process to calculate the weight of the indicator. Results:The authority of expert consultation was ranged from 0.77 to 0.94, and the positive coefficient of experts was 100.00%. The evaluation system of medical students' employment quality was determined, which involved 3 first-class indexes, 9 second-class indexes and 35 third-class indexes, and the weight coefficients of each index were calculated by AHP.Conclusion:The evaluation index system of medical students' employment quality is reasonable, which can be used to provide reference standard for medical students' employment quality evaluation, and has certain application value.

Analyses on employment of clinical medical students of eight-year program and its implications to talent cultivation / 中华医学教育探索杂志

Objective:To analyze employment status and its tendency of eight-year program clinical medical graduates and explore its implications to talent cultivation using employment data from a university in Beijing.Methods:Descriptive analysis was used in this study. Indicators that were analyzed included quantity of employment, employment rate, employment region and specialty.Results:Between 2009 and 2021, a total of 2 281 eight-year clinical medical students graduated in the university. Among them, 2 188 (96.0%) of them were employed in the year of graduation. On average, 90.8% (2 034/2 241) of them were employed by medical institutions although the percentage decreased over years. A majority of them chose to work in economically developed provinces of eastern China. Those chose to work in Beijing accounted for 78.7% (1 723/2 188), the highest percentage among all provinces. The top two specialties of choice were surgery and internal medicine, which respectively accounted for 33.0% (753/2 281) and 24.4% (557/2 281). Only a few of them chose to study some specialties that were challenged by a serious shortage of physicians, including pediatrics, mental diseases and mental health.Conclusion:Although the employment status of eight-year clinical medical graduates are good, it is still necessary to pay attention to the new tendency of employment, and further improve training scheme. Meanwhile, more guidance on choice of secondary specialties are needed to build a competent talent team for specialty development. Finally, education of curriculum iedology and politics should be strengthened to encourage them to work in specialties and remote provinces that face a serious shortage of physicians.

On the employment directions of full-time master of health management in scientific research institutes / 中华医学教育探索杂志

Objective:To analyze the employment directions of full-time health management postgraduates in a scientific research institute in Beijing in recent five years and put forward relevant suggestions.Methods:Taking full-time masters of health management from 2015 to 2019 as the research objects, descriptive analysis was used to analyze the distribution of graduates' employment, and chi-square test was used to compare different training types and genders.Results:The employment rate remained at a high level of 100.0%, and there was no significant difference in the employment direction of the professional master and academic master. Hospitals and medical and health institutions were the main choices, and the trend was increasing in recent years. The employment direction of the graduates with different genders was significantly different due to the influence of income and stability.Conclusion:We should improve the professional training program, reflect the professional characteristics and advantages, strengthen the education of graduate career planning, and guide and help graduate employment.

Effects of Satir model group intervention on coping style, self-consistency and congruence and subjective well-being among re-employment nurses / 中国实用护理杂志

Objective:To investigate the effects of Satir model group intervention on stress coping style, self-consistency and congruence and subjective well-being of re-employment nurses, in order to provide evidence for nursing managers to take targeted intervention measures.Methods:This was a quasi-experimental study. Convenience sampling was used to select 63 re-employment nurses from Shandong Provincial Third Hospital in 2021 as the research objects. The re-employment nurses were divided into control group (32 cases) and observation group (31 cases) by random number table method. The control group received humanistic care including heart-to-heart talk, group discussion and psychological lecture, and the observation group received Satir model group intervention for 6 weeks. Simplified Coping Style Questionnaire, Self Consistency and Congruence Scale and General Well-Being Scale were used to evaluate the intervention effect before intervention, immediately after intervention, 3 months after intervention, and 6 months after intervention.Results:There was no significant difference in coping style, self-consistency and congruence and subjective well-being between the two groups before intervention ( P>0.05). The positive coping scores of the observation group immediately after intervention, 3 months after intervention and 6 months after intervention were (28.94 ± 2.99), (28.71 ± 4.70) and (29.16 ± 3.23) points, significantly higher than the control group (23.38 ± 5.50), (24.72 ± 5.91), (24.65 ± 5.65) points, the differences were statistically significant ( t=4.96, 2.96, 3.87, all P<0.01); the total self-consistency and congruence scores were (94.52 ± 14.00), (99.87 ± 16.82), (91.84 ± 10.36) points, significantly lower than the control group (105.72 ± 10.75), (114.23 ± 20.10), (107.41 ± 13.39) points, the differences were statistically significant ( t=-3.57, -3.07, -5.15, all P<0.01); the total subjective well-being scores were (84.97 ± 7.37), (84.58 ± 10.33), (91.84 ± 7.01) points, which were higher than the control group (75.69 ± 7.94), (77.28 ± 8.27), (77.00 ± 8.48) points, and the differences were statistically significant ( t=4.80, 3.69, 7.56, all P<0.01). Conclusions:Satir model group intervention can improve the coping style, enhance the level of self-consistency and congruence and subjective well-being among re-employment nurses.

A qualitative study on employment experiences of coordinators of In-Hospital Organ Procurement Organization / 中国实用护理杂志

Objective:To explore the employment experiences of coordinators of In-Hospital Organ Procurement Organization (OPO).Methods:Based on purpose sampling, 12 full-time In-Hospital OPO coordinators in Chongqing City were recruited from July to December 2020. A semi-structured and in-depth interview was performed and the data was analyzed by Colaizzi.Results:4 first-level themes were extracted, including professional identity process, negative emotional experience, improvement of professional practice competence and job expectancy. 12 second-level themes were identified including career expectations and identity confusion, professional values, shortage of respect and ratification, huge workloads, great psychological pressure, influence of the bereaved families, enhancement of the ability to communicate, improvement of problem-solving ability, improvement of team-work ability, optimization of scenario simulation, a perfection of the assessment system, a clear career path.Conclusions:In-Hospital OPO coordinators are lack of professional awareness in an initial stage. While feeling a sense of professional value, they also experience some negative emotions. Furthermore, their competences are improved in practice and they, meanwhile, express a strong desire for career development. It is suggested that the administrators could explore establishment of academic education, enhancement of psychological and social support, creation of pretty working environments and improvement of training, assessment and promotion systems to facilitate the career development of coordinators.

Indicadores de saúde bucal e inserção no mercado de trabalho: estudo descritivo com dados da Pesquisa Nacional de Saúde, Brasil, 2019 / Oral health indicators and job market insertion: a descriptive study with data from the National Health Survey, Brazil, 2019

Resumo Objetivo: descrever três indicadores de saúde bucal - as proporções de perda dentária, de consulta ao dentista e de frequência de escovação dentária - segundo o tipo de inserção na força de trabalho, no ano de 2019. Métodos: estudo descritivo realizado com dados da Pesquisa Nacional de Saúde de 2019. Foram incluídos indivíduos empregados ou desempregados, com 18 anos ou mais. Foram calculados os indicadores de saúde bucal, assim como seus respectivos intervalos de confiança de 95% (IC95%). Resultados: a amostra foi composta por 54.343 trabalhadores, sendo 29.889 (53,9%) do sexo masculino. A proporção de perda de 13 ou mais dentes foi maior no setor informal [10,5% (IC95%: 9,8;11,2)]. A proporção de pessoas que não consultaram um dentista nos últimos 12 meses foi maior no setor informal [51,9% (IC95%: 50,8;53,0)] e entre os desempregados [52,4% (IC95%: 49,6;55,2)]. Menor frequência de escovação dentária foi observada no grupo com vínculo informal de emprego [5,2% (IC95%: 4,7;5,6)] e entre indivíduos do sexo masculino [7,5% (IC95%: 6,8;8,2)]. Conclusão: piores indicadores foram encontrados entre os trabalhadores do setor informal ou desempregados e foram observadas desigualdades entre os sexos.

Abstract Objective: to describe three oral health indicators-the proportions of tooth loss, dental visits, and toothbrushing frequency-according to job market insertion in 2019. Methods: a descriptive study with data from the 2019 Brazilian National Health Survey (PNS). We included individuals aged from 18 years or older, irrespective of employment status. We calculated the oral health indicators, as well as their respective 95% confidence intervals (95%CI). Results: the sample was composed by 54,343 workers, 29,889 (53.9%) being male. The proportion of 13 or more teeth loss was higher in the informal employment sector [10.5% (95%CI: 9.8;11.2)]. The proportion of people that did not consult a dentist in the previous 12 months was higher in the informal sector [51.9% (95%CI: 50.8;53.0)] and among unemployed [52.4% (95%CI: 49.6;55.2)]. Lower toothbrushing frequency was observed in the informal workers' group [5.2% (95%CI: 4.7;5.6)] and among male workers [7.5% (95%CI: 6.8;8.2)]. Conclusion: worse oral health indicators were found among informal and unemployed workers, in addition to gender inequalities.

Exploring cross-country heterogeneity in the relation between female labor force participation and fertility in Latin America / Explorando a heterogeneidade entre países na relação entre participação feminina na força de trabalho e fecundidade na América Latina / Explorando la heterogeneidad entre países en la relación entre participación laboral de las mujeres y fecundidad en América Latina

Abstract In Latin America, despite an apparent convergence on the relation between female labor force participation (FLFP) and total fertility rates (TFR), there are differences between and within countries that must be considered. This paper aimed to understand the heterogeneity in the relation between the FLFP rate and the TFR in Latin American from 1990 to 2018 in order to identify cross-country patterns. Using World Bank data for the 20 countries in Latin America, clustering longitudinal data was performed, and mixed-effect models were fitted to quantify the heterogeneity. Three patterns of relationship were observed in Latin American countries: low TFR and intermediate FLFP, high TFR and high FLFP, and high TFR and low FLFP. The heterogeneity identified suggests the diversity of socio-economic and cultural factors influences the dynamics of the relation between FLFP and TFR in Latin America.

Resumo Na América Latina, apesar de uma aparente convergência na relação entre taxas de fecundidade total (TFT) e participação feminina na força de trabalho (PFFT), existem diferenças entre e dentro dos países que devem ser consideradas. Este artigo objetiva entender a heterogeneidade na relação entre a PFFT e a TFR na América Latina de 1990 a 2018, a fim de identificar padrões entre países. Usando dados do Banco Mundial para os 20 países da América Latina, dados de agrupamento longitudinal foram realizados e modelos de efeito misto foram ajustados para quantificar a heterogeneidade. Três padrões de relacionamento foram observados nos países latino-americanos: TFT baixa e PFFT intermediária; TFT alta e PFFT alta; e TFR alta e PFFT baixa. A heterogeneidade identificada sugere que a diversidade de fatores socioeconômicos e culturais influencia a dinâmica da relação entre PFFT e TFT na América Latina.

Resumen En América Latina, a pesar de una aparente convergencia en la relación entre las tasas globales de fecundidad (TGF) y la participación de femenina en la fuerza de trabajo (PFFT), hay diferencias entre y dentro de los países de la región, que deben ser consideradas. El objetivo de este trabajo es entender la heterogeneidad en la relación entre la tasa de PFFT y la TGF en América Latina desde 1990 hasta 2018, con el fin de identificar patrones entre países. Utilizando datos del Banco Mundial para los veinte países de América Latina, se agruparon datos longitudinales y se ajustaron modelos de efectos mixtos para cuantificar la heterogeneidad. Se observaron tres patrones de relación en los países de América Latina: baja TGF y PFFT intermedia; alta TGF y alta PFFT, y alta TGF y baja PFFT. La heterogeneidad identificada sugiere que la diversidad de factores socioeconómicos y culturales influye en la dinámica de la relación entre la PFFT y la TGF en América Latina.