ABSTRACT The election of the histrionic economist Javier Milei, self-identified as anarcho-capitalist, a complete outsider with ultraliberal economic ideas, conservative social ideas, and with authoritarianism overtones in relation with democratic institutions, it is a novelty for the Argentinean political system. Amid an economic crisis with inflation above 200%, the majority chose this outsider whose victory seemed impossible just one year before. The combination of economic voting and antisystem protest vote, with the promise of change and the failed electoral strategies of the traditional parties were key to produce this result. The incapacity of both traditional parties to resolve the long economic crisis during their terms in office generated a rejection of the status quo and an opportunity to renovate the political supply, which was leveraged by Milei. This article describes the emergence of Milei and the 2023 electoral results at all levels. It then moves to discuss the conditions that explain his victory and the perspectives for governability created by the combination of these electoral results and the new political system characterized by political fragmentation.

RESUMEN La elección del histriónico economista Javier Milei, autodenominado anarcocapitalista, un completo outsider con ideas ultraliberales en lo económico, conservadoras en lo social y con tintes autoritarios en relación a las instituciones democráticas, es sin duda una novedad para el sistema político argentino. En un contexto de crisis económica con una inflación interanual que superaba el 200%, la mayoría eligió a este outsider, cuya victoria parecía imposible un año antes. La combinación del voto económico y el voto protesta anti-sistema, con la promesa de cambio y las fallidas estrategias electorales de los partidos tradicionales fueron cruciales para este resultado. La incapacidad de ambas opciones tradicionales para resolver la larga crisis económica durante sus gestiones presidenciales provocó un rechazo del statu quo y una oportunidad para renovar la oferta política que fue aprovechada por Milei. Este artículo describe la emergencia de Milei y los resultados de las elecciones de 2023 en todos los niveles antes de discutir las condiciones que llevaron a su victoria y las perspectivas de gobernabilidad generadas por la combinación de estos resultados electorales y el nuevo sistema político caracterizado por la fragmentación política.

Resumen Los efectos de la democratización disparada con la reforma electoral de 1912 y las características de los gobiernos radicales han sido explorados en el caso de Mendoza a partir del triunfo de José N. Lencinas frente al líder del partido conservador Emilio Civit en 1918. En general, la literatura enfatizó las dotes personalistas del líder radical como acicate del éxito y posterior derrumbe del movimiento. No obstante, mediante un arduo trabajo de archivo que articuló la prensa y los diarios de sesiones, se restituyó la gravitación de las dirigencias políticas en la construcción del proyecto lencinista. Concretamente, la reconstrucción del itinerario del abogado lencinista Manuel Zuloaga permitió advertir la importancia del papel de estos cuadros intermedios y expertos en la configuración de este movimiento político y discutir sobre la supuesta incapacidad de los dirigentes lencinistas. Asimismo, el estudio de los elencos políticos arroja luz sobre las características especiales de las políticas públicas del lencinismo vinculadas a las fortalezas y debilidades de la gestión estatal y a su nuevo rol en lo social. Justamente, las los aportes de Zuloaga relacionados con el reformismo social fueron primordiales para el impulso de la legislación social que caracterizó al lencinismo.

Abstract The effects of the democratization triggered by the electoral reform of 1912 and the characteristics of the radical governments have been explored in the case of Mendoza since the triumph of José N. Lencinas over the conservative party leader Emilio Civit in 1918. In general, literature emphasized the personalistic qualities of the radical leader as the driving force behind the success and subsequent collapse of the movement. However, by means of arduous archival work that articulated the press and the session diaries, the gravitation of the political leadership in the construction of the lencinist project was restored. Specifically, by the reconstruction of the itinerary of the lencinist lawyer Manuel Zuloaga it was possible to highlight the importance of the role played by these intermediate cadres and experts in the shaping of this political movement and to discuss the supposed incapacity of the lencinists leaders. Likewise, the study of the political casts sheds light on the special characteristics of lencinist public policies linked to the strengths and weaknesses of state management and its new social role. It is precisely Zuloaga's contributions related to social reformism that were essential for the promotion of the social legislation that characterized lencinism.

BACKGROUND: Maintaining or promoting employment in the presence of disability or reducing the impact of disability on employability should be the adopted focus to decrease the negative impact that disability has on the economy and just as important on the livelihood and well-being of exposed insured individuals. Group risk disability insurance protects an employee's income when illness or injury result in work disability. To achieve this, factors that promote the success of rehabilitation and support for return-to-work of employees following illness and injury need to be understood from an insurance perspective. OBJECTIVES: To explore principles of disability claims management during the rehabilitation and work reintegration stage using a multi-stakeholder approach for the purpose of successful return to work. METHODS: An exploratory qualitative design was used to collect data via semi-structured interviews with 26 purposively selected participants. Interviews were audio-recorded, data were transcribed and analysed thematically. Qualitative research was used to understand the necessary role players in the work reintegration process, factors that hinder and promote work reintegration and best practice principles for Disability Claims Management (DCM). RESULTS: Three themes emerged from the study; (i) role players and their functions with collaboration is integral to disability claims management, (ii) various factors promote and restrict return-to-work planning, and (iii) best practice principles in the DCM pathway that promote return-to-work. These principles include behavioural economics as the central principle, with resource identification and competency, governance, role engagement and education and awareness as supporting principles. CONCLUSION: Collaborative and integrated approaches by role players within a workers' family unit, health system, employer structure and insurance compensation are required for positive return-to-work outcomes. The various role players are responsible for creating policies, structures, intervention strategies, and environments that foster return-to-work. IMPLICATIONS FOR PRACTICE • An integrated approach is required for optimal RTW outcomes as employers' policies restrict work integration. • A collaborative approach by all role players involved in DCM, focusing on positive RTW outcomes is required in the RTW process • Occupational therapists can influence employer incapacity and disability policies in order to keep people employed and productive in the presence of medical conditions with the application of reasonable accommodations where necessary. • Occupational therapists are suitably positioned to outline workplace environment and other supports required to guide and support employees through rehabilitation and RTW and in ensuring that employees who can remain at work while on a partial or fully insured benefit, can engage optimally in aspects of work function.

ABSTRACT Objective To analyze the impact of Dual Diagnosis on patient’s work capacity and verify if the professional activity sector matters. Dual Diagnosis is defined by the coexistence of an Addiction and another psychiatric disorder. Methodology All patients admitted for inpatient treatment at Alcohol and New Addiction’s Treatment Unit from Lisbon’s Psychiatric Hospital Center, for six months, between 1st November 2021 and 30th April 2022, were selected and screened for sociodemographic and clinical characteristics (age, gender, education level, professional situation, and activity sector at admission as well as main admission diagnosis and other psychiatric comorbidities). Retrospective observative analysis focused on patient’s work capacity was conducted between patients who had been diagnosed with an Addiction Disorder and patients with Dual Diagnosis. Results Our sample had 78 patients and an average age of 51 years. From those, 31 had diagnosis of Addiction Disorder and 47 had Dual Diagnosis. Only 27% patients were still active at admission, with 15% being with temporary incapacity certificate, 41% being unemployed and 17% retired. A significant part of our sample worked in accommodation, transportation, and food services activities (29%), construction sector (19%) and in healthcare, education, and social work activities (17%). The unemployment rates between patients with an Addiction Disorder and Dual Diagnosis were similar. However, 39% of patients with an Addiction Disorder were active while only 19% with Dual Diagnosis were in the same state. Also of interest was that 34% of those with Dual Diagnosis worked in accommodation, transportation, and food services activities. Conclusions These results show that Dual Diagnosis may have a significant impact in the working capacity and suggest that there are important differences between professional activity sectors in patients with or without dual diagnosis.

RESUMO Objetivos Analisar o impacto da Patologia Dual na capacidade de trabalho e verificar se existe relevância com o setor de atividade profissional. A Patologia Dual define-se pela coexistência de uma Adição e de outra patologia psiquiátrica. Metodologia Todos os pacientes internados para tratamento na Unidade de Tratamento para Álcool e Novas Dependências do Centro Hospitalar Psiquiátrico de Lisboa, durante seis meses, entre 1 de novembro de 2021 e 30 de abril de 2022, foram selecionados e avaliados quanto a características sociodemográficas e clínicas (idade, género, nível de educação, situação profissional e setor de atividade aquando da admissão, bem como diagnóstico principal à admissão e outras comorbilidades psiquiátricas). Realizada uma análise observacional retrospetiva focada na capacidade de trabalho dos doentes entre aqueles diagnosticados apenas com uma Adição (com ou sem uso de substância) e doentes com o diagnóstico de Patologia Dual. Resultados A amostra incluiu 78 pacientes com uma idade média de 51 anos. Destes, 31 foram diagnosticados com uma Adição e 47 com Patologia Dual. Apenas 27% dos pacientes estavam com uma situação profissional ativa aquando da admissão hospitalar, com 15% em situação de incapacidade temporária para o trabalho, 41% em situação de desemprego e 17% na reforma. As principais áreas de atividades presentes na amostra pertenciam a três setores, sendo que 29% dos pacientes trabalhava no setor da restauração, hotelaria, transportes e outros serviços de lazer, 19% no setor da construção e 17% no setor da saúde, educação e serviços sociais. As taxas de desemprego presentes entre pacientes diagnosticados com Adição foram semelhantes à dos pacientes diagnosticados com Patologia Dual. No entanto, 39% dos pacientes com Adição encontravam-se com uma situação profissional ativa, enquanto que apenas 19% dos diagnosticados com Patologia Dual estavam profissionalmente ativos. Observamos ainda que 34% dos pacientes com patologia dual trabalhavam no setor da restauração, hotelaria, transportes e outros serviços de lazer. Conclusões Os resultados demonstram que a Patologia Dual pode ter um impacto significativo na capacidade de trabalho da população e sugerem que existem diferenças importantes entre os setores de atividade profissional em pacientes com ou sem o diagnóstico de Patologia Dual, contudo, são necessários estudos mais alargados nesta área.

ABSTRACT Introduction: The specialty of Occupational Medicine studies the impact of work conditions on employees' health, promoting health and ensuring safety and health protection in the workplace. Conditional fitness reports are crucial for assessing healthcare professionals' ability to perform their work activities under specific conditions. This study aims to characterize employees with conditional fitness results in a population of hospital workers. Methods: This retrospective descriptive observational study considers conditional fitness reports issued from January 2022 to October 2023. The analysis includes the type of exams, average age of professionals, professional category, length of service, analysis by type of service, and analysis by disease groups. Results and Discussion: During the mentioned time frame, a total of 2172 Occupational Medicine health exams were conducted, with a total of 354 fitness records issued with Conditioned Fitness results, representing 15% of the health exams conducted. Among these, 50% of professionals with disabilities are above the median age of 50 years. The most representative type of exam was the one requested for return to work after illness or temporary incapacity for work exceeding 30 days. The group with the highest representation was operational assistants. The major disease group follows the same pattern as in other hospital units, with 78% of conditioned fitness related to musculoskeletal injuries. Conclusion: Occupational Medicine plays a crucial role in promoting the health and well-being of employees, preventing absenteeism, and addressing work-related illnesses such as musculoskeletal, psychiatric, respiratory, among others. This study enables Occupational Health Service members to understand the workers with conditional fitness in terms of services, professional classes and ages. This information is essential for supporting management, identifying new occupational risk factors or deficiencies in their management, as well as concentration in the same service or age groups of professionals with work-aggravated illness or non-work-related illness requiring workplace adaptation and potentially causing additional pressure on services and other employees. Investment in this area not only protects workers' health but also strengthens institutions, reducing absenteeism costs and promoting a healthy work environment.

RESUMO Introdução: A especialidade de Medicina do Trabalho estuda o impacto das condições laborais na saúde dos colaboradores, realizando a promoção da saúde e garantindo a proteção da segurança e da saúde no trabalho. As fichas de aptidão condicionadas são cruciais para avaliar a capacidade dos profissionais de saúde para realizar as suas atividades laborais em condições específicas. Este estudo pretende caracterizar os funcionários com resultados de aptidão condicionada, numa população de trabalhadores hospitalares. Métodos: Este estudo observacional descritivo retrospetivo considera as fichas de aptidão com resultado de aptidão condicionada emitidas de janeiro de 2022 a outubro de 2023. A análise inclui a tipologia de exames, a idade média dos profissionais, a categoria profissional, o tempo de serviço, a análise por tipo de serviço e a análise por grupos de doenças. Resultados e discussão: No intervalo de tempo mencionado foram realizados 2172 exames de saúde de Medicina do Trabalho, sendo emitidas 354 fichas de aptidão com resultado de Aptidão Condicionada, representando estas 15,3% dos exames de saúde realizados. Destes, 50% dos profissionais com incapacidades têm idade superior ao valor da mediana de 50 anos. O tipo de exame mais representativo foi por regresso ao trabalho após doença ou incapacidade temporária para o trabalho com período superior a 30 dias. O grupo com maior representatividade foram os assistentes operacionais. O grande subtipo de doenças tem o mesmo padrão representado nas outras unidades hospitalares, com 78% das aptidões condicionadas a serem relacionadas com lesões musculosqueléticas. Conclusão: A Medicina do Trabalho desempenha um papel crucial na promoção da saúde e bem-estar dos colaboradores, prevenindo o absentismo e abordando doenças relacionadas com o ambiente laboral, como as musculoesqueléticas, psiquiátricas, respiratórias, entre outras. O presente estudo permite aos elementos do Serviço de Saúde Ocupacional perceber em que serviços, classes profissionais e idades se concentram os trabalhadores com aptidão condicionada. Esta informação é fundamental para prestar um apoio à gestão, identificar novos fatores de risco ocupacional ou insuficiências na sua gestão, assim como concentração no mesmo serviço ou grupos etários de profissionais com doença agravada pelo trabalho ou doença não relacionada com o trabalho que necessite de adaptação do posto de trabalho e que cause eventual pressão adicional sobre os serviços e outros colaboradores. O investimento nessa área não só protege a saúde dos trabalhadores, como também fortalece as instituições, reduzindo custos associados ao absentismo e promovendo um ambiente de trabalho saudável.

ABSTRACT Background: Cardiovascular diseases in Mexico, represents 23.5% of total deaths. Workers in medical units are not exempt from suffering cardiovascular events. Objective: Estimate cardiovascular risk in workers of a medical unit with prediction tables not based on Gaziano's laboratory. Materials and methods: Descriptive Cross-sectional study carried out from October to November 2021. Workers from all work shifts participated and provided informed consent. Those with temporary incapacity for work, license or commission not to work were excluded. Cardiovascular risk was estimated with Gaziano's non-laboratory-based prediction tables, which include sex, age, diabetes, smoking history, systolic blood pressure, and body mass index, classifying the risk as low (< 5% to 10%), moderate (> 10% to 20%) and high (> 20%). Frequencies and proportions were calculated in qualitative variables, and measures of central tendency and dispersion were calculated in quantitative variables. The chi-square test was performed to compare the distribution of the different job categories by cardiovascular risk. Results: 186 workers from the medical unit participated, 35.5% had grade I obesity, 18.8% had high blood pressure, 11.8% had a previous diagnosis of diabetes, 9.7% smoked and 51.1% had low-intensity physical activity. Low cardiovascular risk was observed in 87.6%, moderate in 8.6% and high in 3.8%. Conclusions: Estimating the cardiovascular risk in medical unit workers will allow for establishing actions in the workplace to reduce or eliminate risk factors.

RESUMEN Antecedentes: Las enfermedades cardiovasculares en México, representan el 23.5% del total de las muertes. Los trabajadores de unidades médicas no están exentos de padecer eventos cardiovasculares. Objetivo: Estimar el riesgo cardiovascular en trabajadores de una unidad médica con tablas de predicción no basadas en laboratorio de Gaziano. Material y métodos: Estudio transversal descriptivo con recolección de datos de octubre a noviembre de 2021. Participaron trabajadores de todas las categorías y turnos laborales que otorgaron consentimiento informado. Se excluyeron aquellos con incapacidad temporal de trabajo, licencia o comisión para no laborar. El riesgo cardiovascular se estimó con las tablas de predicción no basadas en laboratorio de Gaziano, que incluyen sexo, edad, diabetes, antecedente de tabaquismo, presión arterial sistólica e índice de masa corporal, y clasifican el riesgo en bajo (< 5% a 10%), moderado (> 10 a 20%) y alto (> 20%). Las variables categóricas se presentan como frecuencias y proporciones, y las cuantitativas con medidas de tendencia central y dispersión. Se realizó la prueba de ji al cuadrado para comparar la distribución de las diferentes categorías laborales por riesgo cardiovascular. Resultados: Participaron 186 trabajadores de la unidad médica. Presentaron obesidad de grado I el 35.5%, hipertensión arterial el 18.8%, diagnóstico previo de diabetes el 11.8%, tabaquismo el 9.7% y actividad física de intensidad baja el 51.1%. El riesgo cardiovascular fue bajo en el 87.6%, moderado en el 8.6% y alto en el 3.8. Conclusiones: Estimar el riesgo cardiovascular en los trabajadores de las unidades médicas permitirá establecer acciones en el ámbito laboral, para disminuir o eliminar factores de riesgo.

Resumo: Apresentamos o caso de um paciente de 31 anos de idade que trabalha em um moinho de grãos há 12 anos e desenvolveu asma ocupacional. O objetivo do artigo é apresentar a justificativa da origem ocupacional da asma adquirida. Descrevemos as tarefas realizadas, os materiais e os meios de trabalho utilizados. Analisamos especialmente a exposição ocupacional à poeira orgânica e sua conexão temporal com a sintomatologia respiratória. Essas informações nos permitem entender a importância das condições em que o trabalho é realizado e a exposição a um fator de risco, a poeira orgânica, para o desenvolvimento da patologia respiratória ocupacional. As medições do volume pulmonar expiratório máximo foram realizadas com a técnica de pico de fluxo durante e fora da jornada de trabalho. Observamos variações no fluxo expiratório superiores a 20%, tanto durante quanto fora do horário de trabalho, com um padrão sintomático semelhante ao relatado pelo trabalhador. Concluímos que há evidências de um nexo causal entre asma e trabalho e, portanto, propomos o diagnóstico de asma ocupacional. Destacamos a importância de avaliar os riscos ocupacionais em cada atividade para implementar planos de vigilância da saúde tanto do trabalhador quanto do ambiente de trabalho, a fim de evitar o surgimento e a evolução dessa ou de outras patologias que, em muitos casos, geram incapacidade para a tarefa e deterioração da qualidade de vida dos trabalhadores.

Resumen: Se presenta el caso de un trabajador de 31 años que desempeña tareas en un molino de granos desde hace 12 años y que ha desarrollado asma ocupacional. El objetivo del artículo es presentar los fundamentos utilizados para sostener el origen profesional del asma adquirido. Se describen las tareas laborales que desarrolla, materiales y medios de trabajo que utiliza. Se analiza en particular la exposición laboral a polvo orgánico y su vinculación temporal con la sintomatología respiratoria. Esta información permite comprender la importancia de las condiciones en las que realiza el trabajo y la exposición a un factor de riesgo, el polvo orgánico, para el desarrollo de la patología respiratoria laboral. Se realizaron mediciones de volumen máximo espiratorio pulmonar, con técnica de pico flujo, durante la jornada laboral y fuera de ésta. Se observaron variaciones del flujo espiratorio mayores a 20%, tanto durante la jornada laboral como fuera de ella, con similar patrón sintomático, según relata el trabajador. Se concluyó que existe evidencia del nexo causal entre el asma y el trabajo, por lo que se plantea el diagnóstico de asma ocupacional. Se destaca la importancia de evaluar los riesgos laborales en cada actividad para implementar planes de vigilancia de la salud, tanto del operario como del ambiente de trabajo, para prevenir la aparición como la evolución de esta u otras patologías que en muchos casos generan incapacidad para la tarea y deterioro de la calidad de vida de los trabajadores.

Abstract: We present the case of a 31-year-old worker who has been working in a grain mill for 12 years and has developed work-related asthma. The objective of this article is to present the foundations used to support the occupational origin of the acquired asthma. The study describe the work tasks performed, the materials used, and the working methods. The work-related exposure to organic dust and its temporal relationship with respiratory symptoms is particularly analyzed. This information allows us to understand the importance of working conditions and exposure to organic dust, a risk factor, for the development of this work-related respiratory pathology. Measurements of maximum expiratory lung volume were made using the peak flow technique during and outside of the workday. Expiratory flow variations greater than 20% were observed, both during and outside of the workday, which followed a similar symptomatic pattern as reported by the worker. The study concluded that there is evidence of a causal link between asthma and work, thus suggesting the diagnosis of work-related asthma. The importance of assessing occupational risks in each activity to implement health surveillance plans for both workers and the work environment is highlighted, aiming to prevent the onset and progression of this and other pathologies that often result in work incapacity and deterioration of workers’ quality of life.

Organ donation after a circulatory determination of death is possible in selected patients where consent is given to support donation and the patient has been legally declared dead by two doctors. The National Health Act (61 of 2003) and regulations provide strict controls for the certification of death and the donation of organs and tissues after death. Although the National Health Act expressly recognises that brain death is death, it does not prescribe the medical standards of testing for the determination of brain death (neurological determination of death), circulatory death (circulatory determination of death) or for determination of death based on somatic criteria. However, in all cases of organ donation, including after circulatory death, the National Health Act mandates that two doctors certify the death, with one doctor possessing more than 5 years of experience. Additionally, both doctors must be independent from the transplant team. The standard for such determination, as for brain death, aligns with accepted medical standards. The Critical Care Society of Southern Africa has published South African (SA) Guidelines on Death Determination that outline rigorous standards for death determination in hospital settings by either a neurological or circulatory method. Legislation and the Health Professions Council of SA's (HPCSA) professional guidance direct clinicians on obtaining informed consent for donation either from the patient or in cases of incapacity from their surrogate decision maker. Collectively, the legislation, regulations and professional guidelines in SA provide a robust ethical framework that supports organ donation after circulatory death.

ABSTRACT The election of the histrionic economist Javier Milei, self-identified as anarcho-capitalist, a complete outsider with ultraliberal economic ideas, conservative social ideas, and with authoritarianism overtones in relation with democratic institutions, it is a novelty for the Argentinean political system. Amid an economic crisis with inflation above 200%, the majority chose this outsider whose victory seemed impossible just one year before. The combination of economic voting and antisystem protest vote, with the promise of change and the failed electoral strategies of the traditional parties were key to produce this result. The incapacity of both traditional parties to resolve the long economic crisis during their terms in office generated a rejection of the status quo and an opportunity to renovate the political supply, which was leveraged by Milei. This article describes the emergence of Milei and the 2023 electoral results at all levels. It then moves to discuss the conditions that explain his victory and the perspectives for governability created by the combination of these electoral results and the new political system characterized by political fragmentation.

RESUMEN La elección del histriónico economista Javier Milei, autodenominado anarcocapitalista, un completo outsider con ideas ultraliberales en lo económico, conservadoras en lo social y con tintes autoritarios en relación a las instituciones democráticas, es sin duda una novedad para el sistema político argentino. En un contexto de crisis económica con una inflación interanual que superaba el 200%, la mayoría eligió a este outsider, cuya victoria parecía imposible un año antes. La combinación del voto económico y el voto protesta anti-sistema, con la promesa de cambio y las fallidas estrategias electorales de los partidos tradicionales fueron cruciales para este resultado. La incapacidad de ambas opciones tradicionales para resolver la larga crisis económica durante sus gestiones presidenciales provocó un rechazo del statu quo y una oportunidad para renovar la oferta política que fue aprovechada por Milei. Este artículo describe la emergencia de Milei y los resultados de las elecciones de 2023 en todos los niveles antes de discutir las condiciones que llevaron a su victoria y las perspectivas de gobernabilidad generadas por la combinación de estos resultados electorales y el nuevo sistema político caracterizado por la fragmentación política.

ABSTRACT Introduction: Functional incapacity caused by physical alterations leads to significant limitations in daily activities and has a major impact on the return of people with disabilities to the social space and the workplace. This calls for an evaluation of the long-term influence of the use of a device specially developed for orthostatic posture on the physiological, biomechanical and functional parameters of amputees and spinal cord patients. Objective: The objective was evaluate the effect of postural support device use on function, pain, and biomechanical and cardiologic parameters in spinal cord injury and amputees patients compared to a control group. Methods: The orthostatic device was used by the participants for a period of ten consecutive days, for three cycles of 50 minutes each day, and a 15-day follow-up. Participants were positioned and stabilized using adjustable straps on the shoulders, trunk, and hips. The primary outcome was brief pain inventory. Fifteen participants were included the control group, 15 in the amputee group, and 15 in the spinal cord group. Results: Our results demonstrate that the use of the device allows the orthostatic position of amputees and spinal cord patients evaluated for ten days, leading to improved functionality and pain in the spinal cord and amputee groups compared to the control group. In addition, no changes were observed for secondary outcomes, indicating that the use of the device did not cause harm interference to patients. Conclusion: The long-term use of the orthostatic device is beneficial for improving functionality, reduce pain in amputees and spinal cord injury patients. Level of evidence II; Therapeutic Studies - Investigating the results of treatment. Introduction workplace longterm long term physiological Objective function group Methods days 5 day 15day followup. followup follow up. up follow-up shoulders trunk hips inventory 1 Results addition outcomes Conclusion II treatment

RESUMO Introdução: A incapacidade funcional causada por alterações físicas leva a limitações significativas nas atividades diárias e gera um grande impacto no retorno das pessoas com deficiência ao espaço social e ao local de trabalho, demandando a avaliação da influência em longo prazo do uso de um dispositivo especialmente desenvolvido para a postura ortostática nos parâmetros fisiológicos, biomecânicos e funcionais de pacientes amputados e com medula espinhal. Objetivo: O objetivo foi avaliar o efeito do uso do dispositivo de suporte postural na função, dor e parâmetros biomecânicos e cardiológicos em pacientes com lesão medular e amputados em comparação com um grupo controle. Métodos: O aparelho ortostático foi utilizado pelos participantes por um período de dez dias consecutivos, em três ciclos de 50 minutos diários, com acompanhamento de 15 dias. Os participantes foram posicionados e estabilizados por meio de alças ajustáveis nos ombros, tronco e quadris. O desfecho primário foi o questionário Breve Inventário de Dor. Quinze participantes foram incluídos no grupo controle, 15 no grupo amputado e 15 no grupo medular. Resultados: Nossos resultados demonstram que o uso do dispositivo permite a posição ortostática de amputados e pacientes com lesão medular avaliados por dez dias, levando a melhora da funcionalidade e dor nos grupos de amputados e medula espinhal em relação ao grupo controle. Além disso, não foram observadas alterações nos resultados secundários, indicando que o uso do dispositivo não causou interferência prejudicial aos pacientes. Conclusão: O uso prolongado do dispositivo ortostático é benéfico para melhorar a funcionalidade, reduzir a dor em amputados e pacientes com lesão medular. Nível de Evidência II; Estudos Terapêuticos - Investigação dos resultados de tratamento. Introdução trabalho fisiológicos Objetivo função controle Métodos consecutivos 5 diários 1 ombros quadris Dor Resultados disso secundários Conclusão II tratamento

Abstract Objective: To validate the 10-item Cervantes Scale (CS-10) among Brazilian women. Methods: This is a cross-sectional observational study involving women in the community aged 40–55 years in the Southern region of Brazil. They completed a general health, habits and socio-demographic questionnaire, the CS-10 and the Women’s Health Questionnaire (WHQ). Women unable to understand the survey, not consenting to participate, or having incapacity imposing difficulties during the completion of the questionnaire were excluded. A Confirmatory Factor Analysis (CFA) was conducted with the AMOS 16.0 software. Chi-square of degrees of freedom (χ2/df), the Comparative Fit Index (CFI), the Tucker-Lewis Index (TLI) and the Root-Mean-Square Error of Approximation (RMSEA) were used as indices of goodness of fit. Cronbach’s alpha coefficient was used for internal consistency. Results: A total of 422 women were included (premenopausal n=35, perimenopausal n=172, postmenopausal n=215). The CFA for the CS-10 showed a good fit (χ²/df=1.454, CFI=0.989; TLI=0.985; RMSEA=0.033; CI 90%=0.002-0.052; PCLOSE=0.921; Model p=0.049). Good reliability was established in CS-10 and WHQ (Cronbach’s alpha=0.724). Postmenopausal women had higher total CS-10 scores (p≤0.0001), reflecting worse quality of life (QoL) related to menopause symptoms and confirming the greater symptomatology evaluated by high total scores for WHQ found in this population when compared to those in the premenopausal period (p=0.041). Conclusion: The CS-10 is a consistent tool for health-related QoL in Brazilian mid-aged women. Objective 10item item 10 CS10 CS (CS-10 Methods crosssectional cross sectional 4055 40 55 40–5 Brazil health sociodemographic socio demographic CS-1 Womens s WHQ. . (WHQ) survey participate excluded (CFA 160 16 0 16. software Chisquare Chi square χ2/df, χ2df χdf χ2/df , χ2 df χ (χ2/df) CFI, CFI (CFI) TuckerLewis Tucker Lewis TLI (TLI RootMeanSquare Root Mean Square RMSEA (RMSEA Cronbachs Cronbach consistency Results 42 n35 n 35 n=35 n172 172 n=172 n=215. n215 n=215 215 n=215) χ²/df=1.454, χ²df1454 χ² 1 454 (χ²/df=1.454 CFI=0.989 CFI0989 989 TLI=0.985 TLI0985 985 RMSEA=0.033 RMSEA0033 033 90%=0.0020.052 9000020052 90%=0.002 0.052 90 002 052 90%=0.002-0.052 PCLOSE=0.921 PCLOSE0921 PCLOSE 921 p=0.049. p0049 p p=0.049 049 p=0.049) alpha=0.724. alpha0724 alpha=0.724 724 alpha=0.724) p≤0.0001, p00001 p≤0.0001 0001 (p≤0.0001) (QoL p=0.041. p0041 p=0.041 041 (p=0.041) Conclusion healthrelated midaged mid CS1 (CS-1 405 4 5 40– CS- (WHQ (χ2/df (CFI n3 3 n=3 n17 17 n=17 n21 n=21 21 χ²/df=1.454 χ²df145 45 (χ²/df=1.45 CFI=0.98 CFI098 98 TLI=0.98 TLI098 RMSEA=0.03 RMSEA003 03 0020 90%=0.0020.05 900002005 900002 90%=0.00 0052 0.05 9 00 05 90%=0.002-0.05 PCLOSE=0.92 PCLOSE092 92 p004 p=0.04 04 alpha072 alpha=0.72 72 p0000 p≤0.000 000 (p≤0.0001 (p=0.041 (CS- n= n1 n=1 n2 n=2 2 χ²/df=1.45 χ²df14 (χ²/df=1.4 CFI=0.9 CFI09 TLI=0.9 TLI09 RMSEA=0.0 RMSEA00 90%=0.0020.0 90000200 90000 90%=0.0 005 0.0 90%=0.002-0.0 PCLOSE=0.9 PCLOSE09 p00 p=0.0 alpha07 alpha=0.7 7 p000 p≤0.00 (p≤0.000 (p=0.04 (CS χ²/df=1.4 χ²df1 (χ²/df=1. CFI=0. CFI0 TLI=0. TLI0 RMSEA=0. RMSEA0 90%=0.0020. 9000020 9000 90%=0. 0. 90%=0.002-0. PCLOSE=0. PCLOSE0 p0 p=0. alpha0 alpha=0. p≤0.0 (p≤0.00 (p=0.0 χ²/df=1. χ²df (χ²/df=1 CFI=0 TLI=0 RMSEA=0 90%=0.0020 900 90%=0 90%=0.002-0 PCLOSE=0 p=0 alpha=0 p≤0. (p≤0.0 (p=0. χ²/df=1 (χ²/df= CFI= TLI= RMSEA= 90%= 90%=0.002- PCLOSE= p= alpha= p≤0 (p≤0. (p=0 χ²/df= (χ²/df 90% p≤ (p≤0 (p= χ²/df (p≤ (p

Resumo O artigo relata uma pesquisa qualitativa fundamentada nos pressupostos da psicologia histórico-cultural, cujo objetivo foi compreender o processo de desenvolvimento das emoções e sua transformação nas práticas docentes inclusivas. Foram utilizadas entrevistas estruturadas, semiestruturadas e o dispositivo metodológico da autoconfrontação, interpretados por meio da análise microgenética vigotskiana. Participaram da pesquisa duas professoras de turmas inclusivas dos anos iniciais do Ensino Fundamental de uma escola pública brasileira. Identificou-se a dificuldade das professoras em expressar emoções e a ampla presença de emoções desagradáveis, com ênfase no adoecimento docente e na falta de apoio para a inclusão escolar. Evidenciou-se a dificuldade das professoras em expressar e referirem-se às próprias emoções, reverberando o modelo cartesiano que relega as emoções em detrimento da cognição. Embora tenham sido mencionadas emoções como amor/gostar e esperança, os resultados revelaram a ampla presença de emoções desagradáveis (angústia; desamparo, aflição, impotência; frustração; incapacidade, insegurança; incompletude; sentir-se mal; tristeza). Por meio da pesquisa, as docentes participantes puderam reconhecer e refletir sobre suas emoções/práticas inclusivas que se amalgamam no cotidiano da escola, (re)conhecendo suas emoções/práticas e configurando novos sentidos às suas vivências. Conclui-se que a entrevista de autoconfrontação permitiu que as participantes refletissem sobre suas emoções e práticas inclusivas, contribuindo para a tomada de consciência e para a transformação do trabalho das docentes por meio do aumento do poder de agir sobre a própria atividade. históricocultural, históricocultural histórico cultural, cultural histórico-cultural estruturadas vigotskiana brasileira Identificouse Identificou escolar Evidenciouse Evidenciou referiremse referirem cognição amorgostar amor gostar esperança angústia (angústia desamparo aflição impotência frustração incapacidade insegurança incompletude sentirse sentir mal tristeza. tristeza . tristeza) emoçõespráticas reconhecendo re conhecendo vivências Concluise Conclui atividade

Abstract This article is a qualitative research that aims to understand the process of the development of emotions and its transformation in inclusive teachers’ practices based on cultural-historical psychology assumptions. We used structured and semi-structured interviews, as well as the methodology of self-confrontation. We interpreted the data according to a Vigotskian micro-genetic analysis. Two teachers of inclusive classes from the first years of Elementary School at a Brazilian public school participated in the research. We identified the teachers’ difficulty in expressing emotions and the large presence of uncomfortable emotions, with an emphasis on the teachers’ illness, as well as the lack of support for school inclusion. The teachers’ difficulty in expressing themselves and referring to their own emotions was evident, which reflects the Cartesian model that relegates emotions to the detriment of cognition. Although emotions such as love/liking, and hope were mentioned, the results showed that uncomfortable emotions (anguish; helplessness, distress, impotence; frustration; incapacity, insecurity; incompleteness; feeling bad; and sadness) were largely present. With this research, the teachers were able to recognize and understand their emotions/inclusive practices, which merge during the school’s daily life, as well as think about them and give new meanings to their experiences. We conclude that the self-confrontation interview allowed the participants to think about their emotions and inclusive practices, contributing to their awareness and the transformation of the teachers’ work by increasing their power of acting over their own activity. culturalhistorical cultural historical assumptions semistructured semi interviews selfconfrontation. selfconfrontation self confrontation. confrontation microgenetic micro genetic analysis illness inclusion evident cognition loveliking love liking love/liking mentioned anguish (anguish helplessness distress impotence frustration incapacity insecurity incompleteness bad sadness present emotionsinclusive schools s life experiences activity

Abstract Background Musculoskeletal chronic pain is a leading cause of global disability and laboral incapacity. However, there is a lack of population-based studies that investigate the relationship between chronic pain and mental disorders with a control group, particularly among low- and middle-income countries. Chronic pain is a serious public health problem in terms of human suffering, and in terms ofsocioeconomic implications. Frequent association with different mental disorders increases disability, decreases quality of life, and makes diagnosis and treatment challenging. The present study aimed to evaluate the presence of mental disorders in patients with chronic musculoskeletal pain and compare with a control group without pain. Methods We selected 100 patients in a regular follow-up at the Musculoskeletal Pain Outpatient Clinic of the University Hospital and compared them with 100 painless individuals from the control group from June 2016 to June 2018. The instruments used were the Mini International Neuropsychiatric Interview (MINI-PLUS) and a structured questionnaire to collect sociodemographic data. Statistical analysis used t-test, chi-square, Fisher's exact test, Mann-Whitney, Kolmogorov-Smirnov tests, and multiple logistic regression. Results In the sample evaluated, the majority of patients were women (83%), of brown color (54%), with lower-level education (51%), lower salary range (73%) and high absenteeism rate at work (60,7%). Patients with chronic pain had more psychiatric disorders (88% vs. 48% in the control group; p < 0.001). The most frequent diagnoses were anxiety disorders with panic attacks (44%), generalized anxiety (36%), mixed anxiety and depression disorder (33%), social phobia (30%), agoraphobia (29%), suicide risk (28%), and major depression (27%). Conclusion Positive correlations of mental disorders and chronic musculoskeletal pain have been documented. This suggests that psychiatric components must be taken into account in the management of chronic pain syndromes. The use of Mini Plus as a diagnostic tool for psychiatric disorders can contribute to optimizing the diagnosis and treatment of patients with chronic pain and encourage the creation of policies with strategies and criteria for quick access to Multi-professional Services. incapacity However populationbased population based low middleincome middle income countries suffering implications life challenging 10 followup follow up 201 2018 MINIPLUS MINI PLUS (MINI-PLUS data ttest, ttest t test t-test chisquare, chisquare chi square, square chi-square Fishers Fisher s MannWhitney, MannWhitney Mann Whitney, Whitney Mann-Whitney KolmogorovSmirnov Kolmogorov Smirnov tests regression evaluated 83%, 83 83% , (83%) 54%, 54 54% (54%) lowerlevel level 51%, 51 51% (51%) 73% 73 (73% 60,7%. 607 60,7% . 60 7 (60,7%) 88% 88 (88 vs 48 0.001. 0001 0.001 0 001 0.001) 44%, 44 44% (44%) 36%, 36 36% (36%) 33%, 33 33% (33%) 30%, 30 30% (30%) 29%, 29 29% (29%) 28%, 28 28% (28%) 27%. 27 27% (27%) documented syndromes Multiprofessional Multi professional Services 1 20 8 (83% 5 (54% (51% (73 60,7 6 (60,7% (8 4 000 0.00 00 (44% 3 (36% (33% (30% 2 (29% (28% (27% (83 (54 (51 (7 60, (60,7 ( 0.0 (44 (36 (33 (30 (29 (28 (27 (5 (60, 0. (4 (3 (2 (60 (6

RESUMO JUSTIFICATIVA E OBJETIVOS: As dores crônicas representam um desafio global significativo para a saúde pública, afetando milhões de indivíduos em todo o mundo. Caracterizadas por sua persistência e duração prolongada, essas dores não apenas resultam em incapacidade funcional, mas também se revelam como o principal motivo de busca por assistência médica. A complexidade desses quadros não se limita apenas aos aspectos físicos, podendo afetar também o estado emocional e o humor de uma pessoa, favorecendo a presença de quadros de ansiedade e/ou depressão, que não só exacerbam as dores crônicas como também complicam o processo de tratamento. A resiliência e a capacidade de lidar com adversidade são cruciais nesse contexto. O objetivo deste estudo foi buscar e examinar a relação entre resiliência, ansiedade e depressão em pacientes com dores crônicas, visando abordagens terapêuticas mais eficazes e direcionadas. MÉTODOS: Trata-se de um estudo exploratório no qual pacientes com dores crônicas que iniciaram tratamento em um hospital terciário foram avaliados com base em variáveis socio-demográficas, variáveis relacionadas à dor, e por meio da Escala Hospitalar de Ansiedade e Depressão (HAD) e da Escala de Resiliência Connor-Davidson. RESULTADOS: O estudo explorou a relação entre resiliência, ansiedade, depressão e dores crônicas. A amostra, composta majoritariamente por mulheres, mostrou que a maioria dos pacientes (78,3%) apresentava sintomas de transtornos de humor. A resiliência apresentou correlação negativa com ansiedade, depressão e intensidade da dor, sugerindo que auxilie com associação de proteção a esses problemas de saúde. CONCLUSÃO: A resiliência deve ser considerada como um fator importante para a efetividade do tratamento de pessoas com dores crônicas. OBJETIVOS pública mundo prolongada funcional médica físicos pessoa eou ou contexto direcionadas MÉTODOS Tratase Trata sociodemográficas, sociodemográficas socio demográficas, demográficas socio-demográficas dor HAD (HAD ConnorDavidson. ConnorDavidson Connor Davidson. Davidson Connor-Davidson RESULTADOS amostra mulheres 78,3% 783 78 3 (78,3% CONCLUSÃO 78,3 7 (78,3 78, (78, (78 (7 (

ABSTRACT BACKGROUND AND OBJECTIVES: Chronic pain represents a significant global public health challenge, affecting millions of individuals worldwide. Characterized by their persistence and prolonged duration, these kinds of pain not only result in functional incapacity, but are also the main reason for patients to seek medical care. The complexity of these conditions is not only limited to the physical aspects, but can also affect a person’s emotional state and mood, favoring the presence of anxiety and/or depression, which not only exacerbate chronic pain but also complicate the treatment process. Resilience and the capacity to deal with adversity are crucial in this context. The objective of this study was to seek out and examine the relationship between resilience, anxiety and depression in patients with chronic pain, aiming at more effective and targeted therapeutic approaches. METHODS: Exploratory study in which patients with chronic pain starting treatment at a tertiary hospital were assessed based on sociodemographic and pain-related variables. This work also used the Hospital Anxiety and Depression Scale (HAD) and the Connor-Davidson Resilience Scale. RESULTS: The study explored the relationship between resilience, anxiety, depression and chronic pain. The sample, composed mostly of women, showed that the majority of patients (78.3%) had mood disorder symptoms. Resilience presented a negative correlation with anxiety, depression and pain intensity, suggesting that it helps to protect against these health problems. CONCLUSION: Resilience should be considered an important factor in the effective treatment of people with chronic pain. OBJECTIVES challenge worldwide duration incapacity care aspects persons person s andor or process context resilience approaches METHODS painrelated related variables HAD (HAD ConnorDavidson Connor Davidson RESULTS sample women 78.3% 783 78 3 (78.3% symptoms intensity problems CONCLUSION 78.3 7 (78.3 78. (78. (78 (7 (

Persons with disabiliites are a historically marginalised minority, but they do possess the capacity to make a valuable contribution in the workplace. Disabilty in no way dimisses the right of individuals to be employed and to make a contribution to the labour market and the economy at large. Recent case law suggests that the duty to reasonably accommodate disabled respondents remains a conundrum for both respondents and employers in South Africa. In Legal Aid South Africa v Jansen 2020 41 ILJ 2580 (LAC) the Labour Appeal Court (LAC) overturned a judgment by the Labour Court that found that Legal Aid unfairly discriminated against a respondent with depression. In 2018, the Labour Court ordered Legal Aid to reinstate Mr Jansen in that it had acted unfairly as his depression was most likely the true cause for his misconduct. On appeal, the LAC emphasised that in order to prove automatic unfair dismissal an applicant must prove both factual and legal causation. The LAC further found that the most dominant reason for Mr Jansen's dismissal was his misconduct and not his depression. Nonetheless, the LAC emphasised that depression is a prevalent illness in the current work environment and that all employers have a duty to deal with depression in a sympathetic manner and were reminded of their obligation to investigate the disability fully, to consider reasonable accommodation and to consider alternatives short of dismissal. Respondents were also reminded of the fact that they need to co-operate with their employers. Whilst South Africa has made significant progress in enacting legislation, codes, and guidelines to lay the foundation for reasonable accommodation, role-players, with specific reference to employers and the judiciary, often overlook these detailed guidelines, especially in cases where the employee suffers from depression. Disabilty is often used interchangeably with incapacity, which is problematic. This article argues that employers should follow a broad interpretation of the guidelines contained in the Code of Good Practice: Key Aspects on the Employment of People with Disabilities (2002), as well as the Technical Assistance Guidelines. Multi-party consultations and investigations need to be conducted, with the assistance of experts, if needs be. It is further suggested that until South Africa has targeted legislation and policies which make disability management functions mandatory, reasonable accommodation will remain a conundrum.