ABSTRACT Introduction/framework/objectives Salt production, especially using artisanal methods, does not exist in all countries, given the climatic and logistical requirements. Portugal has some tradition in this sector, but even so, most professionals working in Occupational Health and Safety have no experience in the area. The aim of this review was to summarize the most relevant and recent publications, to improve their performance capacity and enhance the productivity, satisfaction and well-being of the workers involved. Methodology This is a Bibliographic Review, initiated through a search carried out in April 2023 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”. Content Salt pans can be inland (far from the sea, using groundwater with a high salt content) or coastal. The former are scarcer in Portugal and only exist between Lisbon and Coimbra. Over time, in our country, evaporation was carried out by fire and sun. The latter is believed to have been developed by the Romans who created the first version of salt flats. At national level there is evidence of salt production since the end of the Neolithic, but here more frequently with the use of fire. Throughout Europe there has been a decline in artisanal versus industrial salt production, even in sea salt pans (especially on the northwest coast of France and, in Portugal, on the western coasts). Artisanal production in our country is more prevalent in the Figueira da Foz area. The product obtained via artisanal production has better quality, particularly in terms of flavor and nutritionally (via industrial production the taste is more metallic). Portugal is a large producer and consumer of traditional salt. The climatic characteristics suit production, due to summers with frequent high temperatures and strong, hot winds. National salt was and is consumed in other European countries; for presenting superior quality, even though it is more expensive. Production depends on the climate, namely insolation (number of hours in the sun), precipitation, temperature, cloudiness and winds (which affect evaporation). In other words, this is more intense and faster if the air temperature is higher, such as with more dry winds (which are generally more frequent in summer); low precipitation is also favorable. Salt production has been increasing, due to growing industrial needs. To be used in this last situation, it must be at 100% purity. Discussion and Conclusions No bibliography was found that referred the dimension of occupational health and safety in this professional sector. Based on the authors' theoretical and practical experience, the most relevant risk factors and risks in the sector are described: ultraviolet radiation and possible skin cancer, cataracts and other associated injuries; thermal discomfort and eventual higher accident rates associated with motor incoordination, worse cardiovascular adjustment, as well as disorientation and ability to make decisions; forced/maintained loads and/or postures and possible musculoskeletal injuries, emergence/worsening of hernia pathology and falling objects at the same level and possible bruises, skin lacerations and/or fractures. It would be interesting to learn more about the national panorama of this sector, through studies that hierarchically stratify the risk, also accurately describing occupational illnesses and associated accidents, as well as more effective measures to mitigate these issues.

RESUMO Introdução/enquadramento/objetivos A produção de sal, sobretudo com métodos artesanais, não existe em todos os países, dadas as exigências climáticas e logísticas. Portugal apresenta alguma tradição nesse setor mas, ainda assim, a maioria dos profissionais a exercer na Saúde e Segurança Ocupacionais não tem experiência na área. Pretendeu-se com esta revisão resumir o que mais relevante e recente se publicou, de forma a melhorar a capacidade de atuação destes e a potenciar a produtividade, satisfação e bem-estar dos trabalhadores afetos. Metodologia Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em abril de 2023 nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Conteúdo As salinas podem ser interiores (afastadas do mar, usando água subterrânea com elevado conteúdo em sal) ou litorais. As primeiras são mais escassas em Portugal e apenas existem entre Lisboa e Coimbra. Ao longo do tempo, no nosso país, a evaporação era realizada pelo fogo e sol. Esta última acredita-se que foi desenvolvida pelos romanos que, de certa forma, criaram a primeira versão das salinas. A nível nacional há evidência de produção de sal desde o final do Neolítico, mas aqui mais frequente com a utilização do fogo. Por toda a Europa tem existido um declínio da produção artesanal de sal, versus industrial, mesmo em salinas marítimas (sobretudo na costa noroeste de França e, em Portugal, na costa ocidental). A produção artesanal no nosso país é mais prevalente na zona da Figueira da Foz. O produto obtido via artesanal tem mais qualidade, nomeadamente a nível de sabor e nutricionalmente (via industrial o paladar é um pouco mais metálico). Portugal é um grande produtor e consumidor de sal tradicional. As caraterísticas climáticas adequam-se à produção, devido aos verões com temperaturas elevadas frequentes e ventos fortes e quentes. O sal nacional era e é consumido noutros países europeus, por apresentar qualidade superior, mesmo tendo um preço mais elevado. A produção depende do clima, nomeadamente a insolação (número de horas ao sol), precipitação, temperatura, nebulosidade e ventos (que condicionam a evaporação). Ou seja, esta é mais intensa e rápida se a temperatura do ar for mais elevada, tal como com mais ventos secos (que geralmente são mais frequentes no Verão); a baixa precipitação também é favorável. A produção de sal tem vindo a aumentar, até pelas crescentes necessidades industriais. Para ser usado nesta última situação, deverá estar no patamar de 100% de pureza. Discussão e Conclusões Não se encontrou bibliografia que fizesse referência à dimensão da saúde e segurança ocupacionais neste setor profissional. Em função de experiência teórica e prática dos autores, descrevem-se os fatores de riscos e riscos mais relevantes do setor: radiação ultravioleta e eventual cancro de pele, cataratas e outras lesões associadas; desconforto térmico e eventual maior sinistralidade associada a descoordenação motora, pior ajuste cardiovascular, bem como desorientação e capacidade de tomar decisões; cargas e/ou posturas forçadas/mantidas e eventuais lesões músculo-esqueléticas, surgimento/agravamento de patologia herniária e queda de objetos e ao mesmo nível e eventuais equimoses, lacerações cutâneas e/ou fraturas. Seria interessante conhecer melhor o panorama nacional deste setor, através de estudos que estratificassem hierarquicamente o risco, descrevendo ainda com rigor as doenças profissionais e acidentes associados, bem como medidas mais eficazes para atenuar essas questões.

ABSTRACT Introduction: Burnout results from chronic exposure to work-related stress and it is characterized by a reduction in professional efficacy, feelings of lack of energy/exhaustion, and negativity related to work activities. It has a higher incidence in professions with significant interpersonal contact and among caregivers, making doctors a vulnerable population. The Maslach Burnout Inventory questionnaire is considered the gold standard for measuring this disease. In 2014, quinquennial prevention was described, aiming to prevent harm to patients through strategies that reduce Burnout in doctors. Clinical Case: The case describes a 29-year-old woman, a physician in her final year of Residency in General and Family Medicine, who sought an urgent consultation due to feelings of physical and mental exhaustion, hopelessness, irritability, initial and middle insomnia, for the last three months, and hyperphagia, two months ago. She has requested a sick leave from work because “I can't stand working anymore. I need to sleep for a week”. She identified excessive workload at the Clinic, stemming from the demands of her medical residency, as the main cause. She feels unsupported by her colleagues and Training Supervisor and feels pressured to manage the medical agenda without adequate preparation. She reports occasional errors in prescriptions, leading her to feel the need to repeatedly review records and decisions she has made. She denies any appointment with her designated Work physician ever since she started her internship. Upon physical examination, she appeared slaughtered, with a depressed mood, tearful, restless, and with fleeting eye contact. Applying the Maslach Burnout Inventory: Section A- 34 points- high level; Section B- 28 points- high level; Section C- 25 points- high level. A work leave from work was issued, laboratory studies were requested, and fluoxetine 20 mg and trazodone 50 mg were initiated, along with psychotherapy. So far, the patient has been re-evaluated in three consultations, with organic causes ruled out, and in the last re-evaluation, her scores were: Section A- 20 points- moderate level; Section B- 5 points- low level; Section C- 39 points- moderate level. She reports a decrease in medical errors. She maintained the prescribed medication and psychotherapy. She declined to join a Balint group. A new re-evaluation was scheduled in six months. Discussion/Conclusion: This is a case of a General and Family Medicine Resident Physician, diagnosed with Burnout, who has managed to substantially improve her quality of life and job satisfaction, as well as her personal life, following the implementation of both pharmacological and non-pharmacological measures, along with workplace adjustments and the setting of boundaries. She has successfully reduced her perception of making medical errors, thereby improving the quality of healthcare provided to the patients. The long journey of recovery from Burnout makes the monitoring of this illness imperative not only by the patients Family Doctor and Psychologist, but also by the Occupational physician, targeting the improvement of the quality of life of the healthcare professionals in their occupational activity. This clinical case’s purpose is to address and raise awareness among professionals to the prevention of Burnout, particularly in Residents, promoting quinquennial prevention. It is important to note that only professionals who are fulfilled in their biopsychosocial sphere can provide quality care and significantly reduce medical errors.

RESUMO Introdução: O Burnout resulta da exposição crónica ao stress laboral e caracteriza-se por redução da eficácia a nível profissional, sentimentos de falta de energia/exaustão e negatividade relacionados com a atividade laboral. Tem maior incidência em profissões de elevado contacto com pessoas e em prestadores de cuidados, tornando os médicos uma população vulnerável. O questionário Maslach Burnout Inventory é considerado gold standard para a medição desta patologia. Em 2014 foi descrita a prevenção quinquenária, que pretende evitar o dano para o paciente, atuando no médico através de estratégias que visem a diminuição do Burnout. Caso Clínico: Descreve-se uma mulher de 29 anos, médica, no último ano da especialização em Medicina Geral e Familiar, que recorreu a consulta aberta por sensação de exaustão física e mental, sentimentos de desesperança, irritabilidade, insónia inicial e intermédia, com três meses de evolução e hiperfagia há dois meses. Solicitou certificado de incapacidade temporária para o trabalho, porque “já não aguento mais trabalhar. Preciso de dormir uma semana”. Aponta como principal etiologia o trabalho excessivo no Centro de Saúde, decorrente da exigência do internato médico. Sente-se pouco apoiada pelos colegas de equipa e orientador de formação e considera-se pressionada a gerir a agenda médica sem ter preparação para tal. Relata erros pontuais na prescrição médica, pelo que sente necessidade de rever várias vezes os registos efetuados e as atitudes tomadas. Nega ter sido convocada para qualquer consulta de Medicina do Trabalho desde que ingressou na especialidade. Ao exame objetivo, apresentava-se cabisbaixa, com humor deprimido, chorosa, inquieta e com contacto ocular fugaz. Aplicando o questionário atrás mencionado: Secção A - 34 pontos - nível elevado; Secção B - 28 pontos - nível elevado; Secção C - 25 pontos - nível elevado. Foi emitido o certificado de incapacidade temporária para o trabalho, solicitado estudo analítico e iniciada fluoxetina 20mg e trazodona 50mg, bem como psicoterapia. Até à data, a doente foi reavaliada em três consultas, foi excluída patologia orgânica e na última reavaliação apresentava os seguintes valores: Secção A- 20 pontos- nível moderado; Secção B- 5 pontos- nível baixo; Secção C- 39 pontos- nível moderado. Refere diminuição dos erros médicos. Manteve a medicação instituída, bem como a psicoterapia. Recusou o grupo Balint. Foi programada nova reavaliação em seis meses. Discussão/Conclusão: Trata-se de uma doente, Médica Interna em Medicina Geral e Familiar com o diagnóstico de Burnout, que conseguiu melhorar substancialmente a sua qualidade de vida e satisfação no trabalho e vida pessoal, após a implementação de medidas farmacológicas e não farmacológicas e também após alterações a nível laboral e imposição de limites. Conseguiu diminuir a perceção de erro médico, melhorando assim os cuidados de saúde prestados aos utentes. O longo percurso de recuperação desta doença torna fulcral o acompanhamento destes utentes pela equipa de Medicina do Trabalho, e não só pelo Médico de Família e Psicólogo, visando melhorar a qualidade de vida e saúde dos profissionais no âmbito da sua atividade laboral. Com este caso clínico pretende-se abordar e sensibilizar os profissionais para a prevenção do Burnout, em particular nos médicos internos, fomentando a prevenção quinquenária. De ressalvar que apenas profissionais realizados na sua esfera biopsicossocial conseguem proporcionar cuidados de qualidade e reduzir de forma importante o erro médico.

ABSTRACT Introduction/framework/objectives: There have always been employers, managers and/or co-workers with less correct and disruptive behaviors, with possible consequences in terms of physical and emotional health, in addition to direct intervention in work parameters (such as performance, satisfaction, productivity and profit). Within this dimension there is a very wide variation between more subtle and possibly less serious situations, to the opposite. The aim of this review is to address the softer part of this spectrum and, possibly, more discreet and frequent, in order to provide Occupational Health and Safety Professionals with more weapons, to better guide the situation. Methodology: This is a Bibliographic Review, initiated through a search carried out in April 2023 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”. Content: Civility can be defined as tolerance, respect and concern for others; with the possibility of sharing and disagreeing in a polite and cooperative way, based on treating with dignity; which can mitigate the effects of workload on employees’ mental health. Incivility occurs when an individual violates respect for others by being rude and/or condescending, leading to disrespect, conflict and anxiety. In other words, it is a deviant behavior that is not very intense, violating the rules of good work conduct. This review also mentions data relating to possible classifications of Incivility, elements that can commit it, factors that increase or mitigate the risk of being a target of this phenomenon, professional areas most affected, some international statistics; as well as personal and work consequences and ways to mitigate the problem. Discussion and Conclusions: Addressing and drawing attention to Workplace Incivility will certainly make everyone involved more aware and capable of mitigating or eliminating it, contributing to the construction of healthier cultures and work environments (physically and emotionally); creating more competitive and profitable institutions. It would be interesting to see if, at a national level, there are employers who have already studied the topic inside (or intend to do so in the future), summarizing the respective incidences/prevalence of the different subtypes of uncivilized behavior, socio-demographic-professional characteristics of the aggressors and attacked workers, measures taken and their effectiveness, publishing this in a specialized magazine.

RESUMO Introdução/enquadramento/objetivos: Desde sempre que existiram empregadores, chefias e/ou colegas de trabalho com comportamentos menos corretos e perturbadores, com eventuais consequências a nível da saúde física e emocional, para além da interação com parâmetros laborais (como desempenho, satisfação, produtividade e lucro). Dentro desta dimensão existe uma variação muito ampla entre situações mais subtis e eventualmente menos graves, até o oposto. Pretende-se com esta revisão abordar a parte mais suave deste espetro e, eventualmente, mais discreta e frequente, de forma a dotar os Profissionais da Saúde e Segurança Ocupacionais de mais armas, para melhor orientarem a situação. Metodologia: Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em abril de 2023 nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Conteúdo: Civilidade pode ser definida como tolerância, respeito e preocupação pelos outros; com possibilidade de partilhar e discordar de uma forma educada, cooperando, baseada no trato com dignidade; podendo atenuar os efeitos da carga de trabalho na saúde mental dos funcionários. Incivilidade ocorre quando um indivíduo viola o respeito por terceiros, sendo rude e/ou condescendente, levando a um ambiente de conflito e ansiedade. Ou seja, é um comportamento desviante não muito intenso, mas violando as normas/condutas de trabalho. Nesta revisão são ainda mencionados dados relativos a eventuais classificações de Incivilidade, elementos que a podem cometer, fatores que potenciam ou atenuam o risco de ser alvo deste fenómeno, áreas profissionais mais atingidas e algumas estatísticas internacionais, consequências pessoais e laborais e forma de atenuar o problema. Discussão e Conclusões: Abordar e chamar a atenção para a Incivilidade Laboral certamente conseguirá que todos os envolvidos ficam mais atentos e capazes de a atenuar ou eliminar, contribuindo para a construção de culturas e ambientes de trabalho mais saudáveis (física e emocionalmente); criando instituições mais competitivas e lucrativas. Seria curioso perceber se a nível nacional existem empregadores que já tenham estudado o tema dentro de suas portas (ou pretendam fazê-lo futuramente), resumindo as respetivas incidências/prevalências dos diversos subtipos de comportamentos incivilizados, caraterísticas socio-demográfico-profissionais dos agressores e agredidos, medidas tomadas e eficácia das mesmas, divulgando tal em revista especializada.

Abstract This research aims to identify the main factors that have been studied about the marketing of services and guest satisfaction in the hotel industry through a review of the literature during the period 2003 to 2023. The research path that was considered was of a qualitative order, since the first attempt was to discover and refine research questions until the main components around the study variables were identified using the database through the LENS platform. ORG, and the use of the VOSviewer tool to carry out bibliometric networks. Two clusters were identified that, through a bibliometric network directed towards the incidence of marketing in the hotel field with emphasis on the hospitality industry, the main study components were distinguished. It can be affirmed that, by effectively linking the advocacy component to human resources towards the organizational goals and objectives, as well as towards the adaptation of the prevailing organizational culture, people can be recruited, developed, encouraged, and retained to gain a competitive advantage; therefore, the success at a strategic and tactical level of a company immersed in the hotel industry.

Resumen Esta investigación tiene como objetivo identificar los principales factores que se han estudiado acerca de la mercadotecnia de servicios y la satisfacción del huésped en la hotelería a través de una revisión de la literatura durante el periodo 2003 a 2023. La ruta de investigación que se consideró fue de orden cualitativo, ya que, se trató primero de descubrir y refinar preguntas de investigación hasta identificar los principales componentes alrededor de las variables de estudio usando la base de datos a través de la plataforma LENS. ORG, y, el uso de la herramienta VOSviewer para realizar redes bibliométricas. Se identificaron dos clústeres que, a través una red bibliométrica dirigida hacia la incidencia de la mercadotecnia en el ámbito hotelero con énfasis en la industria de la hospitalidad se distinguieron los principales componentes de estudio. Se puede afirmar que, al vincular de forma efectiva el componente de incidencia a los recursos humanos hacia las metas y objetivos organizacionales, así también, como hacia la adaptación de la cultura organizacional prevaleciente, las personas pueden ser reclutados, desarrollados, alentados y retenidos para obtener una ventaja competitiva; por lo tanto, el éxito a nivel estratégico y táctico de una empresa inmersa en la industria hotelera.

SUMMARY OBJECTIVE: This study aims to examine the relationship between body image and the level of sexual satisfaction in women who have undergone a hysterectomy. METHODS: This descriptive study utilized a relational screening model. Conducted between June 2023 and March 2024, the study included a total of 300 sexually active women who had undergone a hysterectomy 6 months prior. Data were collected using a personal information form, the Golombok-Rust Sexual Satisfaction Scale, and the Body Image Scale through face-to-face interviews lasting approximately 20–30 min. RESULTS: The average age of the participating women was 44.4±10.55 years. Of the participants, 96.7% were married and 42.4% had entered menopause. The average score on the Body Image Scale was 81.2±3.8, and the average score on the Golombok-Rust Sexual Satisfaction Scale was 33.0±15.1. A positive significant relationship was found between body image and sexual satisfaction (p<0.05). There was also a statistically significant positive relationship between the total scores on the Body Image Scale and the Golombok-Rust Sexual Satisfaction Scale with age and frequency of sexual intercourse (p=0.049, p<0.001, p<0.001, p=0.047, and p=0.014). It was determined that as the age and frequency of sexual intercourse increased, the levels of body image and sexual satisfaction also increased. CONCLUSION: Our study found that women’s self-image is negatively affected, and their level of sexual satisfaction decreases following a hysterectomy. OBJECTIVE METHODS model 202 2024 30 prior form GolombokRust Golombok Rust facetoface face 2030 20 20–3 min RESULTS 4441055 44 4 10 55 44.4±10.5 years participants 967 96 7 96.7 424 42 42.4 menopause 81238 81 2 3 8 81.2±3.8 330151 33 0 15 1 33.0±15.1 p<0.05. p005 p p<0.05 . 05 (p<0.05) p=0.049, p0049 049 (p=0.049 p0001 001 p<0.001 p0047 047 p=0.047 p=0.014. p0014 p=0.014 014 p=0.014) increased CONCLUSION womens s selfimage self affected 203 20– 444105 5 44.4±10. 9 96. 42. 8123 81.2±3. 33015 33.0±15. p00 p<0.0 (p<0.05 p=0.049 p004 04 (p=0.04 p000 00 p<0.00 p=0.04 p001 p=0.01 01 44410 44.4±10 812 81.2±3 3301 33.0±15 p0 p<0. (p<0.0 (p=0.0 p=0.0 4441 44.4±1 81.2± 330 33.0±1 p<0 (p<0. (p=0. p=0. 444 44.4± 81.2 33.0± p< (p<0 (p=0 p=0 44.4 81. 33.0 (p< (p= p= 44. 33. (p

SUMMARY OBJECTIVE: Pregnancy, childbirth, and postpartum periods bring along biological, psychological, and social changes that could affect women's sexual health. The aim of this study was to evaluate the effect of genital self-image on sexual satisfaction and stress in women who had a vaginal delivery. METHODS: This descriptive and cross-sectional study was conducted online between June and September 2023 by using snowball sampling and the data collection forms prepared in the GoogleDocs program. Women who had a normal vaginal delivery were included, were within 6 weeks to 1 year postpartum, were able to use at least one of the social media networks (e-mail, WhatsApp, Facebook, and Instagram), and volunteered to participate in the research. Data were collected through the Personal Information Form, the "Female Genital Self-Image Scale," the "Golombok-Rust Inventory of Sexual Satisfaction," and the "Female Sexual Distress Scale-Revised." RESULTS: The average age of the participating women was 30.54±5.83 years (n=235). The participants’ mean scores were 18.94±2.92 for the Female Genital Self-Image Scale, 40.07±15.51 for the Golombok-Rust Inventory of Sexual Satisfaction, and 8.85±8.50 for the Female Sexual Distress Scale-Revised total. A statistically significant and negative relationship was found between Female Genital Self-Image Scale and Golombok-Rust Inventory of Sexual Satisfaction and Female Sexual Distress Scale-Revised total scores (r=-0.183, p<0.01; r=-0.387, p<0.01). Regression analysis (forward) was performed, and genital self-image was found to be the predictive factor affecting sexual satisfaction and stress. CONCLUSION: This study found that women had a medium level of genital self-image and sexual satisfaction and a low level of sexual distress. OBJECTIVE Pregnancy childbirth biological psychological womens s health selfimage self image METHODS crosssectional cross sectional 202 program included email, email e mail, mail (e-mail WhatsApp Facebook Instagram, Instagram , Instagram) research Form SelfImage Self Image GolombokRust Golombok Rust ScaleRevised. ScaleRevised Revised. Revised Scale-Revised. RESULTS 3054583 30 54 5 83 30.54±5.8 n=235. n235 n n=235 . 235 (n=235) participants 1894292 18 94 2 92 18.94±2.9 40071551 40 07 15 51 40.07±15.5 885850 8 85 50 8.85±8.5 r=0.183, r0183 r r= 0.183, 0 183 (r=-0.183 p<0.01 p001 p 01 r=0.387, r0387 0.387, 387 r=-0.387 p<0.01. p<0.01) forward (forward performed CONCLUSION distress 20 305458 3 30.54±5. n23 n=23 23 (n=235 189429 9 18.94±2. 4007155 4 40.07±15. 88585 8.85±8. r=0.183 r018 0183 0.183 (r=-0.18 p<0.0 p00 r=0.387 r038 0387 0.387 38 r=-0.38 30545 30.54±5 n2 n=2 (n=23 18942 18.94±2 400715 40.07±15 8858 8.85±8 r=0.18 r01 018 0.18 (r=-0.1 p<0. p0 r=0.38 r03 038 0.38 r=-0.3 3054 30.54± n= (n=2 1894 18.94± 40071 40.07±1 885 8.85± r=0.1 r0 0.1 (r=-0. p<0 r=0.3 03 0.3 r=-0. 305 30.54 (n= 189 18.94 4007 40.07± 88 8.85 r=0. 0. (r=-0 p< r=-0 30.5 (n 18.9 400 40.07 8.8 r=0 (r=- r=- 30. 18. 40.0 8. (r= 40. (r

Abstract Sexual satisfaction is expressed as an evaluation to gauge the level of enjoyment in one’s sexual life. Studies of the sexuality of the LGBTIQ population have been limited, as this group grapples with taboos, repression, and social stigma, which impact various aspects of their lives, including health and sexual satisfaction. This study investigates the unidimensional scale of sexual satisfaction in the LGBTIQ population in Ecuador, We analyze how this scale is affected when compared to different sociodemographic variables. We utilized a quantitative, descriptive, correlational, and prospective methodology, applying a questionnaire to 625 residents of Ecuador to gather sociodemographic data and the Sexual Satisfaction Index (SSI). The results on the unidimensional scale of sexual satisfaction are as follows: 33% of respondents report sexual satisfaction, while 60.5% experience sexual dissatisfaction, and 6.6% undergo a severe stress experience. There is less sexual dissatisfaction among individuals living in Quito, males, homosexuals, those with a higher level of education, and Afro-Americans, with a P value < 0,005 that is statistically significant. A negative value of sexual satisfaction is observed in the studied population, emphasizing the need for further investigation into the causes and factors influencing sexual dissatisfaction. This will help us understand their needs and provide support in a safe and respectful environment due to ongoing discrimination.

Resumen La satisfacción sexual se expresa como una evaluación, para manifestar el nivel de agrado a la vida sexual. Los estudios en la sexualidad de la población LGBTIQ han sido poco profundizados, grupos rodeados de tabúes, víctimas de una represión y condenas sociales; afectando las diferentes dimensiones de la salud, como la satisfacción sexual. Este trabajo investiga la escala unidimensional de la satisfacción sexual en la población LGBTIQ Ecuador. Se analiza cómo esta escala es afectada al correlacionarse con las diferentes variables sociodemográficas. Se utiliza una metodología cuantitativa, correlacional descriptiva y prospectiva. Se aplica: cuestionario a 625 personas residentes en Ecuador con recogida de datos sociodemográficos, Índice de Satisfacción Sexual (ISS). Los resultados de la escala unidimensional de satisfacción sexual muestran que el 33 % de la población tiene satisfacción sexual, el 60,5 % experimenta insatisfacción sexual y un 6,6 % reporta una experiencia severa de estrés en esta área. Se observa una menor insatisfacción sexual en los residentes de la ciudad de Quito, en hombres, en personas homosexuales, en aquellos con un nivel educativo más alto y en individuos afrodescendientes, con un valor de p < 0,005, lo que indica una significancia estadística. Estos resultados reflejan un nivel negativo de satisfacción sexual en la población estudiada. Por lo tanto, se hace necesario continuar investigando la satisfacción sexual para comprender las causas y los factores que inciden en la insatisfacción sexual. Es crucial visibilizar las necesidades y los apoyos que requiere esta comunidad en un entorno seguro y respetuoso, especialmente considerando los constantes actos de discriminación que enfrentan.

ABSTRACT This research analyzes the level of satisfaction of public financing programs for the strengthening of Technological Innovation processes in Paraguayan companies: Case of the DETIEC Program (Technological Development, Innovation and Conformity) Assessment of Council National Science and Technology (CONACYT). This study is descriptive and not experimental, a mixed methodology has been used, which combines a qualitative and quantitative analysis. Likert scale surveys have been used, as well as questionnaire guides for the interview with technicians from the DETIEC program, where among the most important results it has been observed that the beneficiary companies have been able to train their Human Capital, as well as link up with foreign companies. and improve its production on the other hand, among the weaknesses, the lack of trained collaborators to submit proposals to government entities to compete for public funds stands out.

RESUMEN Este trabajo de investigación tiene por finalidad analizar el nivel de satisfacción de los programas públicos de financiamiento para el fortalecimiento de los procesos de Innovación Tecnológica en las empresas paraguayas: Caso del Programa DETIEC (Desarrollo Tecnológico, Innovación y Evaluación de la Conformidad), del Consejo Nacional de Ciencia y Tecnología (CONACYT). Este estudio es de carácter descriptivo y no experimental, se ha utilizado una metodología mixta, la cual combina un análisis cualitativo y cuantitativo. Se han utilizado encuestas en escala Likert, y también cuestionario guías para la entrevista a técnicos del programa DETIEC, donde se han observado entre los resultados más importantes se destacan que las empresas beneficiarias han podido capacitar a su Capital Humano, así como vincularse con empresas extranjeras y mejorar su producción, por otra parte, entre las debilidades se resalta la falta de colaboradores capacitados para postular propuestas a entes del Gobierno para concursar a fondos públicos.

ABSTRACT The study of the flipped classroom methods is important for improving the quality of education and the effectiveness of learning in the context of modern technological changes and growing interest in distance education. The aim of this study was to determine the effectiveness of the use of the flipped classroom model in learning a foreign language for professional purposes. Testing was used to diagnose the effectiveness of assimilation of educational material, which included various types of tasks and questionnaires to determine the level of satisfaction with educational video materials and online learning. Tests and questionnaires were pre-validated according to the research objectives. The obtained results (χ2emp = 8.095 > χ2 0.05 = 7.815) gave grounds to conclude that the blended learning model of flipped classroom in the development of foreign language competence is more effective than traditional learning. The experiment showed that this format helps students implement an individual learning trajectory, which contributes to improving academic performance. It was determined that the effectiveness of using this model depends on the quality of video materials and students’ ability to organize their own independent work. The prospects of further research is the study of the influence of the application of the flipped classroom model on the students’ learning motivation.

RESUMEN El estudio de los métodos de aula invertida es importante para mejorar la calidad de la educación y la eficacia del aprendizaje en el contexto de los cambios tecnológicos modernos y el creciente interés por la educación a distancia. El objetivo de este estudio fue determinar la efectividad del uso del modelo de aula invertida en el aprendizaje de una lengua extranjera con fines profesionales. Se utilizaron pruebas para diagnosticar la efectividad de la asimilación del material educativo, que incluyeron varios tipos de tareas y cuestionarios para determinar el nivel de satisfacción con los materiales educativos en video y el aprendizaje en línea. Se prevalidaron pruebas y cuestionarios de acuerdo con los objetivos de la investigación. Los resultados obtenidos (χ2emp = 8,095 > χ2 0,05 = 7,815) permitieron concluir que el modelo de aprendizaje semipresencial de aula invertida en el desarrollo de la competencia en lenguas extranjeras es más efectivo que el aprendizaje tradicional. El experimento demostró que este formato ayuda a los estudiantes a implementar una trayectoria de aprendizaje individual, lo que contribuye a mejorar el rendimiento académico. Se determinó que la efectividad del uso de este modelo depende de la calidad de los materiales de video y de la capacidad de los estudiantes para organizar su propio trabajo independiente. La perspectiva de futuras investigaciones es el estudio de la influencia de la aplicación del modelo de aula invertida en la motivación de aprendizaje de los estudiantes.

BACKGROUND: There was a need to investigate the appropriateness of the standard manual wheelchairfor occupational performance in Thulamela Municipality Vhembe District, Limpopo. METHODS: An observational cross-sectional descriptive design using simple random sampling was used to select n=60 wheelchair users who were issued with standard manual wheelchairs between 2014 and 2018. The Wheelchair Outcome Measure was used to investigate the participants' level of satisfaction in engagement in ADL and IADL and the suitability of the wheelchair in terms of the user's comfort and satisfaction with positioning and prevention of skin breakdown. Descriptive statistics were used to analyse the data. RESULTS: The wheelchair users viewed activity participation in the home as important and were generally satisfied with their standard manual wheelchairs while performing occupational activities at home and outside the home. A total of (n=46; 78%) of the participants felt comfortable in their wheelchair. CONCLUSIONS: Wheelchair prescription should take into consideration the occupational choices of the user. Further qualitative studies to explore the factors that determined the participants' choices for their activity participation goals should be undertaken. IMPLICATIONS FOR PRACTICE • Training of new occupational therapy staff in each facility in the Thulamela district to equip them with the skills to prescribe wheelchairs is necessary. • The level of importance that wheelchair participants attached to level of importance of activity participation inside and outside the home was high therefore there is a need to consider the client's occupational choices when prescribing wheelchairs. • The wheelchair needs to facilitate participation in a wide range of occupational choices ranging from self-care activities and watching TV in the home to visiting friends and family and attending events outside the home.

Abstract The interrelation between community environmental education and local development prepares the individual to be able to improve his or her relationship with the natural environment, and thus the way of thinking and acting. The purpose of this work was to design strategic actions of environmental education for the local development of the "Alvarito Díaz" community, highlighting the links that make possible a socially responsible action in the natural environment, with a view to sustainable local development. A descriptive observational study was carried out with the application of theoretical and empirical methods, and the application of the SWOT matrix to obtain a general perspective of the local situation. As a result, an environmental strategy was designed with a series of elements based on the system approach, which proposes actions to develop strengths, reduce weaknesses, locate and take advantage of opportunities and reduce the threats encountered. Its design had a high level of satisfaction on the part of the users to provide new ways to generate significant changes in behavior and development through training and education of the different social actors.

Resumo A inter-relação entre a educação ambiental comunitária e o desenvolvimento local prepara o indivíduo para ser capaz de melhorar sua relação com o ambiente natural e, portanto, sua forma de pensar e agir. O objetivo deste trabalho foi projetar ações estratégicas de educação ambiental para o desenvolvimento local na comunidade "Alvarito Díaz", destacando os vínculos que permitem uma ação socialmente responsável no ambiente natural, com vistas ao desenvolvimento local sustentável. Foi realizado um estudo observacional descritivo com a aplicação de métodos teóricos e empíricos e a aplicação da matriz SWOT para obter uma visão geral da situação local. Como resultado, foi elaborada uma estratégia ambiental com uma série de elementos baseados na abordagem sistêmica, que propõe ações para desenvolver os pontos fortes, reduzir os pontos fracos, localizar e aproveitar as oportunidades e reduzir as ameaças encontradas. Sua concepção teve um alto nível de satisfação dos usuários por proporcionar novas maneiras de gerar mudanças significativas no comportamento e no desenvolvimento por meio da capacitação e do treinamento dos diferentes atores sociais.

Resumen La interrelación educación ambiental comunitaria y el desarrollo local prepara al individuo para que sea capaz de mejorar su relación con el entorno natural, y así la forma de pensar y actuar. El presente trabajo tuvo como propósito diseñar acciones estratégicas de educación ambiental para el desarrollo local de la comunidad "Alvarito Díaz", destacando los nexos que posibilitan una actuación socialmente responsable en el entorno natural, con una mirada al desarrollo local sostenible. Se realizó un estudio observacional descriptivo con la aplicación de métodos teóricos y empíricos, y la aplicación de la matriz DAFO para obtener una perspectiva general de la situación local. Como resultado se diseñó una estrategia ambiental que en su composición cuenta con una serie de elementos que se fundamentaron desde el enfoque de sistema, lo que propone acciones para desarrollar fortalezas, reducir las debilidades, localizar y aprovechar las oportunidades y disminuir las amenazas encontradas. Su diseño tuvo un elevado nivel de satisfacción por parte de los usuarios para proporcionar nuevas maneras de generar cambios significativos de comportamiento y de desarrollo mediante la capacitación y la formación de los diferentes actores sociales.

ABSTRACT The objective of this non-experimental, correlational, cross-sectional study was to investigate the relationship between personality traits and levels of resilience in employees of a private company in Asunción. The Personality Inventory - Eysenck form B for adults (EPI) and the Wagnild and Young Resilience Scale (RS) were administered to a purposive sample of 48 participants, in which the age group of 40 years and older predominated (f= 21; %= 43.8) and was composed of a total of 23 men (%= 47.9) and 25 women (%= 52.1). The results indicate that the level of personal satisfaction increases as the degree of extroversion increases (r= .182), while the higher the level of personal satisfaction, the lower the degree of instability (r= -.12). On the other hand, the higher the equanimity, the higher the degree of extroversion (r = .220) to the detriment of the level of instability (r = -.024). On the other hand, the greater the ability to feel good alone, the degree of extroversion (r = .046) also increased, to the detriment of the level of instability (r = -.19). It was also observed that those with greater self-confidence were more extroverted (r= .158) and less unstable (r= -.155). Finally, the participants' level of perseverance decreased as the degrees of extroversion (r = -.032) and instability (r = -.255) increased.

RESUMEN El presente estudio no experimental, correlacional y de corte transversal, tuvo por objetivo investigar la relación entre los rasgos de personalidad y los niveles de resiliencia en colaboradores de una empresa privada de Asunción. Se administró el Inventario de Personalidad - Eysenck forma B, para adultos (EPI) y la Escala de Resiliencia de Wagnild y Young (RS) a una muestra intencionada de 48 participantes, en donde predominó la franja etaria de 40 años en adelante (f= 21; %= 43.8) y estuvo compuesta por un total 23 hombres (%= 47,9) y 25 mujeres (%= 52.1). Los resultados señalan que el nivel de Satisfacción personal aumenta conforme aumenta el grado de extroversión (r= .182), mientras que, a mayor nivel de satisfacción personal, menor era el grado de inestabilidad (r= -.12). Por otra parte, cuanto mayor era Ecuanimidad, mayor era el grado de extroversión (r= .220) en detrimento del nivel de inestabilidad (r= -.024). Por otra parte, cuanto mayor era la capacidad de Sentirse bien solo, aumentaba también el grado de extroversión (r= .046), en detrimento del nivel de inestabilidad (r= -.19). También se apreció que quienes contaban con mayor Confianza en sí mismo eran más extrovertidos (r= .158) y menos inestables (r= -.155). Finalmente, el nivel de Perseverancia de los participantes decrecía conforme aumentaban los grados de extroversión (r= -.032) e inestabilidad (r= -.255).

ABSTRACT With the aim of perfecting the improvement process for the development of environmental education in Physical Education teachers, from the classes they teach, a methodology structured in three stages (diagnosis, implementation and assessment) is presented. For the diagnosis, the documentary review, participant observation and interviews with the teachers were taken into account, which made it possible to implement actions for the treatment of the curricular contents with an interdisciplinary approach, once the aspect that affect pedagogical performance were declared from the planning of the methodological work system. The information collected allowed to assess the effectiveness of the methodology, considering the possibilities offered by the discipline for the integration of the environment-sport-health relationship and the level of satisfaction reflected in the students. As a result, teaching work is perfected, students' relationships with the environment in the school environment are improved, and one of the tasks of the FARO Research Project “Active, Reflective, and Optimal Training of Teachers in Schools.” Pedagogical Schools" is fulfilled.

RESUMO Com o objetivo de aperfeiçoar o processo de melhoria para o desenvolvimento da educação ambiental nos professores de Educação Física, a partir das aulas que ministram, é apresentada uma metodologia estruturada em três etapas (diagnóstico, implementação e avaliação). Para o diagnóstico foram levados em consideração a revisão documental, a observação participante e entrevistas com os professores, o que possibilitou implementar ações para o tratamento dos conteúdos curriculares com abordagem interdisciplinar, conforme foram declarados a partir do planejamento do sistema de trabalho . aspectos metodológicos que afectam o desempenho pedagógico. As informações coletadas permitiram avaliar a eficácia da metodologia, considerando as possibilidades oferecidas pela disciplina para a integração da relação meio ambiente-esporte-saúde e o nível de satisfação refletido nos alunos. Como resultado, o trabalho docente é melhorado, as relações dos alunos com o meio ambiente escolar são melhoradas e uma das tarefas do Projeto de Pesquisa FARO é cumprida: “Formação Pedagógica Ativa, Reflexiva e Ótima de Professores nas Escolas”. Escolas".

RESUMEN Con el objetivo de perfeccionar el proceso de superación para el desarrollo de la educación ambiental en los maestros de Educación Física, desde las clases que imparten, se presenta una metodología estructurada en tres etapas (diagnóstico, implementación y valoración). Para el diagnóstico se tuvo en cuenta la revisión documental, la observación participante y las entrevistas a los maestros, lo que posibilitó la implementación de acciones para el tratamiento a los contenidos curriculares con un enfoque interdisciplinar, al quedar declaradas desde la planificación del sistema de trabajo metodológico los aspectos que afectan el desempeño pedagógico. La información recogida permitió valorar la efectividad de la metodología, al considerar las posibilidades que ofrece la disciplina para la integración de la relación medioambiente-deporte-salud y el nivel de satisfacción reflejado en los educandos. Como resultado se perfecciona la labor docente, se mejoran las relaciones de los educandos con el medioambiente en el entorno escolar y se da cumplimiento a una de las tareas del Proyecto de Investigación FARO: “Formación Activa, Reflexiva y Óptima de maestros y profesores en las Escuelas Pedagógicas".

RESUMEN Introducción: A lo largo de los años se ha propuesto una notable variedad de protocolos quirúrgicos periodontales, cuyo enfoque pasó de la simple resolución de defectos de tejidos blandos a la realización de procedimientos predecibles y mínimamente invasivos. Inicialmente se usaba el injerto gingival libre. Posteriormente se han probado diversas técnicas, incluidas aquellas con sustitutos de tejidos blandos, como membranas tipo Alloderm. Hoy en día se considera el gold standard el injerto de tejido conectivo subepitelial asociado al colgajo de avance coronal. Por último, se ha examinado la técnica Pinhole, con mayor preservación de tejido y resultado más estético. Objetivos: El objetivo de esta revisión fue la comparación de técnicas actualizadas para el tratamiento de recesiones múltiples en maxilar superior e inferior. El resultado del procedimiento se evaluó en términos de cobertura radicular completa, reducción de la recesión, ganancia en altura y volumen, resultado estético, dolor postoperatorio y morbilidad del lecho donante y receptor del paciente. Material y métodos: Se realizaron búsquedas electrónicas y manuales para recopilar estudios de boca dividida, ensayos clínicos controlados aleatorios, series de casos, estudios piloto, libros de periodoncia, estudios de casos, revisiones sistemáticas y metanálisis, incluyendo los defectos de recesiónes gingivales múltiples, en maxilar y mandibular, de las cuatro clases de Miller, debido a su extensa evidencia. Resultados: Se incluyeron treinta y cuatro publicaciones y se extrajeron datos sobre el resultado de las técnicas quirúrgicas de dieciocho artículos. La evaluación clínica analizó la cantidad de cobertura radicular completa, la reducción de la recesión y la ganancia de altura y volumen, mientras que la perspectiva del paciente se expresó en términos de satisfacción estética y posibles complicaciones postoperatorias. Los procedimientos de los últimos diez años mostraron mejores resultados en todos los factores mencionados anteriormente. Conclusión: La predictibilidad y la estabilidad del tratamiento a largo plazo representan los factores que guían el proceso de elección de la técnica y que añaden valor a los procedimientos más actualizados. Se observaron progresos tanto a nivel estético, al reducir las discrepancias entre el área intervenida y el tejido circundante, como a nivel postoperatorio, al aminorar las molestias del paciente. Los desafíos propios de esta rama pronto podrían encontrar respuesta gracias a su rápida evolución, la cual permite concebir más avances.

ABSTRACT Background: Along the years, a remarkable variety of periodontal surgical protocols has been proposed, the focus of which has shifted from the mere resolution of a soft tissue defect to the performance of predictable and minimally invasive procedures. Initially, the free gingival graft was used. Subsequently, many different techniques were experimented, including those using soft tissue substitutes, such as the Alloderm membrane. Nowadays, the association of the connective tissue graft with the coronally advanced flap is considered the gold standard. Finally, the Pinhole technique, being a more conservative method in terms of tissue preservation and aesthetic outcome, was proposed. Objectives: The aim of this review was the comparison of the updated techniques for the treatment of multiple periodontal recessions, affecting both maxilla and mandible. The procedure outcome was assessed in terms of complete root coverage, recession reduction, gain in height and volume, aesthetic outcome, patient’s post-operative pain and morbidity of donor and recipient sites. Material and methods: Electronic and hand searches were performed to collect split- mouth studies, randomized controlled clinical trials, case series, pilot studies, periodontal books, case studies, systematic reviews and meta-analysis, including maxillary and mandibular multiple gingival recession defects of all four Miller’s classes, for its extensive evidence. Results: Thirty-four publications were included and data regarding the surgical techniques outcome were extracted from eighteen articles. The clinical evaluation analyzed the amount of complete root coverage, recession reduction and gain in height and volume, while the patient’s perspective was expressed in terms of aesthetic satisfaction and possible postoperative complications. Procedures in the last ten years showed better results in all the above-mentioned factors. Conclusion: Procedural predictability and long-lasting treatment stability embody the factors driving the technique election process and adding value to more updated procedures. Progress was observed both at an aesthetic level, by reducing the discrepancias between the surgical region and the surrounding tissue, and at a postoperative level, by reducing patient discomfort. The challenges inherent to this branch could soon find answers thanks to its prompt evolution, which allows for further advances to be conceived.

Resumo Introdução: O médico de família desenvolve uma abordagem centrada na pessoa, orientada para o indivíduo, a família e a comunidade em que se insere, sendo a empatia a chave-mestra desta relação. Objetivos: Compreender a relação médico-doente no contexto dos cuidados de saúde primários (CSP) do Nordeste Transmontano. Métodos: Foi realizado um estudo descritivo com uma amostra de utentes de CSP. Os dados demográficos (sexo biológico - classificação binária, idade, concelho de residência e escolaridade), perguntas acerca da perceção dos CSP e a aplicação da Escala de Empatia de Jefferson (JSPPPE-VP) foram recolhidos através de uma plataforma online, recorrendo à divulgação pelas redes sociais, e em formato físico nos CSP da Unidade Local de Saúde do Nordeste. A análise estatística descritiva foi realizada com recurso ao software IBM SPSS® Statistics. Resultados: A amostra incluiu 584 indivíduos (idade mediana: 45 anos), maioritariamente mulheres (67,47%), com um nível de escolaridade não graduado (57,71%). A maioria dos inquiridos (75,51%) revela que o seu médico de família é a primeira pessoa a quem recorrem quando têm um problema de saúde, considerando que este tem as capacidades necessárias para a melhor orientação dos seus problemas de saúde (69,52%). Relativamente à acessibilidade, 61,30% e 60,96% considera, respetivamente, que o acesso à marcação de consulta e esclarecimento de dúvidas pontuais é fácil. Dos inquiridos, 22,95% discorda do tempo médio de consulta praticado (20 minutos), defendendo uma duração de 30 minutos. Quando aplicada a JSPPPE-VP, cerca de 50,00% dos indivíduos responderam que estão bastante ou totalmente de acordo com as afirmações que se encontram ao longo de toda a escala. Conclusões: A amostra obtida revela uma satisfação global relativamente à prestação, acessibilidade e qualidade dos serviços, bem como à duração da consulta. Além disso, pode-se concluir que existe uma elevada satisfação com a empatia do médico de família.

Abstract Introduction: The family doctor develops a person-centered approach, oriented toward the individual, the family, and the community in which he is inserted, with empathy being the major key to this relationship. Objectives: Understand the doctor-patient relationship in the context of primary health care (PHC) in the Northeast of Portugal. Methods: A descriptive study was carried out with a sample of PHC. Demographic data (biological sex-binary classification, age, county of residence, and education), questions about the perception of PHC, and the application of the Jefferson Empathy Scale (JSPPPE-VP) were collected through an online platform with the dissemination of information through social media and physical format in PHC of the Unidade Local de Saúde do Nordeste. Descriptive statistical analysis was performed using the IBM SPSS® Statistics software. Results: The sample consisted of 584 individuals (median age: 45 years old), mostly women (67.47%), with an undergraduate level of education (57.71%). Most people (75.51%) say that their family doctor is the first person that they turn to when they have a health problem because they believe he has the necessary skills to better manage their health problems (69.52%). In terms of accessibility, 61.30% and 60.96% respectively consider that it is easy to get an appointment and to clarify specific doubts. Of the respondents, 22.95% did not agree with the average duration of consultations (20 minutes), preferring 30 minutes. When the JSPPE-VP was applied, approximately 50.00% of the respondents indicated that they strongly or completely agreed with all the items evaluated. Conclusions: The sample obtained showed overall satisfaction with the provision, accessibility, and quality of services, as well as the duration of the consultation. It can also be concluded that there is a high level of satisfaction with the empathy of the family doctor.