BackgroundThe relationship between users and health services is considered essential to strengthen the quality of care. However, the Lesbian, Gay, Bisexual, and Transgender population suffer from prejudice and discrimination in access and use of these services. This study aimed to identify the difficulties associated with homosexuality in access and utilization of health services.MethodA systematic review conducted using PubMed, Cochrane, SciELO, and LILACS, considering the period from 2004 to 2014. The studies were evaluated according to predefined inclusion and exclusion criterias. Were included manuscripts written in English or Portuguese, articles examining the Lesbian, Gay, Bisexual, and Transgender population’s access to health services and original articles with full text available online.ResultsThe electronic databases search resulted in 667 studies, of which 14 met all inclusion criteria. Quantitative articles were predominant, showing the country of United States of America to be the largest producer of research on the topic. The studies reveal that the homosexual population have difficulties of access to health services as a result of heteronormative attitudes imposed by health professionals. The discriminatory attendance implies in human rights violations in access to health services.ConclusionsThe non-heterosexual orientation was a determinant factor in the difficulties of accessing health care. A lot must still be achieved to ensure access to health services for sexual minorities, through the adoption of holistic and welcoming attitudes. The results of this study highlight the need for larger discussions about the theme, through new research and debates, with the aim of enhancing professionals and services for the health care of Lesbian, Gay, Bisexual, and Transgender Persons.

Background and Objectives: Several factors can compromise patient safety, such as ineffective teamwork, failed organizational processes, and the physical and psychological overload of health professionals. Studies about associations between burn out and patient safety have shown different outcomes. Objective: To analyze the relationship between burnout and patient safety. Materials and Methods: A systematic review with a meta-analysis performed using PubMed and Web of Science databases during January 2018. Two searches were conducted with the following descriptors: (i) patient safety AND burnout professional safety AND organizational culture, and (ii) patient safety AND burnout professional safety AND safety management. Results: Twenty-one studies were analyzed, most of them demonstrating an association between the existence of burnout and the worsening of patient safety. High levels of burnout is more common among physicians and nurses, and it is associated with external factors such as: high workload, long journeys, and ineffective interpersonal relationships. Good patient safety practices are influenced by organized workflows that generate autonomy for health professionals. Through meta-analysis, we found a relationship between the development of burnout and patient safety actions with a probability of superiority of 66.4%. Conclusion: There is a relationship between high levels of burnout and worsening patient safety.

Objetivou-se evidenciar a atuação das políticas públicas direcionadas à saúde da população homossexual brasileira. Trata-se de uma revisão integrativa da literatura, realizada na Scientific Eletronic Library Online (SciELO) e na Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), utilizando os Decs: políticas públicas, assistência integral à saúde e homossexualidade. A saúde LGBT é apontada como vulnerável mesmo após a publicação de importantes documentos que garantem o acesso e a inclusão do grupo na saúde. A fragilidade na efetivação das propostas preconizadas vão ao encontro ao atendimento discriminatório e heteronormativo prestado pelos profissionais de saúde.

rESUMo Objetivou-se determinar o perfil de violência psicológica perpetrada contra Lésbicas, Gays, Bissexuais, Travestis e Transexuais (LGBTT) no interior cearense. Estudo quantitativo realizado com 316 indivíduos LGBTT nos municípios de Juazeiro do Norte e Crato, Ceará, Brasil. Evidenciou-se prevalência de violência psicológica, sendo insultos por parte dos agressores localizados longe da vítima o tipo mais comum. Os principais agressores são pessoas desconhecidas e as reações físicas, como agressões, são as principais formas de reação. Os índices de violência psicológica cometidas contra essa população são elevados; achado importante para o planejamento de estratégias para redução desse agravo. PalaVraS-cHaVE Comportamento sexual; Violência; Homossexualidade; Bissexualidade.aBStract This study aimed to determine the profile of psychological violence against Lesbians, Gays, Bisexuals, Transvestites and Transgender (LGBTT) in Ceará. Quantitative study arried out with 316 LGBTT in individuals in the municipalities of Juazeiro do Norte and Crato, Ceará, Brazil. It showed a prevalence of psychological violence, and insults by the attackers located away from the victim were the most common type. The main perpetrators are unknown people and physical reactions, such as aggression, the main forms of reaction. The rates of psychological violence committed against this population are high; found important for planning strategies for the reduction of this aggravation.

Objective: The aim of this study was to identify the social representations (SR) of health and major inequities, obstacles and challenges experienced by lesbians, gays, bisexuals, and transgenders regarding access to health services. Methods: This qualitative research was conducted with a group of sexual minorities recruited using the snowball technique. The data were organised according to Bardin and analysed from the perspective of SR. Results: Twelve gays, nine transvestites, six lesbians and three bisexuals participated. Most believed health to be the absence of disease and indicated the group's vulnerability to sexually transmitted diseases. The search for health services was motivated by pathological symptoms or screening for sexually transmitted diseases. The diffi culties were related to the defi ciencies of the health service regarding prejudice. Conclusions:The study population showed reductionist health representations, sought health services under the curative perspective and faced challenges/obstacles when accessing health services.

Conclusion The study evidenced the influence of all patient safety domains for the development of burnout syndrome in pediatric professionals. Also, it was identified that the organizational climate is the main determinant of burnout, especially in what refers to "teamwork between units".

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RESUMO O número de pacientes com Doença Renal Crônica aumentam, ocorrendo por diversos fatores: patologias de base descompensadas, falta de cuidados, estilo de vida errôneos, acompanhamento renal ausentes, dentre outros. Assim evoluindo para diálise que pode ser: hemodiálise ou diálise peritoneal. A hemodiálise é um dos tratamentos de substituição renal mais utilizado. Quando o paciente chega a fase dialítica muitas restrições alimentares ocorrem, dentre elas: fósforo, potássio, proteína. Diante do exposto, este trabalho permite um maior conhecimento aos profissionais de saúde, voltado principalmente aos da nutrição, para que estes possam desenvolver estratégias voltadas ao paciente hiperfosfatêmico, assim diminuindo os índices de morbidade e mortalidade como também maior eficiência ao tratamento. O objetivo deste estudo é conhecer as consequências da hiperfosfatemia sérica em pacientes renais em tratamento hemodialítico. O presente estudo define-se como uma revisão integrativa de abordagem qualitativa. A partir dos descritores de saúde e dos critérios de inclusão e exclusão, obteve-se vinte artigos científicos sendo utilizados dez artigos, estes discorrem sobre complicações da hiperfosfatemia em pacientes renais em tratamento hemodialítico. A partir dos artigos selecionados, foi elaborada duas tabelas uma contendo dados dos artigos como: nome dos autores, ano das publicações, título entre outros. E outra: dividindo os artigos divididos em categorias.Apesar das consequências da hiperfosfatemia serem bastante prejudiciais, o controle deste ocorre de maneira simples: com utilização de quelantes, alimentação adequada e sessões de diálise. Porém o tratamento depende essencialmente do paciente.