Trade unionism: a past with a future

Nascidos na sequência da emergência da sociedade capitalista, os sindicatos são organizações duplamente centenárias que constituem uma das mais relevantes instituições do mercado de trabalho. A partir da década de 70, os seus principais recursos de poder começaram a ser erodidos e o movimento sindical passou a estar confrontado com uma crise profunda que não pode ser negada, a qual constitui atualmente a sua característica dominante à escala internacional, mas cujos contornos convém delimitar com precisão. As suas causas são múltiplas, nelas se mesclando fatores exógenos ao movimento (ciclos económicos, mudanças estruturais na economia, no social, no domínio político e no campo cultural), com outros endógenos, remetendo para a sua burocratização, oligarquização e deficiente capacidade de adaptação à mudança. O movimento sindical só muito tardiamente enfrentou esta situação, implementando desde então um conjunto de ações diversificadas, onde se contam fundamentalmente a realização de campanhas de recrutamento que não têm como objetivo central o reforço da organização sindical e dos laços dos trabalhadores com as suas estruturas, mas apenas o aumentar o número de efetivos sindicais, e os processos de reestruturação organizacional, numa perspetiva defensiva e não transformadora. Portugal segue o padrão internacional, quer no que respeita ao decréscimo da sindicalização quer no que se refere às respostas que tem dado ao refluxo na sindicalização, daí o amplo processo de reestruturação organizativa, no quadro de um movimento sindical extremamente fragmentado. No entanto, esta crise não representa uma decadência inexorável do sindicalismo que conduzirá ao seu desmoronamento definitivo. Estamos antes perante uma mudança qualitativa, em que à medida que declina o sindicalismo operário se consolida um sindicalismo ancorado no sector público, em torno de grupos socioprofissionais técnicos dotados de um elevado capital escolar. Neste sentido, e adotando uma perspetiva transformadora, o sindicalismo tem futuro.info:eu-repo/semantics/acceptedVersio

Accidents with agriculture and forestry tractors: to learn for preventing

A entrada de Portugal na União Europeia permitiu uma enorme evolução da mecanização das principais tarefas desenvolvidas nos setores de atividade da agricultura, produção animal e florestas. A mecanização trouxe riscos específicos que conduzem a um elevado número de acidentes, envolvendo a maioria deles a utilização de tratores. Partindo de fontes oficiais, neste artigo caraterizam-se os acidentes ocorridos para percecionar a dimensão dessa sinistralidade e discute-se a ausência de registo oficialinfo:eu-repo/semantics/publishedVersio

Bacteriocin production by Escherichia coli during biofilm development

Escherichia coli is a highly versatile bacterium ranging from commensal to intestinal pathogen, and is an important foodborne pathogen. E. coli species are able to prosper in multispecies biofilms and secrete bacteriocins that are only toxic to species/strains closely related to the producer strain. In this study, 20 distinct E. coli strains were characterized for several properties that confer competitive advantages against closer microorganisms by assessing the biofilm-forming capacity, the production of antimicrobial molecules, and the production of siderophores. Furthermore, primer sets for E. coli bacteriocins–colicins were designed and genes were amplified, allowing us to observe that colicins were widely distributed among the pathogenic E. coli strains. Their production in the planktonic phase or single-species biofilms was uncommon. Only two E. coli strains out of nine biofilm-forming were able to inhibit the growth of other E. coli strains. There is evidence of larger amounts of colicin being produced in the late stages of E. coli biofilm growth. The decrease in bacterial biomass after 12 h of incubation indicates active type I colicin production, whose release normally requires E. coli cell lysis. Almost all E. coli strains were siderophore-producing, which may be related to the resistance to colicin as these two molecules may use the same transporter system. Moreover, E. coli CECT 504 was able to coexist with Salmonella enterica in dual-species biofilms, but Shigella dysenteriae was selectively excluded, correlating with high expression levels of colicin (E, B, and M) genes observed by real-time PCR.info:eu-repo/semantics/publishedVersio

DOMINO-AD protocol: donepezil and memantine in moderate to severe Alzheimer's disease - a multicentre RCT.

BACKGROUND: Alzheimer's disease (AD) is the commonest cause of dementia. Cholinesterase inhibitors, such as donepezil, are the drug class with the best evidence of efficacy, licensed for mild to moderate AD, while the glutamate antagonist memantine has been widely prescribed, often in the later stages of AD. Memantine is licensed for moderate to severe dementia in AD but is not recommended by the England and Wales National Institute for Health and Clinical Excellence. However, there is little evidence to guide clinicians as to what to prescribe as AD advances; in particular, what to do as the condition progresses from moderate to severe. Options include continuing cholinesterase inhibitors irrespective of decline, adding memantine to cholinesterase inhibitors, or prescribing memantine instead of cholinesterase inhibitors. The aim of this trial is to establish the most effective drug option for people with AD who are progressing from moderate to severe dementia despite treatment with donepezil. METHOD: DOMINO-AD is a pragmatic, 15 centre, double-blind, randomized, placebo controlled trial. Patients with AD, currently living at home, receiving donepezil 10 mg daily, and with Standardized Mini-Mental State Examination (SMMSE) scores between 5 and 13 are being recruited. Each is randomized to one of four treatment options: continuation of donepezil with memantine placebo added; switch to memantine with donepezil placebo added; donepezil and memantine together; or donepezil placebo with memantine placebo. 800 participants are being recruited and treatment continues for one year. Primary outcome measures are cognition (SMMSE) and activities of daily living (Bristol Activities of Daily Living Scale). Secondary outcomes are non-cognitive dementia symptoms (Neuropsychiatric Inventory), health related quality of life (EQ-5D and DEMQOL-proxy), carer burden (General Health Questionnaire-12), cost effectiveness (using Client Service Receipt Inventory) and institutionalization. These outcomes are assessed at baseline, 6, 18, 30 and 52 weeks. All participants will be subsequently followed for 3 years by telephone interview to record institutionalization. DISCUSSION: There is considerable debate about the clinical and cost effectiveness of anti-dementia drugs. DOMINO-AD seeks to provide clear evidence on the best treatment strategies for those managing patients at a particularly important clinical transition point. TRIAL REGISTRATION: Current controlled trials ISRCTN49545035.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Incidence, typology and measures of prevention and treatment of skin lesions associated with the use of personal protective equipment in health care professionals during the COVID-19 pandemic in Spain

Introducción: La reciente pandemia de COVID-19 ha representado la utilización por parte de los profesionales de la salud de diferentes equipos de protección individual (EPI), lo que ha dado lugar a la aparición de lesiones cutáneas asociadas a los mismos (LC-EPI). Conocer la epidemiología, las características y los factores relacionados con el uso de los diferentes tipos de EPI y la prevención y el tratamiento de las LC-EPI puede ser muy útil para comprender el alcance del problema y definir estrategias para su prevención y tratamiento en posibles pandemias futuras. Métodos: Estudio transversal realizado por el Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas (GNEAUPP) en el ámbito geográfico del Estado español, mediante una encuesta autoadministrada utilizando un cuestionario de Google Forms. El universo de estudio fueron profesionales de la salud, de cualquier disciplina y nivel asistencial o tipo de institución que habían estado en contacto con pacientes o sospechosos de COVID-19 y habían utilizado EPI durante la primera ola de la pandemia de COVID-19 en España. Resultados: Se obtuvieron 2078 cuestionarios, el 75,5% de enfermeras, el 10,79% de técnicos en cuidados auxiliares de enfermería (TCAE) y el 6,6% de médicos. De los respondedores, el 84,7% eran mujeres y el 15,3% hombres con una edad media de 43,7 años. En el 18,2% de los casos, la institución del profesional contaba con un protocolo para la prevención de las LC-EPI, en el 10,2% el profesional no sabía si existía y en el 71,3% restante la institución no contaba con dicho protocolo. El 29,9% de los profesionales utilizaba siempre algún producto de prevención de LC-EPI y el 25,3% en ocasiones. El 52,4% de los encuestados informó haber presentado al menos una LC-EPI, de los cuales el 39% había presentado una, el 35,8% dos, el 14,3% tres, el 2,2% cuatro y el 8,6% más de cuatro. En relación con el tipo de lesiones, el 74,3% fueron definidas como lesiones por presión (LPP), el 11% como lesiones por fricción (LF), el 8,5% como lesiones combinadas o multicausales (LCMC) y el 6,1% como lesiones cutáneas asociadas a la humedad (LESCAH). La duración media de las lesiones incidentes fue de 11,6 días (9,7 días para las LPP, 10,2 días para las LF, 19,9 días para las LCMC y 19,4 días para las LESCAH). En el artículo se presenta información más detallada por tipo de dispositivo causante, tipología y gravedad de las lesiones por dispositivo, así como las medidas preventivas utilizadas.Introduction: The recent COVID-19 pandemic has represented the use by health care professionals (HCP) of different personal protective equipment (PPE), resulting in the appearance of skin injuries associated with PPE (PPE-SI). Knowing the epidemiology, characteristics and factors related to the use of different types of PPE and the prevention and treatment of PPE-SI can be very useful to understand the scope of the problem and to define strategies for its prevention and treatment in possible future pandemics. Methods: To this end, the GNEAUPP proposed the performance of a cross-sectional study, in the geographical area of the Spanish state, by means of a self-administered survey using a Google forms questionnaire. The study universe was HCP, from any discipline and from any level of care or type of institution with patients who have been in contact with COVID-19 patients or COVID-19 suspects and have used PPE during the first wave of the COVID-19 pandemic in Spain. Main results: We obtained 2078 questionnaires, 75.5% from nurses, 10.79% from nurse aids, and 6.6% from physicians. Of these, 84.7% were women and 15.3% were men with an average age of 43.7 years. In 18.2% of the cases the institution of the professional had a protocol for the prevention of PPE-SI, in 10.2% the professional did not know if it existed or not and in the remaining 71.3% the institution did not have such a protocol. 29.9% of the professionals always used some prevention product and 25.3% sometimes. 52.4% of respondents reported having submitted at least one PPE-SI, of which 39% had submitted one, 35.8% two, 14.3% three, 2.2% four and 8.6% more than four. In relation to PPE-SI, 74.3% were defined as pressure injuries (PI), 11% were friction injuries (FI), 8.5% were combined or multicausal injuries (CMCI) and 6.1% were skin injuries associated with moisture (MASI). The mean duration of incident injuries was 11.6 days (9.7 days for PI, 10.2 days for FI, 19.9 days for CMCI and 19.4 days for MASI). More detailed Information is presented in the paper by type of device causing, typology and severity of injuries per device as well as preventive measures used