Gestão da saúde e segurança no trabalho no processo de contratação de empresas externas

Dissertação para obtenção do Grau de Mestre em Engenharia e Gestão IndustrialO recurso ao trabalho de empresas externas por parte das organizações é uma prática cada vez mais comum, potenciada pela abertura dos mercados e dissolução das fronteiras entre países. A contratação de empresas externas permite o acesso a trabalhadores especializados e altamente competentes, sempre que necessário, sem que para isso as organizações contratantes tenham que incorrer em grandes investimentos. Outra das vantagens deve-se à possibilidade das empresas e organizações contratantes poderem centrar-se no seu Core Business, podendo ao mesmo tempo tirar partido da superioridade tecnológica e know-how das empresas externas. Considerando as vantagens que a contratação de empresas externas representa para as empresas clientes, tornou-se necessário analisar de que modo a organização e relações estabelecidas na cadeia de outsourcing influenciam a Saúde e Segurança no Trabalho dos trabalhadores das empresas externas. Verificou-se através da análise da literatura realizada que existe em grande parte dos casos uma maior precariedade nas relações e contratos de trabalho estabelecidos com os trabalhadores das empresas externas. Esta precariedade reflete-se em piores condições de trabalho e acesso a formação adequada por parte dos trabalhadores, sendo esta situação mais grave em empresas de menores dimensões. O conjunto de procedimentos de subcontratação apresentado no presente trabalho tem como objetivo conduzir o processo de seleção, contratação e acompanhamento das empresas externas que venham a realizar trabalho para a FCT-UNL, de modo a assegurar que apenas empresas que realizem o seu trabalho respeitando todas as regras de Saúde e Segurança no Trabalho possam servir a Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa. O referido conjunto de procedimentos de subcontratação foi desenvolvido tendo por base conjuntos de procedimentos semelhantes utilizados em empresas de áreas como a construção civil e a indústria de exploração, bem como as prescrições legais aplicáveis e os requisitos apresentados pelo Gabinete de Segurança da FCT-UNL. Do processo de desenvolvimento resultou um conjunto de procedimentos que abrange a análise do trabalho a realizar, a seleção, a contratação, a formação dos trabalhadores, a monitorização da fase de execução e a análise pós contratual. As empresas abrangidas foram as empresas de limpeza, as de construção civil e as de segurança

Mobile pupillometry in manual assembly : a pilot study exploring the wearability and external validity of a renowned mental workload lab measure

Human operators in the upcoming Industry 4.0 workplace will face accelerating job demands such as elevated cognitive complexity. Unobtrusive objective measures of mental workload (MWL) are therefore in high demand as indicated by both theory and practice. This pilot study explored the wearability and external validity of pupillometry, a MWL measure robustly validated in laboratory settings and now deployable in work settings demanding operator mobility. In an ecologically valid work environment, 21 participants performed two manual assemblies - one of low and one of high complexity - while wearing eye-tracking glasses for pupil size measurement. Results revealed that the device was perceived as fairly wearable in terms of physical and mental comfort. In terms of validity, no significant differences in mean pupil size were found between the assemblies even though subjective mental workload differed significantly. Exploratory analyses on the pupil size when attending to the assembly instructions only, were inconclusive. The present work suggests that current lab-based procedures might not be adequate yet for in-the-field mobile pupillometry. From a broader perspective, these findings also invite a more nuanced view on the current validity of lab-validated physiological MWL-measures when applied in real-life settings. We therefore conclude with some key insights for future development of mobile pupillometry

Portuguese multidisciplinary recommendations for non-pharmacological and non-surgical interventions in patients with rheumatoid arthritis

BACKGROUND: Patients with rheumatoid arthritis (RA) report significant levels of disease impact, which are improved, but not fully abrogated by immunosuppressive therapy, even when remission is achieved. This imposes the need for adjuvant interventions targeting the uncontrolled domains of disease impact. Non-pharmacological interventions are widely used for this purpose, but they have not been the object of professional recommendations or guidelines. OBJECTIVE: To propose multidisciplinary recommendations to inform clinical care providers regarding the employment of non-pharmacological and non-surgical interventions in the management of patients with RA. METHODS: The EULAR standardized operating procedures for the development of recommendations were followed. First, a systematic literature review was performed. Then, a multidisciplinary Technical Expert Panel (TEP) met to develop and discuss the recommendations and research agenda. For each developed recommendation i) the level of evidence and grade of recommendation were determined, and ii) the level of agreement among TEP members was set. A recommendation was adopted if approved by ≥75% of the TEP members, and the level of agreement was considered high when ≥8. All relevant national societies were included in this construction process to attain their endorsement. RESULTS: Based on evidence and expert opinion, the TEP developed and agreed on five overarching principles and 12 recommendations for non-pharmacological and non-surgical interventions in patients with RA. The mean level of agreement between the TEP members ranged between 8.5 and 9.9. The recommendations include a broad spectrum of intervention areas, such as exercise, hydrokinesiotherapy, psychological interventions, orthoses, education, general management of comorbidities, among others; and they set the requirements for their application. CONCLUSIONS: These recommendations are based on the consensus judgment of clinical experts from a wide range of disciplines and patients' representatives from Portugal. Given the evidence for effectiveness, feasibility and safety, non-pharmacological and non-surgical interventions should be an integral part of standard care for people with RA. It is hoped that these recommendations should be widely implemented in clinical practice. The target audience for these recommendations includes all health professionals involved in the care of patients with RA. The target patient population includes adult Portuguese people with RA.publishersversionpublishe

Complicação pós cateterização venosa central: relato de caso / Complication after central venous catheterization: case report

A cateterização intravascular venosa - em especial, cateteres venosos centrais - é um procedimento extremamente frequente em pacientes cirúrgicos. Há diversas complicações a depender do sítio de inserção. Alocação anômala da ponta do cateter na punção de veia subclávia é um exemplo disso. Uma manobra simples que pode ser realizada a fim de minimizar esta complicação é a manobra de Ambesh, sobretudo, para garantir desfecho favorável estes pacientes

A influência da suplementação de coenzima Q10 sobre o esquema de tratamento medicamentoso de Hipertensão Arterial Sistêmica

Objetivo: Avaliar, através de revisão de literatura, qual o efeito do uso de CoQ10 sobre a dose dos medicamentos hipotensores, quando usados em conjunto. Método: Trata-se de um estudo de revisão da literatura. A busca de artigos foi realizada na base de dados Medline entre os meses de janeiro a março de 2023. Foram utilizados na pesquisa os descritores “hypertension” e “coenzyme Q10”. Resultados: Foram encontrados 17 estudos, mas atenderam aos critérios da pesquisa apenas 2 estudos; em uma publicação os autores descreveram o resultado da administração de CoQ10 a pacientes hipertensos e em outra compilou várias intervenções feitas com o uso de CoQ10 em diferentes cardiopatias. Conclusão: Os estudos que avaliaram a influência da CoQ10 na dose de anti-hipertensivos quando associada ao tratamento padrão mostraram necessidade de menor dose ou de menos medicamentos para controle pressórico

The Bom Santo Cave (Lisbon, Portugal): catchment, diet, and patterns of mobility of a Middle Neolithic population

The study of the Bom Santo Cave (central Portugal), a Neolithic cemetery, indicates a complex social, palaeoeconomic, and population scenario. With isotope, aDNA, and provenance, analyses of raw materials coupled with stylistic variability of material culture items and palaeogeographical data, light is shed on the territory and social organization of a population dated to 3800-3400 cal BC, i.e. the Middle Neolithic. Results indicate an itinerant farming, segmentary society, where exogamic practices were the norm. Its lifeway may be that of the earliest megalithic builders of the region, but further research is needed to correctly evaluate the degree of this community's participation in such a phenomenon

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

COVID-19 outcomes in people living with HIV: Peering through the waves

Objective: To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods: This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results: Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions: Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group