Desgaste físico e mental de auxiliares de enfermagem: uma análise sob o enfoque gerencial

Seeking a better understanding of job stress, auxiliary nurses were evaluated in General Hospitals Belo Horizonte. The emotional stress which accompanies auxiliary nurses caring for the sick and easing physical and mental suffering affects their own mental state and physical health. Elements that cause suffering and diseases can be attenuated or intensified depending on labor relations. However, organizations have not been concerned about working conditions. This paper suggests some protective safety and health measures that can improve labor relations and consequently reduce the suffering of working in hospitals.Buscando comprender mejor el trabajo en organizaciones de salud, fue realizada una investigación en hospitales generales contemplando algunos grupos ocupacionales. Se supone que una actividad ligada a dolor, sufrimiento y muerte interfiere en la organización, gestión, condiciones de trabajo y que de manera general, expone a los trabajadores de esas organizaciones a un desgaste físico y mental intenso. Se notó también, que tanto las organizaciones como los propios grupos ocupacionales aún tienen escasa conciencia sobre estos problemas, desenvolviendo pocas formas de regulación o atenuación de los conflictos decorrentes. El artículo presenta un análisis específico sobre el grupo de auxiliares de enfermería y sugiere, a título de conclusión medidas que pueden mejorar esa situación.Buscando melhor compreender o trabalho em organizações de saúde. Foi realizada uma pesquisa em hospitais gerais contemplando alguns grupos ocupacionais. Supõe-se que a atividade de lidar com dor, sofrimento e morte interfere na organização, gestão, condições de trabalho e que de maneira geral, expõe os trabalhadores dessas organizações a um desgaste físico e mental intenso. Percebeu-se, no entanto, que tanto as organizações quanto os próprios grupos ocupacionais têm ainda pouca consciência sobre estes problemas, desenvolvendo poucas formas de regulação ou atenuação dos conflitos daí decorrentes. O artigo apresenta uma análise específica sobre o grupo de auxiliares de enfermagem e sugere, a título de conclusivo, algumas medidas que podem melhorar essa situação

Capacidade gerencial e habilidade política dos empresários de transporte por ônibus de Belo Horizonte: mito ou realidade?

O sistema de transporte por ônibus em Belo Horizonte, comparado ao de outras capitais brasileiras, apresenta algumas particularidades, como seu elevado número de empresas e o predomínio de empresas de médio porte. Este artigo discute o processo de evolução das empresas de Belo Horizonte, destacando questões como a diferença em relação ao padrão nacional de concentração, o desenvolvimento da capacidade gerencial e da habilidade política dos transportadores mineiros, e o papel do órgão gestor nesses processos. Optou-se pelo enfoque político das organizações, privilegiando-se as relações de trabalho e de poder entre os diversos atores do sistema. Pôde-se concluir que os empresários belo-horizontinos destacam-se como articuladores na criação e no desenvolvimento de suas empresas, como pioneiros na diversificação e expansão geográfica de seus negócios e como lideranças políticas e empresariais nacionais. A partir de um processo de profissionalização e expansão no setor em Belo Horizonte, ocorreu a articulação da classe, inicialmente para fazer frente ao poder público local, expandindo-se nacionalmente. Esse processo permitiu a alavancagem e a padronização da gestão empresarial

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Desgaste físico e mental de auxiliares de enfermagem: uma análise sob o enfoque gerencial Desgaste físico y mental de auxiliares de enfermería: un análisis bajo el enfoque gerencial Mental and physical stress of auxiliary nurses: analysis of management

Buscando melhor compreender o trabalho em organizações de saúde. Foi realizada uma pesquisa em hospitais gerais contemplando alguns grupos ocupacionais. Supõe-se que a atividade de lidar com dor, sofrimento e morte interfere na organização, gestão, condições de trabalho e que de maneira geral, expõe os trabalhadores dessas organizações a um desgaste físico e mental intenso. Percebeu-se, no entanto, que tanto as organizações quanto os próprios grupos ocupacionais têm ainda pouca consciência sobre estes problemas, desenvolvendo poucas formas de regulação ou atenuação dos conflitos daí decorrentes. O artigo apresenta uma análise específica sobre o grupo de auxiliares de enfermagem e sugere, a título de conclusivo, algumas medidas que podem melhorar essa situação.<br>Buscando comprender mejor el trabajo en organizaciones de salud, fue realizada una investigación en hospitales generales contemplando algunos grupos ocupacionales. Se supone que una actividad ligada a dolor, sufrimiento y muerte interfiere en la organización, gestión, condiciones de trabajo y que de manera general, expone a los trabajadores de esas organizaciones a un desgaste físico y mental intenso. Se notó también, que tanto las organizaciones como los propios grupos ocupacionales aún tienen escasa conciencia sobre estos problemas, desenvolviendo pocas formas de regulación o atenuación de los conflictos decorrentes. El artículo presenta un análisis específico sobre el grupo de auxiliares de enfermería y sugiere, a título de conclusión medidas que pueden mejorar esa situación.<br>Seeking a better understanding of job stress, auxiliary nurses were evaluated in General Hospitals Belo Horizonte. The emotional stress which accompanies auxiliary nurses caring for the sick and easing physical and mental suffering affects their own mental state and physical health. Elements that cause suffering and diseases can be attenuated or intensified depending on labor relations. However, organizations have not been concerned about working conditions. This paper suggests some protective safety and health measures that can improve labor relations and consequently reduce the suffering of working in hospitals

Proceedings of the 4th World Conference on Research Integrity

CITATION: O’Brien, S. P., et al. 2016. Proceedings of the 4th World Conference on Research Integrity. Research Integrity and Peer Review, 1:9, doi:10.1186/s41073-016-0012-9.The original publication is available at https://researchintegrityjournal.biomedcentral.comThese Proceedings contain the abstracts of the presentations given at the 4th World Conference in concurrent sessions, partner symposia, and poster sessions. Also included are summaries of the discussions in three focus tracks, which allowed delegates to consider and work on questions about the roles of funders, institutions, and countries in improving research systems and strengthening research integrity. Videos of the plenary presentations are available at the conference website (www.wcri2015.org).https://researchintegrityjournal.biomedcentral.com/articles/10.1186/s41073-016-0012-

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p&lt;0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p&lt;0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status