A degeneração dos espaços públicos e a supervalorização narcísica como facetas do mal-estar no trabalho

In some spaces, the work model is being characterized differently in the present times when compared to that Taylorist way that still predominates in many organizations, with the classic figure centered on the boss and the goals. Precisely because of these changes, this new model has a good reputation for focusing on the individual and a proposal for supposed freedom in working environments where there are no goals and the figure of the boss is dissolved. It is possible to perceive that this overvaluation in the individual creates increasingly particular and individualistic spaces, in the same way that there is a decrease in the investment of places that value the collectivity. Therefore, the purpose of this paper is to analyze how the degeneration of public spaces and the narcissistic overvaluation present themselves as factors of malaise at work. In order to carry out this study, some Freudian and Balintian psychoanalytic works were used, in addition to the contribution of the authors of Psicossociology. Thus, it is argued here that the decline of public spaces and narcissistic exacerbation, so labor-related, are increasingly difficult for individuals to find effective spaces for drive satisfaction.Em alguns espaços, o modelo de trabalho está se caracterizando de maneira diferente nos tempos atuais quando comparado com aquela forma taylorista que ainda predomina em muitas organizações, com a clássica figura centralizada no chefe e nas metas. Justamente devido a essas mudanças, esse novo modelo apresenta uma boa notoriedade por se centrar no indivíduo e por uma proposta de uma suposta liberdade dentro de ambientes laborais, onde não existem metas e a figura do chefe é dissolvida. É possível perceber que essa supervalorização no indivíduo cria espaços cada vez mais particulares e individualistas, na mesma medida em que existe uma diminuição do investimento de lugares que prezam a coletividade. Diante disso, o objetivo deste escrito é analisar como a degeneração dos espaços públicos e a supervalorização narcísica se apresentam como fatores de mal-estar no trabalho. Para realizar este estudo, foram utilizadas algumas obras psicanalíticas freudianas e balintianas, além do aporte dos autores da Psicossociologia. Assim, defende-se aqui que o declínio dos espaços públicos e a exacerbação narcísica, tão relacionada ao trabalho, levam cada vez mais dificuldades aos indivíduos em encontrarem espaços efetivos de satisfação pulsional

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

O sentimento de vazio: reflexões psicanalíticas na atualidade

Verifica-se, em observações clínicas e também em literaturas científicas, um crescente sentimento de vazio nas pessoas nos tempos atuais. Assim, este trabalho busca compreender tal sentimento - o de vazio - e a sua relação com a subjetividade na atualidade, considerando o referencial psicanalítico. A pesquisa apresenta um entendimento da atualidade na ótica da Sociologia e, também, as possíveis relações entre a psicanálise de Freud e Balint para compreender esse sentimento. É um estudo teórico-reflexivo que traz subsídios para discussão desse fenômeno clínico tão comum hoje. Diante disso, é necessário contextualizar a atualidade e apresentar alguns conceitos psicanalíticos como o narcisismo, a transitoriedade e o amor primário. Levando-se em consideração que a psicanálise se encontra atravessada em sua teoria pela cultura, considera-se possível compreender o vazio na atualidade, tal como sua relação com a subjetividade. Ao realizar esse estudo, é possível apresentar subsídios para compreender o sentimento do vazio como uma possibilidade, não patológica, mas de desenvolvimentoThrough clinical observations and in scientific literature, a growing feeling of emptiness in the current times has been noticed. On this purpose, this paper aims to understand this feeling – the vacuum – and its relation to the subjectivity on the current days, considering the psychoanalytic approach. The research presents a current understanding through the perspective of Sociology and also the possible relationship between psychoanalysis of Freud and Balint to understand this feeling. It is a theoretical-reflexive study that brings support for discussion of this common clinical phenomenon. Therefore, it is necessary to contextualize the present and reveal some psychoanalytic concepts such as narcissism, the transitory and primary love. Taking into consideration that psychoanalysis is traversed in this theory through culture, it is possible to understand the void on the present days, as well as its relation to subjectivity. Conducting this study, it is possible to provide subsidies to understand the feeling of emptiness as a possibility, not pathological, but as a developmentCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

A degeneração dos espaços públicos e a supervalorização narcísica como facetas do mal-estar no trabalho

Em alguns espaços, o modelo de trabalho está se caracterizando de maneira diferente nos tempos atuais quando comparado com aquela forma taylorista que ainda predomina em muitas organizações, com a clássica figura centralizada no chefe e nas metas. Justamente devido a essas mudanças, esse novo modelo apresenta uma boa notoriedade por se centrar no indivíduo e por uma proposta de uma suposta liberdade dentro de ambientes laborais, onde não existem metas e a figura do chefe é dissolvida. É possível perceber que essa supervalorização no indivíduo cria espaços cada vez mais particulares e individualistas, na mesma medida em que existe uma diminuição do investimento de lugares que prezam a coletividade. Diante disso, o objetivo deste escrito é analisar como a degeneração dos espaços públicos e a supervalorização narcísica se apresentam como fatores de mal-estar no trabalho. Para realizar este estudo, foram utilizadas algumas obras psicanalíticas freudianas e balintianas, além do aporte dos autores da Psicossociologia. Assim, defende-se aqui que o declínio dos espaços públicos e a exacerbação narcísica, tão relacionada ao trabalho, levam cada vez mais dificuldades aos indivíduos em encontrarem espaços efetivos de satisfação pulsional.In some spaces, the work model is being characterized differently in the present times when compared to that Taylorist way that still predominates in many organizations, with the classic figure centered on the boss and the goals. Precisely because of these changes, this new model has a good reputation for focusing on the individual and a proposal for supposed freedom in working environments where there are no goals and the figure of the boss is dissolved. It is possible to perceive that this overvaluation in the individual creates increasingly particular and individualistic spaces, in the same way that there is a decrease in the investment of places that value the collectivity. Therefore, the purpose of this paper is to analyze how the degeneration of public spaces and the narcissistic overvaluation present themselves as factors of malaise at work. In order to carry out this study, some Freudian and Balintian psychoanalytic works were used, in addition to the contribution of the authors of Psicossociology. Thus, it is argued here that the decline of public spaces and narcissistic exacerbation, so labor-related, are increasingly difficult for individuals to find effective spaces for drive satisfaction

(DE)FORMA TRABALHISTA: FLEXIBILIZAÇÃO E PRECARIZAÇÃO PELA(S) PERSPECTIVA(S) DA(S) PSICOLOGIA(S) DO TRABALHO

Assente nas intersecções das perspectivas da sociologia e direito do trabalho, do existencialismo de Jean-Paul Sartre e da psicanálise sobre a reforma trabalhista, e, especialmente, sobre a terceirização, este artigo reúne reflexões frutos da apresentação de seus autores em Mesa Redonda que integrou a programação do II Encontro do Laboratório Interinstitucional de Subjetividade e Trabalho, II Simpósio Psicologia e Trabalho: Dimensões Sociais e Subjetividade e VIII Encontro de Psicologia Organizacional e do Trabalho (EPOT) realizado no período de 21 a 23 de novembro de 2018, na Universidade Estadual de Maringá, Paraná. Discute-se a compreensão de principais mudanças frutos da reforma trabalhista; da flexibilização como diretriz da estruturação social de trabalho; e do papel da terceirização – destacando a questão da vulnerabilidade, do isolamento, da desproteção e do desamparo do trabalhador. Finaliza com o empenho de chamar a atenção sobre a necessidade de o psicólogo do trabalho não restringir seu foco às condições externas de trabalho, sendo igualmente necessário apreender como ocorre a sua relação com essas condições, isto é, dispor-se a ter consciência reflexiva e crítica sobre as implicações de seus fazeres diante a precarização do trabalho e da vida do trabalhador

O impacto do ambiente laboral nas relações de trabalho de costureiros de indústria de confecção sob a perspectiva da psicodinâmica do trabalho (Work environment impact on the working relationships of dressmakers in the clothing industry from the work...)

The sewing sector is dependent of manual labor due to the manipulations of its products in the phases of the production process. For the industry, it is interesting to harmonize the environment with healthy working conditions so that the worker feels good when carrying out his work routine, without the possibility of harming his physical, emotional or psychological health. In this context, this study aims to identify how the work environment impacts on the work context of seamstresses of industrial confectionery companies of the north of Paraná, from the study of work psychodynamics. The semi-structured interview was used as a methodological technique, because the researchers tried to obtain the subjective data of the interviewees. As main results, elements of suffering and strategies of defenses are present in the discourses of the work, as well as elements of work satisfaction was observed.Entende-se que o setor de costura é dependente de trabalhos manuais devido às manipulações de seus produtos nas fases do processo de produção. Para a indústria, é interessante harmonizar o ambiente com condições de trabalho salubres, para que o trabalhador se sinta bem ao realizar sua rotina laboral, sem a possibilidade de prejudicar sua saúde física, emocional ou psicológica. Dentro deste tema, este trabalho teve como objetivo identificar como o ambiente laboral impacta no contexto de trabalho de costureiros de empresas de confecção industrial do Norte do Paraná, a partir do estudo da psicodinâmica de trabalho. A entrevista semiestruturada foi utilizada como técnica metodológica, pois, os pesquisadores buscaram obter os dados subjetivos dos entrevistados. Como principais resultados, observou-se que elementos de sofrimento e estratégias de defesas estão presentes nos discursos dos trabalhadores, bem como elementos de satisfação no trabalho

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

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures

International Impact of COVID-19 on the Diagnosis of Heart Disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted