Os efeitos iatrogénicos das técnicas de gestão / The iatrogenic effects of management techniques

O principal objetivo deste texto é apresentar uma perspectiva crítica aos efeitos das técnicas de gestão empresariais sobre a saúde dos trabalhadores. Sabemos que o trabalho é um elemento central na vida das pessoas, porque, entre outros aspetos, a subsistência humana depende maioritariamente do fator trabalho. Essa é uma dimensão ética que tende a ser ignorada no universo laboral contemporâneo. As modernas técnicas de gestão, nomeadamente, a intensificação do trabalho, a qualidade total, a avaliação individual de desempenho, o aumento da precarização, a gestão pelo estresse ou a terceirização estão a destruir as relações sociais de trabalho e, consequentemente, a saúde dos trabalhadores. O adoecimento por via do trabalho é um problema social grave e a sua resolução parece difícil de alcançar, pelo menos nos tempos mais próximos, caso não se alterem profundamente as atuais técnicas de gestão empresariais

This study aims to show a critical perspective of the effects of business management techniques on workers' health. Work is a central element in people's lives because, among other aspects, human livelihood depends mostly on the work factor. This is an ethical dimension which the contemporary work universe tends to ignore. Modern management techniques, i.e., work intensification, total quality, individual performance evaluation, precariousness, and management by stress or outsourcing are destroying work relationships, work groups, and thus workers' health. Sickness due to work is a serious social problem and its resolution seems difficult to achieve (at least in the near future) if current business management techniques are not profoundly altered

Trabalho, subjetividade e gestão gerencialista: um estudo com trabalhadores do comércio / Work, subjectivity and management techniques: a study with commerce workers

O presente estudo teve como objetivo caracterizar e problematizar as técnicas de gestão gerencialistas utilizadas no contexto de trabalho do comércio varejista. Essa análise teve como eixos teóricos os estudos de Vincent de Gaulejac a respeito das técnicas de gestão da subjetividade e os estudos da Psicodinâmica do Trabalho. Realizou-se uma pesquisa qualitativa, por meio de entrevistas semiestruturadas com cinco comerciários da cidade de Porto Alegre. As entrevistas foram submetidas à análise de conteúdo, a partir da qual foram identificadas quatro categorias temáticas. Destacou-se primazia da gestão do desempenho e da excelência, pautada por técnicas que visam à homogeneização de comportamentos e à mobilização subjetiva dos trabalhadores. Os resultados dão luz a particularidades e precarizações no setor do comércio, assim como às implicações dessas técnicas de gestão para a subjetividade dos trabalhadores.

This study aims to characterize and discuss management techniques applied in the retail business. The analysis was based on the studies of Vincent de Gaulejac on techniques for managing subjectivity and on Psychodynamic of Work. We conducted five semi-structured interviews with retailers from Porto Alegre, Brazil, which were analyzed using qualitative methods. The results showed four categories. It was highlighted the primacy of performance management and excellence, ruled by techniques that aim to homogenize behavior management. The results also shed light on particularities and precariousness in the commercial sector, as well as the implications of management techniques on the subjectivity of the workers.

Lesiones ováricas en pediatría. Estudio retrospectivo de 10 años / Ovarian lesions in pediatrics age. Retrospective study of 10 years

Justificación:las lesiones ováricas en la edad pediátrica no han sido muy documentadas en Costa Rica; el estudio permitirá comprender mejor sus características en el país, optimizando su manejo. Al comparar los datos obtenidos con los resultados de estudios similares en todo el mundo, Costa Rica tendrá más información para tratar nuevos casos y estar actualizada internacionalmente.Métodos:la investigación se basó en la observación y descripción de datos hallados en los expedientes de las niñas tratadas en el Hospital "Dr. Maximiliano Peralta Jiménez", de Cartago, por lesiones ováricas en el periodo 2003 - 2013, y su posterior comparación con estudios internacionales.Resultados:las edades de diagnóstico más frecuentes abarcan a niñas de 10-12 años de edad (61,5%). La manifestación clínica más común fue el dolor abdominal, con un 53,8%. Las lesiones ováricas no neoplásicas se mostraron en un 58,8% en comparación con las lesiones neoplásicas con un 41,1%, y de estas el 87,8% se clasificó como histológicamente benignas y solo un 14,29% correspondió a lesiones malignas; el quiste simple fue el hallazgo histopatológico no neoplásico más prevalente, abarcando un 70,0%. La laparotomía fue el método quirúrgico más utilizado para el manejo, con un 76,9%, y la técnica más empleada corresponde a la salpingooferectomía, con un 41,1% de los casos.Conclusiones:la edad media de afectación de las lesiones ováricas es de 9,5 años. Las lesiones no neoplásicas son las más predominantes y de estas, el quiste simple es el más común. El método quirúrgico más realizado para el manejo fue la laparotomía, y la técnica más empleada, la salpingooferectomía.

Justification: Ovarian lesions in children have not been very studied in Costa Rica, this study will allow a better understanding of the characteristics of them in the country, improving their treatment. Comparing the data obtained with the results of similar studies worldwide, Costa Rica will have better information to treat new cases and be updated internationally.Methods: The research is based on observation and description of data found in the files of the girls who were treated at the "Dr. Max Peralta Jiménez" Hospital in Cartago, for ovarian lesions in the period from 2003 to 2013 and subsequent comparison with international studies.Results: The most frequent ages of diagnosis include girls from 10-12 years old (61.5%). The most common clinical manifestation was abdominal pain with a 53.8%. Non-neoplastic ovarian lesions showed a 58.8% compared to neoplastic lesions with 41.1%, with 87.8% of these classified as histologically benign and only 14.29% as malignant lesions. Simple cyst was the most prevalent nonneoplastic histopathological finding, covering 70.0%. Laparotomy was the most common surgical method of management with 76.9%, and the most used technique corresponds to the salpingooophorectomy with 41.1% of cases.Conclusions: The average age of presentation of ovarian lesions was 9.5 years. The most common initial clinical manifestation corresponded to abdominal pain. Non-neoplastic lesions were the most prevalent and of these, simple cysts were the most common finding. The prefered surgical method was laparotomy and the most widely used technique was the salpingo-oophorectomy.

Effect comparison of monitored anesthesia care management technology and intravenous anesthesia in outpatient artificial abortion operation / 中国综合临床

Objective To investigate the analgesia effects and adverse effect of the monitored anesthesia care of remifentanil assisted by cervix nerves block and the propofol intravenous general anesthesia on abortion.Methods Eighty patients with ASA Ⅰ-Ⅱ were selected and divided into the group of propofol intravenous general anesthesia (E group,n =40) and the group of the monitored anesthesia care of remifentanil assisted by cervix nerves block (R group,n =40).Heart rate (HR),respiratory rate (RR),mean arterial pressure(MAP),oxygen saturation(SpO2) were recorded before,during and after the operation.Operative time,respiratory depression time,recovery time,VAS score,hospital time and patient satisfaction of the patients in the two groups were recorded.Results The MAP,HR,RR,SpO2 of the patients in the two groups after analgesia were significantly decreased compared with that of before analgesia (P ＜ 0.05 or P ＜ 0.01).The levels of RR,SpO2 in R group after analgesia were obviously lower than that in group E (P ＜ 0.05).The cases number who occurred incidence of injection pain,physical movement in E group were higher than that in R group(injection pain:11 cases vs.0 case,P =0.0004 ; Physical movement:4 cases vs.0 case,P =0.0402).The wake up time and the period of staying in hospital in E group were longer than that of R group(wake up time:(5.01 ±0.75)min vs.(0.00 ± 0.00) min,t =-42.248,P =0.000 ; Time from hospital:(27.78 ± 4.65) min vs.(18.68±3.80) min,t =-9.584,P =0.000).The analgesic effects of VAS in E group was (0.00 ±0.0),better than that of group R ((0.45 ± 0.09),t =3.162,P =0.002).The satisfaction rate in two groups were 100％.Conclusion The method of monitored anesthesia care of remifentanil assisted by cervix nerves block is proved to be better than that of propofol intravenous general anesthesia at induced abortion regarding of precise monitored anesthesia pain management techniques,stable hemodynamics,rapid postoperative recovery,adverse reactions and shorten the time from the hospital,which was better than propofol anesthesia,and is a safe and effective method of anesthesia.

Miedos dentales / Dental fears

El miedo al dentista no es tan infrecuente como la mayoría de la gente puede pensar. Una mala experiencia puede crear una fantasía horrible en la mente de una persona que programó, o debe programar, una visita a una clínica dental. OBJETIVO: describir la actitud de los pacientes en relación a diferentes factores subyacentes a los miedos dentales. MÉTODO: se realiza una encuesta a una muestra de 218 pacientes en el Consultorio 1, Santiago, Chile. Se utiliza un cuestionario con 17 ítem. El tratamiento estadístico se desarrolla con el programa SPSS 12. RESULTADOS: al analizar la estructura factorial de la escala de miedos dentales se encuentran cuatro factores. El principal factor está relacionado con "mala praxis profesional", mientras que los "aspectos inherentes al tratamiento" generan menos miedo. CONCLUSIONES: ha sido posible diferenciar cuatro factores que pueden generar o contribuir al miedo dental. La dimensión más trascendente es la denominada ""aspectos inherentes al tratamiento"", aunque los otros factores explorados pueden generar temor en menor grado. Las técnicas de manejo conductual son métodos para controlar las conductas de pacientes derivadas del miedo. Estas técnicas son necesarias para ayudar a modelar conductas.

Fear of the dentist, isn't as uncommon as most people might think. One bad experience can create a horrific fantasy in the mind of a person who is scheduled, or should be scheduled, to see go to a dental clinic. The aim of the current study is to describe the patient's attitude regarding several factors hidden in dental fears. METHOD: a survey has been performed among 218 patients who visited the Consultorio 1, Santiago, Chile. The questionnaire used included 17 items. The statistical data processing was carried out with the help of software SPSS 12. RESULTS: analyzing the factorial composition of dental fears scale, we detected four factors. The main factor is related to bad professional praxis, while "inherent actions to the treatments" factor generate less fear. CONCLUSION: among dental fears, it has been possible to differentiate four aspects or dimensions that could represent answers to the title: Dental Fears. One of these dimensions, which generate less level fear, is called "treatment inherent aspects". However, the others three dimensions do provoke a certain degree of fear. Behavioral management techniques are methods to control patient's behavior. These techniques are necessary to help modeling behaviors.