Hair cortisol and changes in cortisol dynamics in chronic kidney disease.

Objective: We compared hair cortisol (HC) with classic tests of the hypothalamic-pituitary-adrenal (HPA) axis in chronic kidney disease (CKD) and assessed its association with kidney and cardiometabolic status. Design and methods: A cross-sectional study of 48 patients with CKD stages I-IV, matched by age, sex, and BMI with 24 healthy controls (CTR) was performed. Metabolic comorbidities, body composition, and HPA axis function were studied. Results: A total of 72 subjects (age 52.9 ± 12.2 years, 50% women, BMI 26.2 ± 4.1 kg/m2) were included. Metabolic syndrome features (hypertension, dyslipidaemia, glucose, HOMA-IR, triglycerides, waist circumference) and 24-h urinary proteins increased progressively with worsening kidney function (p < 0.05 for all). Reduced cortisol suppression after 1-mg dexamethasone suppression (DST) (p < 0.001), a higher noon (12:00 h pm) salivary cortisol (p = 0.042), and salivary cortisol AUC (p = 0.008) were seen in CKD. 24-h urinary-free cortisol (24-h UFC) decreased in CKD stages III-IV compared with I-II (p < 0.001); higher midnight salivary cortisol (p = 0.015) and lower suppressibility after 1-mg DST were observed with declining kidney function (p < 0.001). Cortisol-after-DST cortisol was >2 mcg/dL in 23% of CKD patients (12.5% in stage III and 56.3% in stage IV); 45% of them had cortisol >2 mcg/dL after low-dose 2-day DST, all in stage IV (p < 0.001 for all). Cortisol-after-DST was lineally inversely correlated with eGFR (p < 0.001). Cortisol-after-DST (OR 14.9, 95% CI 1.7-103, p = 0.015) and glucose (OR 1.3, 95% CI 1.1-1.5, p = 0.003) were independently associated with eGFR <30 mL/min/m2). HC was independently correlated with visceral adipose tissue (VAT) (p = 0.016). Cortisol-after-DST (p = 0.032) and VAT (p < 0.001) were independently correlated with BMI. Conclusion: Cortisol-after-DST and salivary cortisol rhythm present progressive alterations in CKD patients. Changes in cortisol excretion and HPA dynamics in CKD are not accompanied by significant changes in long-term exposure to cortisol evaluated by HC. The clinical significance and pathophysiological mechanisms explaining the associations between HPA parameters, body composition, and kidney damage warrant further study.

A comparative study of CNN-capsule-net, CNN-transformer encoder, and Traditional machine learning algorithms to classify epileptic seizure.

INTRODUCTION: Epilepsy is a disease characterized by an excessive discharge in neurons generally provoked without any external stimulus, known as convulsions. About 2 million people are diagnosed each year in the world. This process is carried out by a neurological doctor using an electroencephalogram (EEG), which is lengthy. METHOD: To optimize these processes and make them more efficient, we have resorted to innovative artificial intelligence methods essential in classifying EEG signals. For this, comparing traditional models, such as machine learning or deep learning, with cutting-edge models, in this case, using Capsule-Net architectures and Transformer Encoder, has a crucial role in finding the most accurate model and helping the doctor to have a faster diagnosis. RESULT: In this paper, a comparison was made between different models for binary and multiclass classification of the epileptic seizure detection database, achieving a binary accuracy of 99.92% with the Capsule-Net model and a multiclass accuracy with the Transformer Encoder model of 87.30%. CONCLUSION: Artificial intelligence is essential in diagnosing pathology. The comparison between models is helpful as it helps to discard those that are not efficient. State-of-the-art models overshadow conventional models, but data processing also plays an essential role in evaluating the higher accuracy of the models.

Bariatric Surgery Outcomes in Patients with Chronic Kidney Disease.

Obesity increases the risk of developing chronic kidney disease (CKD), which has a major negative impact on global health. Bariatric surgery (BS) has demonstrated a substantial improvement of obesity-related comorbidities and thus, it has emerged as a potential therapeutic tool in order to prevent end-stage renal disease. A limited number of publications to date have examined the beneficial effects and risks of BS in patients with non-advanced stages of CKD. We aimed to investigate the safety of BS in patients with CKD stages 3-4 (directly related or not to obesity) and both the metabolic/renal outcomes post-BS. A total of 57 individuals were included (n = 19 for CKD-group; n = 38 for patients with obesity, but normal eGFR [control-group]). Weight loss and obesity comorbidities resolution after BS were similar in both groups. Renal function (eGFR [CKD-EPI]) improved significantly at the 1-year follow-up: Δ10.2 (5.2-14.9) (p < 0.001) for CKD-group and Δ4.0 (-3.9-9.0) mL/min/1.73 m2 (p = 0.043) for controls. Although this improvement tended to decrease in the 5-year follow-up, eGFR remained above its basal value for the CKD-group. Noteworthy, eGFR also improved in those patients who presented CKD not directly attributed to obesity. For patients with CKD, BS appears to be safe and effective regarding weight loss and obesity comorbidities resolution, irrespective of the main cause of CKD (related or not to obesity).

Exocrine pancreatic insufficiency following bariatric surgery: unveiling alternative aetiology-case report and short review.

Bariatric surgery (BS) is currently the most effective treatment for severe obesity, requiring ongoing multidisciplinary follow-up to ensure proper progress and nutrition post-procedure. Despite its favourable safety profile, it is not exempt from complications, one of which being exocrine pancreatic insufficiency (EPI). The underlying pathophysiological mechanisms of EPI after BS are multifactorial, including poorly synchronized pancreatic enzyme secretion with the passage of nutrients (pancreaticocibal or postcibal asynchrony), insufficient pancreatic stimulation and bacterial overgrowth. We conducted a short literature review of the topic through a case of a patient who underwent BS in our centre and subsequently developed EPI and severe malnutrition. EPI initially was attributed to the surgery, but after a comprehensive evaluation, an unexpected cause was revealed.

Effectiveness of flash glucose monitoring in patients with type 1 diabetes and recurrent hypoglycemia between early and late stages after flash glucose monitoring initiation.

AIMS: Evaluate the effectiveness of reimbursed flash glucose monitoring with optional alarms (FGM) in preventing severe hypoglycemia (SH) and reducing hypoglycemia exposure in T1D patients prone to hypoglycemia. METHODS: Ambispective study in T1D patients treated with multiple daily injections (MDI) and prone to hypoglycemia, initiating reimbursed FGM (FreeStyle Libre 2). The primary outcome was the number of SH events (requiring third party assistance) and main secondary outcomes were time below range < 70 (TBR < 70) and < 54 mg/dL (TBR < 54), impaired awareness of hypoglycemia (IAH) and quality of life (QoL). Logistic regression models were constructed to explore variables associated with success of the intervention. RESULTS: We included 110 patients (52.7 % women, mean age 47.8 ± 17.0 years). SH events at 1-year follow-up decreased from 0.3 ± 0.6 to 0.03 ± 0.2 (p < 0.001). Significant reductions in patients presenting an SH (26.4 % vs. 2.9 %, p < 0.001) and IAH (47.1 % vs. 25.9 %, p = 0.002) were observed, as well as improvements in QoL. TBR < 70 and TBR < 54 were not significantly reduced. Baseline GMI was inversely associated with a decrease in TBR < 70 [OR 0.37 (0.15-0.93)] and directly with an increase in time in range 70-180 mg/dL [OR 2.10 (1.03-4.28)]. CONCLUSIONS: FGM decreased SH and improved hypoglycemia awareness and QoL. Initial tight glycemic control was associated with a decrease in hypoglycemia, while patients with suboptimal control reduced hyperglycemia.

Programa de intervención educativa para prevenir cáncer cervicouterino en jóvenes del Policlínico Norte Placetas / Educational intervention program to prevent cervical cancer in young people from the North Placetas Polyclinic

Fundamento: el cáncer es una enfermedad que representa un problema de salud pública a nivel mundial. Objetivo: determinar la efectividad de un programa de intervención educativa sobre prevención del cáncer cervicouterino en jóvenes pertenecientes al Policlínico Docente Norte de Placetas. Métodos: se realizó un estudio de intervención prexperimental con enfoque mixto en el Policlínico Docente Norte de Placetas durante el año 2018. Se utilizaron métodos teóricos: histórico-lógico, inductivo-deductivo, sistémico- estructural-funcional y modelación; empíricos: análisis documental, cuestionario, grupo focal y nominal y la triangulación de fuentes y estadísticos. Resultados: las relaciones sexuales tempranas fueron la condición prevalente. El 40% de las féminas presentaban 1 o 2 factores de riesgo; antes de aplicar el programa de intervención educativa, a pesar de predominar la escolaridad preuniversitaria, el nivel de información era insuficiente (66,66 %), por lo que se elaboró una intervención educativa. Posterior a su aplicación se pudo constatar que hubo cambios muy significativos en el nivel de información sobre cáncer cervicouterino. Conclusiones: el programa de intervención educativa diseñado fue valorado por los especialistas como adecuado y efectivo al elevar el nivel de información sobre la prevención del cáncer cervicouterino en la población estudiada.

Background: cancer is a disease that represents a public health problem worldwide. Objective: to determine the effectiveness of an educational intervention program on the prevention of cervical cancer in young people belonging to the North Placetas Teaching Polyclinic. Methods: a pre-experimental intervention study with a mixed approach was carried out at the North Placetas Teaching Polyclinic during 2018. Theoretical methods were used: historical-logical, inductive-deductive, systemic-structural-functional and modeling; Empirical: documentary analysis, questionnaire, nominal and focal group and the review of sources and statistics. Results: early sexual relations were the prevalent condition. 40% of the females presented 1 or 2 risk factors; Before applying the educational intervention program, despite the predominance of pre-university education, the level of information was insufficient (66.66%), so an educational intervention was developed. After its implementation, it was possible to verify that there were very significant changes in the level of information on cervical cancer. Conclusions: the designed educational intervention program was valued by the specialists as adequate and effective in raising the level of information on the prevention of cervical cancer in the population studied.

The Japanese Educational System as an International Model for Urban Resilience.

Global cities in the context of accelerated urbanization have to deal with more diverse risk factors than ever before, which highlights the need for a faster and more creative response capacity. Although it is necessary to strengthen technical systems, since they are surrounded by human systems, individual resilience will help to strengthen the community. The educational system is key to developing the human factor in a world where various systems in global cities are increasingly interconnected, which in turn increases risks. Japan is fostering a culture of disaster risk reduction in both the formal, non-formal, and informal education sectors, in which creativity and autonomy are key competencies. Tokyo is the highest populated metropolitan area globally, and its educational system is the international model for education in disaster risk reduction. Urban areas around the world face similar challenges and experience similar needs. This article addresses the challenges that the human factor faces in large cities and the possibilities of increasing resilience in both individuals and communities through Disaster Resilience Education (DRE), taking the Japanese educational system as a model.

Progressive acclimation alters interaction between salinity and temperature in experimental Daphnia populations.

Environmental stressors rarely act in isolation, giving rise to interacting environmental change scenarios. However, the impacts of such interactions on natural populations must consider the ability of organisms to adapt to environmental changes. The phenotypic adaptability of a Daphnia galeata clone to temperature rise and salinisation was investigated in this study, by evaluating its halotolerance at two different temperatures, along a short multigenerational acclimation scenario. Daphniids were acclimated to different temperatures (20°C and 25°C) and salinities (0gL(-1) and 1gL(-1), using NaCl as a proxy) in a fully crossed design. The objective was to understand whether acclimation to environmental stress (combinations of temperature and salinity) influenced the response to the latter exposure to these stressors. We hypothesize that acclimation to different temperature×salinity regimes should elicit an acclimation response of daphniids to saline stress or its interaction with temperature. Acute (survival time) and chronic (juvenile growth) halotolerance measures were obtained at discrete timings along the acclimation period (generations F1, F3 and F9). Overall, exposure temperature was the main determinant of the acute and chronic toxicity of NaCl: daphniid sensitivity (measured as the decrease of survival time or juvenile growth) was consistently higher at the highest temperature, irrespective of background conditions. However, this temperature-dependent effect was nullified after nine generations, but only when animals had been acclimated to both stressors (high salinity and high temperature). Such complex interaction scenarios should be taken in consideration in risk assessment practices.

The suitability of EBC-Pb as a new biomarker to assess occupational exposure to lead.

Occupational exposure to lead (Pb) requires continuous surveillance to assure, as much as possible, safe and healthful working conditions. This study addresses the suitability of assessing Pb exposure in relevant workers using their exhaled breath condensate (EBC). This study enrolled workers of two different Pb processing industries characterized by moderate and high Pb exposure levels in the work environment, and a group of non-exposed individuals working in offices who served as baseline for Pb exposure. The EBC-Pb of workers reflected the Pb levels in the work environment of all three settings, although the relationship with B-Pb was not clear. The lack of correlation between EBC-Pb and B-Pb most probably indicates the time lag for Pb to enter in the two body pools. The EBC-Pb seems to reflect immediate exposure, providing a prompt signature of Pb in the environmental that may interact directly with the organ. By delivering short-term evaluation of exposure, EBC-Pb represents a clear advantage in biomonitoring and may become an interesting tool for estimating organ burden.

Symptoms other than pain in palliative care in Portugal.

OBJECTIVE: To study the burden of patients' symptoms other than pain and their treatment by Portuguese palliative care teams. METHODS: Of the 21 Portuguese palliative care teams identified, 10 accepted to participate. Data from all patients observed on the 18th week of 2011 were collected. RESULTS: One hundred and sixty-four patients were included in this study. One hundred and fifty-one patients (92%) had cancer. The patients' median age was 71 years (16-95) and 84 (51%) were females. The main symptoms were fatigue (116 [85%]) and depression/sadness (107 [65%]). Many different drugs were used for symptom control and other aims. Symptoms and drugs used here are similar to those practiced in other countries. CONCLUSION: The practice of palliative care in Portugal seems to be similar to those in other countries.

Can physiological endpoints improve the sensitivity of assays with plants in the risk assessment of contaminated soils?

Site-specific risk assessment of contaminated areas indicates prior areas for intervention, and provides helpful information for risk managers. This study was conducted in the Ervedosa mine area (Bragança, Portugal), where both underground and open pit exploration of tin and arsenic minerals were performed for about one century (1857-1969). We aimed at obtaining ecotoxicological information with terrestrial and aquatic plant species to integrate in the risk assessment of this mine area. Further we also intended to evaluate if the assessment of other parameters, in standard assays with terrestrial plants, can improve the identification of phytotoxic soils. For this purpose, soil samples were collected on 16 sampling sites distributed along four transects, defined within the mine area, and in one reference site. General soil physical and chemical parameters, total and extractable metal contents were analyzed. Assays were performed for soil elutriates and for the whole soil matrix following standard guidelines for growth inhibition assay with Lemna minor and emergence and seedling growth assay with Zea mays. At the end of the Z. mays assay, relative water content, membrane permeability, leaf area, content of photosynthetic pigments (chlorophylls and carotenoids), malondialdehyde levels, proline content, and chlorophyll fluorescence (Fv/Fm and ΦPSII) parameters were evaluated. In general, the soils near the exploration area revealed high levels of Al, Mn, Fe and Cu. Almost all the soils from transepts C, D and F presented total concentrations of arsenic well above soils screening benchmark values available. Elutriates of several soils from sampling sites near the exploration and ore treatment areas were toxic to L. minor, suggesting that the retention function of these soils was seriously compromised. In Z. mays assay, plant performance parameters (other than those recommended by standard protocols), allowed the identification of more phytotoxic soils. The results suggest that these parameters could improve the sensitivity of the standard assays.

A cross-sectional survey of pain in palliative care in Portugal.

OBJECTIVE: The purpose of this work is to study the prevalence, intensity, and treatment of pain in Portuguese palliative care teams. METHODS: Twenty-one palliative care teams were invited to participate in a cross-sectional survey. Ten of these accepted and were included in the study. Data of all patients observed on the 18th week of 2011 were collected. The data collected concerning pain were: demographic data, pain intensity, drugs prescribed, and invasive techniques. The intensity of pain was rated using a five-point verbal rating scale from none to maximum. The Pain Management Index (PMI) was used to calculate the adequacy of the analgesia. RESULTS: A total of 164 patients were included in this study. One hundred fifty-one (92 %) had cancer. The median age was 71 years (16 to 95). Eighty-four (51 %) were females. Pain was directly assessed in 136 (83 %) of the patients, whereas 27 patients could not report pain because of cognitive failure. Of those directly assessed, 77 (57 %) had pain when they were assessed: 42 (55 %) mild, 25 (32 %) moderate, 9 (12 %) severe, and 1 (1 %) maximum. Non-opioid analgesics were used: paracetamol in 61 (37 %) and NSAID in 20 (12 %). Tramadol was the only opioid for mild to moderate pain used in 25 (15 %) patients. The opioids most used for moderate to intense pain were: morphine 74 (45 %), transdermal (TD) fentanyl 32 (20 %), and buprenorphine TD 28 (17 %). The adjuvants most used were: corticosteroids 38 (23 %), gabapentin 37 (23 %), and amitriptyline 15 (9 %). Only five (4 %) patients had a negative PMI, meaning an inadequate analgesia. CONCLUSION: The general prevalence of pain is similar to that reported by other. The prevalence of moderate to severe pain is also similar to that reported in other studies, although severe pain is somewhat lower than indicated in most reports. According to the PMI, pain control was acceptable to good.

A cross-sectional survey of the activity of palliative care teams in Portugal.

Of the 21 Portuguese teams identified, 10 accepted to participate in the study. A total of 164 patients were included with a median of 15.5 per team (4-32). Of all the patients included, 60 (37%) were identified as inpatients in palliative care units; 59 (36%) by an intrahospital support team; 26 (16%) as outpatients; and 19 (12%) at home. The median age was 71 years (16-95). Fifty-one percent were females. The diagnosis was cancer in 151 (92%) patients. The most common cancer was colorectal in 22 (15%) patients, followed by gastric 17 (11%), head and neck 17 (11%), breast 15 (10%), and lung cancers 14 (9%). All patients were treated by doctors and nurses experienced in palliative care.

Sedación y analgesia en los procedimientos diagnósticos y terapéuticos en el paciente pediátrico / Sedation and pain relief in diagnostic and therapeutic procedures in children

Introducción. El control del dolor agudo, la ansiedady el temor del niño forma parte de la atencióndel paciente y su calidad de vida.Objetivo. Describir nuestra experiencia en sedacióny analgesia en procedimientos dolorosos decorta duración con la asociación de midazolam yketamina.Población, material y método. Se incluyeron 75pacientes de 6 meses a 15 años, entre junio de 1999 yjunio de 2002. Se excluyeron pacientes con contraindicaciónde ketamina, sin el ayuno requerido y condescompensación hemodinámica. Se evaluaron elnivel de sedación y analgesia, los efectos colateralesy el síndrome del despertar. Se consignaron la frecuenciacardíaca, frecuencia respiratoria, saturaciónde oxígeno y presión arterial cada 5 minutos. Seutilizó midazolam a 0,1 mg/kg/dosis y ketamina a1 mg/kg/dosis, por vía intravenosa.Resultados. Se realizaron 150 procedimientos en 75pacientes: punción lumbar: 65; punción de médulaósea o biopsia: 36; punción de médula ósea y lumbar:26; punción pleural o colocación de tubo de drenajepleural: 13; reducción de fractura: 10. Se alcanzó elnivel deseado de sedación y analgesia en 80 por ciento deellos, la recuperación fue menor de 30 minutos en el80 por ciento de los casos.El 2 por ciento de los procedimientos presentó descenso dela saturación por debajo de 85 por ciento, que se corrigió con oxígeno. Un paciente presentó depresión respiratoria, uno tuvo alucinaciones visuales que revirtieron con contención emocional y 2 presentaron sialorrea.Conclusiones. En nuestra experiencia, la asociaciónde midazolam y ketamina fue segura y eficaz parala sedación y analgesia de procedimientos dolorososfuera del quirófano

Sedación y analgesia en los procedimientos diagnósticos y terapéuticos en el paciente pediátrico / Sedation and pain relief in diagnostic and therapeutic procedures in children

Introducción. El control del dolor agudo, la ansiedady el temor del niño forma parte de la atencióndel paciente y su calidad de vida.Objetivo. Describir nuestra experiencia en sedacióny analgesia en procedimientos dolorosos decorta duración con la asociación de midazolam yketamina.Población, material y método. Se incluyeron 75pacientes de 6 meses a 15 años, entre junio de 1999 yjunio de 2002. Se excluyeron pacientes con contraindicaciónde ketamina, sin el ayuno requerido y condescompensación hemodinámica. Se evaluaron elnivel de sedación y analgesia, los efectos colateralesy el síndrome del despertar. Se consignaron la frecuenciacardíaca, frecuencia respiratoria, saturaciónde oxígeno y presión arterial cada 5 minutos. Seutilizó midazolam a 0,1 mg/kg/dosis y ketamina a1 mg/kg/dosis, por vía intravenosa.Resultados. Se realizaron 150 procedimientos en 75pacientes: punción lumbar: 65; punción de médulaósea o biopsia: 36; punción de médula ósea y lumbar:26; punción pleural o colocación de tubo de drenajepleural: 13; reducción de fractura: 10. Se alcanzó elnivel deseado de sedación y analgesia en 80 por ciento deellos, la recuperación fue menor de 30 minutos en el80 por ciento de los casos.El 2 por ciento de los procedimientos presentó descenso dela saturación por debajo de 85 por ciento, que se corrigió con oxígeno. Un paciente presentó depresión respiratoria, uno tuvo alucinaciones visuales que revirtieron con contención emocional y 2 presentaron sialorrea.Conclusiones. En nuestra experiencia, la asociaciónde midazolam y ketamina fue segura y eficaz parala sedación y analgesia de procedimientos dolorososfuera del quirófano(AU)

Sedación y analgesia en los procedimientos diagnósticos y terapéuticos en el paciente pediátrico / Sedation and pain relief in diagnostic and therapeutic procedures in children

Introducción. El control del dolor agudo, la ansiedady el temor del niño forma parte de la atencióndel paciente y su calidad de vida.Objetivo. Describir nuestra experiencia en sedacióny analgesia en procedimientos dolorosos decorta duración con la asociación de midazolam yketamina.Población, material y método. Se incluyeron 75pacientes de 6 meses a 15 años, entre junio de 1999 yjunio de 2002. Se excluyeron pacientes con contraindicaciónde ketamina, sin el ayuno requerido y condescompensación hemodinámica. Se evaluaron elnivel de sedación y analgesia, los efectos colateralesy el síndrome del despertar. Se consignaron la frecuenciacardíaca, frecuencia respiratoria, saturaciónde oxígeno y presión arterial cada 5 minutos. Seutilizó midazolam a 0,1 mg/kg/dosis y ketamina a1 mg/kg/dosis, por vía intravenosa.Resultados. Se realizaron 150 procedimientos en 75pacientes: punción lumbar: 65; punción de médulaósea o biopsia: 36; punción de médula ósea y lumbar:26; punción pleural o colocación de tubo de drenajepleural: 13; reducción de fractura: 10. Se alcanzó elnivel deseado de sedación y analgesia en 80 por ciento deellos, la recuperación fue menor de 30 minutos en el80 por ciento de los casos.El 2 por ciento de los procedimientos presentó descenso dela saturación por debajo de 85 por ciento, que se corrigió con oxígeno. Un paciente presentó depresión respiratoria, uno tuvo alucinaciones visuales que revirtieron con contención emocional y 2 presentaron sialorrea.Conclusiones. En nuestra experiencia, la asociaciónde midazolam y ketamina fue segura y eficaz parala sedación y analgesia de procedimientos dolorososfuera del quirófano(AU)

Emergências e primeiros socorros em Geriatria / Geriatry

Apresenta algumas situações de emergência específicas, que são mais freqüentemente encontradas em pessoas idosas, incluindo seus sinais e sintomas, uma breve revisão dos mecanismos fisiopatológicos, prováveis causas e intervenções apropriadas. Revisa: dor torácica; perda de consciência; incluindo inconsciência decorrnte de diabetes; dificuldade respiratória; reações alérgicas (anafilaxia); convulsões; disreflexia autonômica, e dor após queda na terapia. Inclui considerações sobre ressuscitação cardiopulmonar (RCP) e transporte de acidentados

Condições de vida, trabalho e saúde de trabalahdores de comércio em shopping center / Working conditions, everyday life and health of shopping center's workers

A 'subproletarização' – trabalhos parciais, temporários, precários e sub-contratados –caracteriza as relações de trabalho encontradas principalmente em cidades turísticas. Com o objetivo de caracterizar alguns aspectos das condições de vida, trabalho e saúde de trabalhadores do comércio varejista e de comportamentos apresentados em local de trabalho, foram entrevistados 20 vendedores de lojas em um shopping center e realizadas observações direta de oito vendedores de lojas no mesmo local, durante o período de baixa estação. Percebeu-se que o predomínio é de mulheres, com média de idade de 26 anos, com participação na renda familiar de mais de 50 por cento, baixo nível salarial e com pouca tempo de serviço no local. A maioria desses vendedores sentem-se satisfeitos com seu trabalho, e dizem ter boas condições de saúde. Os dados obtidos por meio da observação dos comportamentos de vendedores em seus locais de trabalho permitiu revelar que, entre os comportamentos quando da ausência de clientes, as categorias que apresentaram mais ocorrências foram as de distração (46

), de espera (44

) e de locomoção (43

); o comportamento relacionado a arrumar a loja teve menos ocorrências (15

). Dentre os comportamentos do vendedor em relação ao cliente, as categorias que mais aparecem foram as de pronto atendimento (28

) e, durante o atendimento ao cliente, as que mais ocorreram foram aquelas caracteristicamente de vender (19

) e de interação com o cliente (11

). Os dados permitem concluir que esses funcionários parecem possuir boas condições de vida e saúde; entretanto, no trabalho têm baixo nível salarial e pouco tempo de serviço no emprego. A partir dos dados obtidos na observação direta, foi possível concluir que a atividade primordial para a qual são contratados é a venda, e que não parece haver atividades substitutivas para eles em períodos de pouco movimento de clientes e durante a baixa estação(AU)

Diagnóstico do trabalho e repercussões sobre a saúde dos trabalhadores de centrais telefônicas / Work diagnostic and repercussions about call center workers health

Este estudo propõe analisar as condições de trabalho de operadores de call center (central de atendimento), a partir das contribuições da psicologia do trabalho, tomando como base um estudo realizado em uma empresa de telecomunicações de Santa Catarina. Os dados foram obtidos por meio de análises das situações de trabalho do call center durante o período de setembro/2001 a fevereiro/2002. Para a coleta de dados foram utilizadas entrevistas semi-estruturadas e observações livres, focadas em aspectos como: características dos trabalhadores, organização do trabalho, o ambiente, os níveis de satisfação que podem, juntos, ter repercussões sobre a saúde dos trabalhadores. Participaram desse estudo 71 supervisores de teleatendimento e 40 operadores. O estudo contou com uma equipe multidisciplinar composta por três psicólogos do trabalho, um fisioterapeuta e um engenheiro de segurança. Verificou-se a existência de correlação entre as respostas dadas e as características da atividade do operador de teleatendimento quanto às exigências físicas e mentais. Destacou-se, também, a insuficiência de pausas no trabalho, falta de repasse de informações, insegurança causada por um processo de reestruturação tecnológica e gerencial, entre os principais. Assim, os resultados obtidos indicam que a natureza do trabalho de sistemas de telefonia caracterizada hoje, pela introdução de novas tecnologias aliada a modelos rígidos de organização do trabalho continua mantendo os mesmos padrões históricos de queixas relatadas por Le Guillant no seu trabalho sobre as neuroses das telefonistas(AU)