Long-term outcomes of pandemic 2009 influenza A(H1N1)-associated severe ARDS.

BACKGROUND: No data on long-term outcomes of survivors of 2009 influenza A(H1N1) (A[H1N1])-associated ARDS are available. The objective of this study was to compare the 1-year outcomes of survivors of A(H1N1)-associated ARDS, according to use or no use of extracorporeal lung assist (ECLA), using its need as an ARDS severity surrogate. METHODS: Survivors of ARDS (12 with ECLA use vs 25 without, corresponding to 75% and 54% of the eligible patients for each group, respectively) selected from the Réseau Européen de Ventilation Artificielle (REVA) registry had previously been healthy, with only pregnancy and/or moderate obesity (BMI ≤ 35 kg/m²) as known risk factors for A(H1N1) infection. Lung function and morphology, health-related quality of life (HRQoL), and psychologic impairment were evaluated. RESULTS: At 1 year post-ICU discharge for the ECLA and no-ECLA groups, respectively, 50% and 40% reported significant exertion dyspnea, 83% and 64% had returned to work, and 75% and 64% had decreased diffusion capacity across the blood-gas barrier, despite their near-normal and similar lung function test results. For both groups, exercise test results showed diminished but comparable exercise capacities, with similar alveolar-arterial oxygen gradients at peak exercise, and CT scans showed minor abnormal findings. HRQoL assessed by the 36-Item Short-Form Health Survey was poorer for both groups than for a sex- and age-matched general population group, but without between-group differences. ECLA and no-ECLA group patients, respectively, had symptoms of anxiety (50% and 56%) and depression (28% and 28%) and were at risk for posttraumatic stress disorder (41% and 44%). CONCLUSIONS: One year post-ICU discharge, a majority of survivors of A(H1N1)-associated ARDS had minor lung disabilities with diminished diffusion capacities across the blood-gas barrier, and most had psychologic impairment and poorer HRQoL than a sex- and age-matched general population group. ECLA and no-ECLA group patients had comparable outcomes. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01271842; URL: www.clinicaltrials.gov

Executive Order Number Forty Five, August 27, 1992

Orders the Department of Econmic Development to work with the Regional Coordinating Council.

Contribuição dos factores motivacionais para a satisfação no trabalho

A motivação é vista, desde meados do Século XX, como o principal factor de satisfação no trabalho, de aumento da produtividade e de melhoria da qualidade dos produtos e serviços. Na conclusão de um curso conducente ao Mestrado em Gestão Global, interessou-nos abordar o valor humano da organização, cujo componente importante é o nível de satisfação das pessoas no trabalho, obtido da avaliação a um leque de variáveis independentes, relacionadas com duas coisas – o conteúdo do trabalho e o contexto do trabalho. O objectivo da presente dissertação é identificar em que medida as variáveis do meio envolvente do trabalho contribui para a satisfação no trabalho. Inspirados na Teoria dos dois Factores (Herzberg, 1959 e 1982) e na Teoria da Avaliação Cognitiva (Deci, 1971), pretendemos justapor a satisfação das pessoas à diferentes variáveis particulares que formam dois subsistemas – o intrínseco ou motivador, que inclui a aprendizagem, as emoções, o trabalho em si, a realização e o reconhecimento; e o extrínseco ou higiénico, que inclui o salário, a supervisão e as condições físicas. Além de uma incursão à literatura especializada, realizamos dois inquéritos em empresas cabo-verdianas, um em Outubro de 2003 e outro em Outubro de 2007, que nos permitiram determinar índices específicos e gerais de satisfação no trabalho, fazer correlações e análises comparativas. Concluímos que as pessoas estão razoavelmente satisfeitas no trabalho, dão mais ênfase aos factores do conteúdo que aos factores do contexto do trabalho, mas a fonte de satisfação varia de categoria por categoria. Work motivation is viewed, since middle of the 20th Century, as a main factor of job satisfaction, also for increasing of productivity and quality of goods and services. By the ending of a Master’s Programme in Global Management, we was moved by a great interest to research and report about the organization human values, important component of which is the people’s satisfaction level in work conditions, obtained through an evaluation of a great number of independent variables, related to two items – work content and work context. The main objective of the present dissertation is to identify in which measure the job environmental variables contribute to work satisfaction. Inspired into the Two Factors Theory (Herzberg, 1959, 1982) and into The Cognitive Evaluation Theory (Deci, 1971), we intent to relate people satisfaction to different particular variables, which perform two subsystems – intrinsic or motivator, that includes learning, emotions, work itself, achievement and recognition and; extrinsic or hygienic, that includes salary, supervision and work physical conditions. Besides a specialized literature review, we took up two separated inquiries within capeverdian companies, the first conducted in October, 2003, and the second in October, 2007, which allowed specifics and general job satisfaction indexes, correlations and comparative analysis. We concluded that people are fair satisfied on job, and give more emphasis on work content factors, than on work context factors, but the source of satisfaction is different category by category.

Pool Worker Survey

Study to examine the motivation of Iowa’s direct care workers to work in medical personnel pools or temporary staffing agencies.

Health problems of nursing workers in a public educational institution

Objective: To identify the issues occurred with nursing workers through a Health Monitoring System for Nursing Workers (SIMOSTE) and to describe the consequences of those problems. Method: This is a quantitative, exploratory and descriptive study realized in a teaching hospital in the west region of the city of São Paulo. Results: From the SIMOSTE, 1.847 occurrences were registered in a six month period. Within the main occurrences, medical licenses, work related accidents with and without removals; psychiatric consultations and psychotherapy were highlighted. Conclusion: The data points out to the need for the development of new health vigilance actions to notify accidents and illness related to work, besides the prevention of issues. 


Rehabilitation outcomes for orthopaedic trauma individuals as measured by the INTERMED.

PURPOSE: Bio-psychosocial characteristics of patients after orthopaedic traumas may be a strong predictor of poor outcome. The objective of this prospective study was to assess whether the INTERMED, a measure of bio-psychosocial complexity, identifies complex inpatients during rehabilitation including vocational aspects with a poor outcome 1 year after discharge. METHOD: At entry, the INTERMED scores of 118 inpatients were used to assign patients to the high or low complexity group. A questionnaire evaluated 1 year after discharge whether patients: (1) returned to work, (2) still have therapies, (3) take psychoactive drugs, (4) take medication against pain and (5) were satisfied with vocational therapy. Univariate logistic regressions identified which variables predict INTERMED case complexity during hospitalisation as well as predictors (i.e. INTERMED case complexity, French as preferred language, duration of the disability, accident at work, work qualification, severity of the injury, psychiatric co-morbidities, pain) of the five measured outcomes 1 year after discharge. RESULTS: During hospitalisation, the high complexity group was associated with a high prevalence of psychiatric co-morbidities, a higher level of pain and a weaker perception of treatment effects. One year after discharge, the INTERMED was the sole variable to predict all outcomes. CONCLUSION: The INTERMED identifies complex patients during vocational rehabilitation after orthopaedic trauma and is a good predictor of poor outcome 1 year after discharge.

Analysis of the physical aspects of quality of life of kidney recipients

OBJECTIVE To identify the main factors of the physical domain modified after kidney transplantation and analyze the influence of those aspects in the perception of Overall quality of life (QOL). METHOD Longitudinal study, conducted with 63 chronic kidney patients, evaluated before and after kidney transplant, using the quality of life scale proposed by the World Health Organization. RESULTS We observed significant improvement in the physical aspects of QOL after kidney transplantation. Significant correlations were observed between physical aspects and the Overall QOL. CONCLUSION The kidney transplant generated improvement in all physical aspects of QOL. The factors that showed stronger correlation with the Overall QOL before the transplant were the capacity to work and pain. After the transplant, the perception of need for treatment was the factor that showed stronger correlation with the Overall QOL.

Educational intervention on malignant hyperthermia with nursing professionals of the operating room

OBJECTIVE To evaluate the effectiveness of an educational intervention on malignant hyperthermia with operating room nurses. METHOD A quasi-experimental study, aimed at an educational intervention of short duration with the nursing staff in the operating room of the institution hosting the research in the city of São Paulo, with the participation of 96 professionals. Pre-intervention tests and post-intervention tests were applied, which consisted of a lecture followed by simulation. RESULTS Considering the overall results of the intervention, there was a statistically significant difference (p<0.00). After the educational intervention, there was an increase of the minimum and maximum scores, and average growth of 2.64 points in the knowledge of professionals when compared to the previous step. CONCLUSION The educational intervention strategy favors the concept of the content developed by everyone involved and qualifies professionals to work safely.

Implementing the intermed in a post-acute care rehabilitation clinic for traumatic injuries: Obstacles and benefits

In 2003, the INTERMED, an instrument to assess biopsycho- social case complexity and to direct care, was introduced in daily clinical practice in the .Clinique romande de réadaptation suvaCare., a national rehabilitation hospital for traumatic injuries, located in the French speaking part of Switzerland. The introduction of the INTERMED was easy to realize and no major obstacles hampered its systematic implementation. Up to now, about 2,000 patients have been evaluated with the INTERMED and are followed for different outcomes. The INTERMED improved not only patients. assessment by including relevant psychosocial aspects of the clinical situation, it also favoured interdisciplinary communication, enhanced work satisfaction of the nursing staff and allowed early identification and adaptation of treatment for the injured patient showing a high degree of case complexity. Upon follow up, patients with a high degree of case-complexity showed a less favourable outcome, i.e. more health care utilization and lower rates of return to work. In conclusion, the systematic implementation of the INTERMED enabled the reorganization of medical rehabilitation, anchored it in a bio-psycho-social framework, improving interdisciplinary communication and collaboration and ameliorated treatment outcome.

A sequential model for older workers’ labor transitions after a health shock

In this work we study older workers (50 64) labor force transitions after a health/disability shock. We find that the probability of keeping working decreases with both age and severity of the shock. Moreover, we find strong interactions between age and severity in the 50 64 age range and none in the 30 49 age range. Regarding demographics we find that being female and married reduce the probability of keeping work. On the contrary, being main breadwinner, education and skill levels increase it. Interestingly, the effect of some demographics changes its sign when we look at transitions from inactivity to work. This is the case of being married or having a working spouse. Undoubtedly, leisure complementarities should play a role in the latter case. Since the data we use contains a very detailed information on disabilities, we are able to evaluate the marginal effect of each type of disability either in the probability of keeping working or in returning back to work. Some of these results may have strong policy implications.

Compensating wage differentials and voluntary job changes: Evidence from West Germany

Does the labor market place wage premia on jobs that involve physical strain,job, insecurity or bad regulation of hours? This paper derives bounds on themonetary returns to these job disamenities in the West German labor market.We show that in a market with dispersion in both job characteristics andwages, the average wage change of workers who switch jobs voluntarily and optfor consuming more (less) disamenities,provides an upper (lower) bound on themarket return to the disamenity. Using longitudinal information from workersin the German Socio Economic Panel, we estimate an upper bound of 5% and alower bound of 3.5% for the market return to work strain in a job.

Formação profissional e empregabilidade: O caso dos diplomados da escola de formação profissional da Cabnave em São Vicente – Cabo Verde

Se houve um tempo em que eram as empresas as mais preocupadas em dotar os seus empregados com um determinado leque de competências técnicas, pela via da Formação Profissional, para se tornarem cada vez mais competitivas, hoje torna-se crucial para qualquer país poder determinar o grau de empregabilidade dos diversos cursos de formação profissional realizados pela sua população activa, de modo a optimizar a inserção dos seus cidadãos no mercado de trabalho. A presente investigação visa analisar a empregabilidade a partir de um caso nacional, em que uma escola de formação profissional, inserida numa empresa – a Cabnave – vem desenvolvendo um modelo de formação, que para além de estar directamente relacionado com a sua própria actividade, encontra-se ligado a vários sectores da actividade económica de Cabo Verde, particularmente ao da indústria Mecânica e Metalomecânica. O estudo contém dois principais momentos. Um primeiro, no qual se procedeu à contextualização e fundamentação do tema, com base em bibliografia nacional e internacional, e enfoque nos seguintes assuntos: o sistema de ensino em Cabo Verde, mais concretamente a via do ensino secundário técnico; a formação profissional; e o mercado de trabalho em Cabo Verde. Num segundo momento desenvolveu-se um Caso de Estudo, para se determinar o grau de empregabilidade dos diplomados da Escola de Formação Profissional da Cabnave, que seguiram uma carreira em áreas profissionais diferentes do curso realizado, recorrendo-se à aplicação de um questionário a uma amostra final de 80 inquiridos, e à interpretação dos resultados, através dos métodos de análise estatística Descritiva e Correlacional. Das conclusões resultantes da análise das respostas obtidas, chama-se a atenção para o facto de a maioria dos diplomados partilharem de uma opinião positiva relativamente à empregabilidade dos cursos que frequentaram, independentemente de os mesmos terem ou não conduzido a uma profissão directamente ligada ao sector da Mecânica e MetalomecânicaIf at one point companies used to be the ones that were the most concerned with providing specific technical skills to their employees, through professional education, as to become more competitive, it is today highly important for every country to determine the level of employability of the numerous professional education programs pursued by its active population, so as to increase citizens’ chances to enter the labor market. The present research aims to study the concept of employability, with focus on a national case, a school of professional education which integrates the company Cabnave, and has been developing an educational model that, in addition to responding to the company’s own needs, is also connected to Cape Verde’s various economic sectors, notably the Mechanics and Metalworking industry. The study consists of two main parts. A first one where, based on national and international bibliography, the theme is contextualized, with closest attention to the following subjects: the Cape Verdean education system, especially vocational education in secondary schools; professional education; and the labor market in Cape Verde. In the second part, a Case Study is conducted, in order to determine the level of employability of those who were trained by Cabnave’s School of Professional Education, but have pursued a career in a different professional field. Therefore, a questionnaire was submitted to a sample of 80 respondents, and the correspondent data was analyzed and interpreted, with the use of Descriptive Statistics and Correlation Analysis. One of the conclusions deriving from the survey results is that most of the School’s trained graduates have a positive view of the employability of the programs they have pursued, independently of whether they continued to work in the Mechanics and Metalworking industry

Social preferences and skill segregation

This paper shows that models where preferences of individuals dependnot only on their allocations, but also on the well-being of otherpersons, can produce both large and testable effects. We study theallocation of workers with heterogeneous productivities to firms. Weshow that even small deviations from purely selfish preferences leadsto widespread workplace skill segregation. That is, workers ofdifferent abilities tend to work in di¤erent firms, as long as theycare somewhat more about the utilities of workers who are close .

Motivação e desempenho dos funcionários da administração pública cabo-verdiana actual

The process of changes that have been taking place in contemporary world reaches undoubtedly to the public sector. The quest for a new public management, that seeks to provide quality and effective services to the citizens, has been the target of contemporary State. Within this framework, the study of people inside publics organizations becomes strategic. Knowledge is generated, processed, and communicated at great speed, taking society to adopt new approaches. In order to meet the challenges of the new millennium, organizations must thing more of people and, above all, they must be more concerned with creating incentives that can motivate their collaborators to achieve not only the objectives of the organization but also personal objectives of each individual, since there is no point in gaining profit and having productivity if the organization do not develop policies and practices that focus on the human being. Motivation implies accomplishment feelings and professional recognition, expressed by means of executing tasks and activities that are sufficiently challenging and meaningful to the job. The truth is that the adoption of a public management focused on quality requires changes in organization culture, requiring mainly motivation, which leads to efforts, dedication, persistence, and commitment. This work is intended to research motivation as a tool to achieve productivity and excellence in the performance of activities in Cape Verdean Public Administration. To achieve the aim of this work, a bibliographical research on Human Resources Administration as well as different theories related to work motivation in organizations was conducted. The inquisitive method was used based upon a written questionnaire aimed at obtaining data referring to motivation of Public Administration workers.

Motivação e desempenho dos funcionários da administração pública cabo-verdiana actual

O processo de mudanças que vem acontecendo no mundo contemporâneo alcança, inevitavelmente, o sector público. A busca de uma nova gestão pública, que procure prestar serviços ao cidadão com qualidade e eficiência tem sido o alvo a ser alcançado pelo Estado contemporâneo. Dentro desse prisma o estudo das pessoas dentro das organizações públicas apresenta-se como estratégico. O conhecimento é gerado, processado e comunicado a grande velocidade, o que leva a sociedade a assumir novas posturas. Para enfrentar os desafios do novo milénio, as organizações terão que pensar mais nas pessoas e sobretudo, preocupar-se mais em criar estímulos que motivem os colaboradores para alcançarem tanto os objectivos da organização quanto os objectivos pessoais de cada um porque não adianta obter lucro e produtividade se a organização não desenvolver políticas e práticas que privilegiam o ser humano. Motivação envolve sentimentos de realização e de reconhecimento profissional, manifestado por meio de exercícios das tarefas e actividades que oferecem suficiente desafio e significado para o trabalho. A verdade é que a adopção de uma gestão pública focada na qualidade requer mudanças na cultura organizacional, exigindo principalmente motivação, que conduz ao esforço, dedicação, persistência e comprometimento. Com o presente trabalho pretende-se investigar a motivação como uma ferramenta para alcançar a produtividade e a excelência no desempenho das actividades na Administração Pública Cabo-verdiana. Para alcançar o objectivo deste trabalho, fez-se uma pesquisa bibliográfica sobre a Administração dos Recursos Humanos e sobre as diversas teorias relacionadas com a motivação para o trabalho nas organizações. Utilizou-se o método inquisitivo baseado num interrogatório escrito para se obter dados referentes a motivação dos funcionários da Administração Pública.