RESUMO Objetivo: analisar fatores associados ao presenteísmo em trabalhadores de enfermagem com variáveis sociodemográficas, condições de saúde e trabalho, produtividade e sintomas osteomusculares. Métodos: estudo transversal, descritivo e analítico, com 306 trabalhadores de enfermagem de um hospital e pronto-socorro municipal de uma capital brasileira. Utilizaram-se o Stanford Presenteeism Scale, o Work Limitations Questionnaire, o Questionário Nórdico de Sintomas Osteomusculares e um questionário demográfico de condições de trabalho e saúde dos profissionais de enfermagem. Realizaram análises bivariadas e multivariadas, respeitando um nível de significância de 5%. Resultados: o presenteísmo foi constatado em 43,8% dos profissionais e associações significativas com o regime de trabalho celetista (p=0,002), local de trabalho - Unidades de Terapia Intensiva (p=0,008), prática de exercícios físicos 2 vezes por semana (p=0,008), presença de sintomas osteomusculares, sendo a dor lombar representativa (p=0,001). A perda de produtividade foi de 8,8. Conclus ões : o estudo confirma alto índice de presenteísmo entre trabalhadores de enfermagem.

ABSTRACT Objective: to analyze factors associated with presenteeism in nursing workers with sociodemographic variables, health and work conditions, productivity and musculoskeletal symptoms. Methods: this is a cross-sectional, descriptive and analytical study, with 306 nursing workers from a hospital and municipal emergency room in a Brazilian capital. The Stanford Presenteeism Scale, the Work Limitations Questionnaire, the Nordic Musculoskeletal Questionnaire and a demographic questionnaire on nursing professionals’ working conditions and health were used. Bivariate and multivariate analyzes were performed, respecting a significance level of 5%. Results: presenteeism was found in 43.8% of professionals and significant associations with CLT work (p=0.002), workplace - Intensive Care Units (p=0.008), physical exercise twice a week (p=0.008), presence of musculoskeletal symptoms, with low back pain being representative (p=0.001). The productivity loss was 8.8. Conclusions: the study confirms a high rate of presenteeism among nursing workers.

RESUMEN Objetivo: analizar factores asociados al presentismo en trabajadores de enfermería con variables sociodemográficas, condiciones de salud y trabajo, productividad y síntomas musculoesqueléticos. Métodos: estudio transversal, descriptivo y analítico, con 306 trabajadores de enfermería de un hospital y urgencias municipales de una capital brasileña. Se utilizo el Stanford Presenteeism Scale, el Work Limitations Questionnaire, el Cuestionario Nórdico Musculoesquelético y un cuestionario demográfico sobre las condiciones laborales y de salud de los profesionales de enfermería. Realizaron análisis bivariados y multivariados, respetando un nivel de significancia del 5%. Resultados: se encontró presentismo en el 43,8% de los profesionales y asociaciones significativas con el régimen de trabajo celetista (p=0,002), lugar de trabajo - Unidades de Cuidados Intensivos (p=0,008), ejercicio físico dos veces por semana (p=0,008), presencia de musculoesquelético síntomas, siendo la lumbalgia representativa (p=0,001). La pérdida de productividad fue de 8.8. Conclusiones: el estudio confirma una alta tasa de presentismo entre los trabajadores de enfermería.

Reflection is now an established technique for achieving dynamic adaptability of middleware platforms. It provides a clean and comprehensive way to access the internals ofa platform implementation, allowing its customisation in order to achieve the best performance and adequacy under given operation environments and user requirements. In addition, the use ofa runtime component model for the design ofthe internal platform structure facilitates the identification of the elements to be adapted, as all platform aspects are built in terms ofcomponents. The major limitation ofthis approach, however, is related to the multitude ofaspects that make up a middleware platform, together with the requirement ofkeeping platform consis-tencyafter adaptations take place. This paper presents the results of ongoing research contributing to reduce this limitation. The approach is based on the use ofa common meta-model, together with meta-information techniques to provide a uniform way to specify and manipulate platform configurations. Both platform configuration and runtime adaptation are always specified using a small number of building blocks defined in the meta-model. The paper also describes the overall architecture ofthe Meta-ORB platform, which demonstrates this approach, and presents its two implementations: a proof-of-concept prototype written in Python, and a Java-based implementation aimed at supporting mobile devices. The results are also evaluated from a quantitative perspective, according to the requirements ofmultimedia applications, one ofthe major areas of application of reflective middleware.