El síndrome do agotamiento profesional en el marco de la enfermería: una revisión integrativa de la literatura

OBJETIVO Caracterizar la producción científica acerca del Síndrome del Agotamiento Profesionalen el marco de la enfermería, sistematizando los sitios en donde las investigaciones fueron realizadas, los constructos relacionados, los métodos empleados y sus principales resultados. MÉTODO Revisión integrativa de la literatura, con abordaje bibliométrico, en artículos en lengua portuguesa, española e inglesa publicados entre 2005 y 2016. RESULTADOS Fueron seleccionados 106 artículos. La mayoría se compuso de estudios de prevalencia, descriptivos, cuantitativos y realizados en hospitales. En las regiones Sureste y Sur de Brasil se halla el mayor número de publicaciones, siendo el estrés el constructo más relacionado con el agotamiento profesional. La mayor parte de los estudios utilizó el Maslach Burnout Inventorycomo medio de la averiguación de la presencia del síndrome. CONCLUSIÓN Nuevos estudios de caso control y cohorte deben llevarse a cabo. Investigaciones de cuño cualitativo-exploratorio son necesarias para poder comprender mejor el Síndrome del Agotamiento Profesionalentre los profesionales de enfermería con grupos focales o entrevistas, como también investigaciones causales comparativas, a fin de explorar las manifestaciones del síndrome.OBJETIVO Caracterizar a produção científica sobre a Síndrome do Esgotamento Profissionalno contexto da enfermagem, sistematizando os locais onde as pesquisas foram realizadas, os construtos relacionados, os métodos empregados e seus principais resultados. MÉTODO Revisão integrativa da literatura, com abordagem bibliométrica, em artigos na língua portuguesa, espanhola e inglesa publicados entre 2005 e 2016. RESULTADOS Foram selecionados 106 artigos.A maioria estudos de prevalência, descritivos, quantitativos e realizados em hospitais. Nas regiões Sudeste e Sul do Brasil encontram-se o maior número de publicações, sendo o estresse o construto mais relacionado com o esgotamento profissional. A maior parte dos estudos utilizou o Maslach Burnout Inventory como meio de averiguação da presença da síndrome. CONCLUSÃO Novos estudos de caso controle e coorte devem ser realizados. Pesquisas de cunho qualitativo-exploratório são necessárias para poder compreender melhor a Síndrome do Esgotamento Profissionalentre os profissionais de enfermagem com grupos focais ou entrevistas, como também pesquisas causais comparativas, com o intuito de explorar as manifestações da síndrome.OBJECTIVE To characterize the scientific production on Burnout Syndrome in the Nursingcontext, systematizing the location where the studies were carried out, the related constructs, the employed methods and their main results. METHOD An integrative review of the literature with a bibliometric approach of articles published in Portuguese, Spanish and English between 2005 and 2016. RESULTS 106 articles wereincluded. Mostinvolvedprevalence, and were descriptive, quantitative studies performed in hospitals.The Southeastern and Southern regions of Brazil had the largest number of publications, and stress was the construct most related to burnout.Most of the studies used the Maslach Burnout Inventory to investigate the presence of the syndrome. CONCLUSION New case-control and cohort studies should be carried out.Qualitative-exploratory studies are necessary to better understand Burnout Syndrome among nursing professionals usingfocus groups or interviews, as well as comparative causal studies, with the purpose of exploring the syndrome’smanifestations

Interacionismo simbólico: origens, pressupostos e contribuições aos estudos em Psicologia Social

The current study addresses the theoretical perspective named symbolic interactionism, aiming at the description of its roots, consolidation, main assumptions and contributions to the field of social psychology. Using literature review, conceptions of some scholars known as pioneers to that approach are examined, emphasizing the work of George Mead. The initial landmarks of the symbolic interactionism movement’s consolidation (whose name and main assumptions were established by Herbert Blumer) and the different possibilities to work on that concept, represented by the methodological and conceptual divergences between the chicago and Iowa Schools, constitute the major points of focus. Approaches from scholars like Strauss, Shibutani, Berger and Luckmann, and Stryker are shortly discussed for the purpose of identifying the main developments derived from the interactionist conceptions. Lastly, based on this review, which provided distinct points of view regarding the symbolic interactionism approach, we conclude that its evolution and strengthening along the time have contributed to its permanence as a theoretical perspective with broad applicability in social life studies.O estudo aborda a perspectiva teórica denominada interacionismo simbólico, com o objetivo de resgatar suas origens, consolidação, pressupostos centrais e contribuições ao campo da Psicologia social. com base em revisão de literatura, são examinadas algumas concepções de pensadores reconhecidos como precursores dessa corrente, com destaque para o trabalho de George Mead. Os marcos iniciais da estruturação do movimento interacionista simbólico (cujo nome e principais pressupostos foram estabelecidos por Herbert Blumer) e as diferentes possibilidades de operacionalização do conceito, representadas pelas divergências conceituais e metodológicas das Escolas de chicago e Iowa, constituem os pontos centrais da discussão. No intuito de identificar os principais desdobramentos oriundos das concepções interacionistas, são brevemente expostas as abordagens de estudiosos como Strauss, Shibutani, Berger e Luckmann, e Stryker. Por fim, com base na revisão empreendida, que permitiu identificar diferentes pontos de vista acerca da abordagem interacionista simbólica, conclui-se que sua evolução e fortalecimento ao longo do tempo contribuíram para que pudesse se sustentar como uma perspectiva teórica com amplas possibilidades de aplicação nos estudos da vida social.El estudio aborda la perspectiva teórica denominada interaccionismo simbólico, con el objetivo de rescatar sus orígenes, consolidación, supuestos centrales y contribuciones al campo de la Psicología social. con base en revisión de literatura, son examinadas algunas concepciones de pensadores reconocidos como precursores de esa corriente, con destaque para el trabajo de George Mead. Los marcos iniciales de la estructuración del movimiento interaccionista simbólico (cuyo nombre y principales supuestos fueron establecidos por Herbert Blumer) y las diferentes posibilidades de operacionalización del concepto, representadas por las divergencias de conceptos y metodológicas de las Escuelas de chicago e Iowa, constituyen los puntos centrales de la discusión. En el designio de identificar los principales desdoblamientos oriundos de las concepciones interaccionistas, son brevemente expuestos los abordajes de estudiosos como Strauss, Shibutani, Berger y Luckmann, y Stryker. Por fin, con base en la revisión emprendida, que permitió identificar diferentes puntos de vista acerca del abordaje interaccionista simbólico, se concluye que su evolución y fortalecimiento a lo largo del tiempo aportaron para que pudiese sostenerse como una perspectiva teórica con amplias posibilidades de aplicación en los estudios de la vida social

Strenuous Acute Exercise Induces Slow and Fast Twitch-Dependent NADPH Oxidase Expression in Rat Skeletal Muscle

The enzymatic complex Nicotinamide Adenine Dinucleotide Phosphate (NADPH) oxidase (NOx) may be the principal source of reactive oxygen species (ROS). The NOX2 and NOX4 isoforms are tissue-dependent and are differentially expressed in slow-twitch fibers (type I fibers) and fast-twitch fibers (type II fibers) of skeletal muscle, making them different markers of ROS metabolism induced by physical exercise. The aim of this study was to investigate NOx signaling, as a non-adaptive and non-cumulative response, in the predominant fiber types of rat skeletal muscles 24 h after one strenuous treadmill exercise session. The levels of mRNA, reduced glycogen, thiol content, NOx, superoxide dismutase, catalase, glutathione peroxidase activity, and PPARGC1α and SLC2A4 gene expression were measured in the white gastrocnemius (WG) portion, the red gastrocnemius (RG) portion, and the soleus muscle (SOL). NOx activity showed higher values in the SOL muscle compared to the RG and WG portions. The same was true of the NOX2 and NOX4 mRNA levels, antioxidant enzymatic activities, glycogen content. Twenty-four hours after the strenuous exercise session, NOx expression increased in slow-twitch oxidative fibers. The acute strenuous exercise condition showed an attenuation of oxidative stress and an upregulation of antioxidant activity through PPARGC1α gene activity, antioxidant defense adaptations, and differential gene expression according to the predominant fiber type. The most prominent location of detoxification (indicated by NOX4 activation) in the slow-twitch oxidative SOL muscle was the mitochondria, while the fast-twitch oxidative RG portion showed a more cytosolic location. Glycolytic metabolism in the WG portion suggested possible NOX2/NOX4 non-regulation, indicating other possible ROS regulation pathways

Occupational Burnout Syndrome in the nursing context: an integrative literature review

OBJECTIVE To characterize the scientific production on Burnout Syndrome in the Nursingcontext, systematizing the location where the studies were carried out, the related constructs, the employed methods and their main results. METHOD An integrative review of the literature with a bibliometric approach of articles published in Portuguese, Spanish and English between 2005 and 2016. RESULTS 106 articles wereincluded. Mostinvolvedprevalence, and were descriptive, quantitative studies performed in hospitals.The Southeastern and Southern regions of Brazil had the largest number of publications, and stress was the construct most related to burnout.Most of the studies used the Maslach Burnout Inventory to investigate the presence of the syndrome. CONCLUSION New case-control and cohort studies should be carried out.Qualitative-exploratory studies are necessary to better understand Burnout Syndrome among nursing professionals usingfocus groups or interviews, as well as comparative causal studies, with the purpose of exploring the syndrome’smanifestations.OBJETIVO Caracterizar a produção científica sobre a Síndrome do Esgotamento Profissionalno contexto da enfermagem, sistematizando os locais onde as pesquisas foram realizadas, os construtos relacionados, os métodos empregados e seus principais resultados. MÉTODO Revisão integrativa da literatura, com abordagem bibliométrica, em artigos na língua portuguesa, espanhola e inglesa publicados entre 2005 e 2016. RESULTADOS Foram selecionados 106 artigos.A maioria estudos de prevalência, descritivos, quantitativos e realizados em hospitais. Nas regiões Sudeste e Sul do Brasil encontram-se o maior número de publicações, sendo o estresse o construto mais relacionado com o esgotamento profissional. A maior parte dos estudos utilizou o Maslach Burnout Inventory como meio de averiguação da presença da síndrome. CONCLUSÃO Novos estudos de caso controle e coorte devem ser realizados. Pesquisas de cunho qualitativo-exploratório são necessárias para poder compreender melhor a Síndrome do Esgotamento Profissionalentre os profissionais de enfermagem com grupos focais ou entrevistas, como também pesquisas causais comparativas, com o intuito de explorar as manifestações da síndrome.OBJETIVO Caracterizar la producción científica acerca del Síndrome del Agotamiento Profesionalen el marco de la enfermería, sistematizando los sitios en donde las investigaciones fueron realizadas, los constructos relacionados, los métodos empleados y sus principales resultados. MÉTODO Revisión integrativa de la literatura, con abordaje bibliométrico, en artículos en lengua portuguesa, española e inglesa publicados entre 2005 y 2016. RESULTADOS Fueron seleccionados 106 artículos. La mayoría se compuso de estudios de prevalencia, descriptivos, cuantitativos y realizados en hospitales. En las regiones Sureste y Sur de Brasil se halla el mayor número de publicaciones, siendo el estrés el constructo más relacionado con el agotamiento profesional. La mayor parte de los estudios utilizó el Maslach Burnout Inventorycomo medio de la averiguación de la presencia del síndrome. CONCLUSIÓN Nuevos estudios de caso control y cohorte deben llevarse a cabo. Investigaciones de cuño cualitativo-exploratorio son necesarias para poder comprender mejor el Síndrome del Agotamiento Profesionalentre los profesionales de enfermería con grupos focales o entrevistas, como también investigaciones causales comparativas, a fin de explorar las manifestaciones del síndrome

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London