Physicians' perceptions of psychosocial factors and coping strategies in their ability to work: a multivariate analysis

Background/Objective: Physicians play a crucial role in healthcare systems but face negative impacts from a challenging work environment, leading to burnout. Burnout has negative effects on physician health and patient care. Understanding psychosocial aspects of work and coping strategies used by physicians is essential. Validated tools, including COPSOQ-II, BriefCOPE, and WAI scales, can provide insight into the psychosocial impact of the medical profession. The study aims to use these scales to explore the relationship between job demands (COPSOQ-II), coping strategies (BriefCOPE), and work ability (WAI) among Portuguese physicians. Methods: Participants were recruited through professional associations and organizations with access to physicians, and data was collected via a self-administered web-based questionnaire. Participants’ sociodemographic characteristics were associated with WAI scores through Chi-Square analysis and One-way ANOVA. Outliers were detected through sensitivity analysis, and exploratory and confirmatory factor analyses were performed for the COPSOQ-II and BriefCOPE scales. Associations between WAI scores and COPSOQ-II and BriefCOPE scales were also analyzed. Results: The study surveyed 55 physicians and found that except for sex, there were no significant differences in the work ability index (WAI) by sociodemographic characteristics. Significant differences were found between WAI and higher scores in job purpose, quality of management, and general health, while higher stress, sleep issues, and depressive symptoms were associated with lower WAI groups. Exploratory (EFA) and confirmatory factorial analyses (CFA) were conducted on the BriefCOPE and COPSOQ-II scales, revealing disconnection with the theoretical model. Under EFA, the BriefCOPE items related to theoretical dimension of "dysfunctional coping" are scattered into other coping dimensions, and the empirical model of the COPSOQ-II scale presented a different configuration from its theoretical model, either in the number of dimensions or in the distribution of items by their dimensions. Under CFA, these differences between the theoretical and empirical models are even clearer, as neither dataset fits to its theoretical counterpart without changes. In BriefCOPE, removing self-blaming is sufficient to correct this, while in COPSOQ, a minimum of 9 dimensions needed to be excluded. Even then this result presents unacceptable CFI(Comparative Fit Index), TLI(Tucker-Lewis Index) and RMSEA(Root Mean Square Error of Approximation) values. Conclusions: This study analyzed physician perceptions of workplace environment and job-related and psychosocial factors using a questionnaire. However, the results did not provide any significant findings, and only suggested some possible associations between certain workplace factors, coping abilities, and work ability. The study had a small sample size and further research with larger sample sizes is needed to confirm these findings.publishe

O Comando-Missão na campanha militar no Teatro de Operações da Guiné-Bissau (1963-1974)

O presente trabalho de investigação tem como objetivo geral compreender e identificar como era aplicado e conduzido o Sistema Comando Missão na Campanha Militar no Teatro de Operações de Guiné (1963-74), constituindo como modelo de análise os conceitos doutrinários que definem o Comando Missão na atualidade. Para atingir o objetivo geral a que nos propomos, procedemos a uma abrangente e detalhada análise documental de documentos históricos bem como de uma diversa bibliografia publicada sobre o tema. A investigação centrou-se em três pilares: a Direção do Processo Operacional, a Condução do Processo Operacional e Sistema do Comando-Missão, conduzido pelos Comandantes e seu Estado-Maior (EM). Na conclusão do presente trabalho de estudo, e não obstante algumas diferenças resultantes do contexto da realidade à época, é possível afirmar que os conceitos de Comando Missão eram efetivamente empregues pelos Comandantes no Teatro de Operações da Guiné, na medida em que estes procediam à análise da situação e, consequentemente, à identificação do problema, como base para desenvolver a sua resolução e, assim, transmitir ao seu Estado-Maior o seu planeamento e orientações para a condução das operações, por forma a obter os resultados por si visualizados e expectados. Abstract: This research paper has the general objective to understand and identify how was applied and conducted the System of Mission-Command in Guinea Theater of Operations (1963-74)", using as analysis model the doctrinal concepts that define the Mission Command. In order to fulfil the general objective that we proposed to, a large and detailed documental analysis on historical documentation was carried out, as well as on a diverse bibliography published on the theme. The research focused on three of the pillars of the Direct Operational Process, Conduct Operational, and System of Mission-Command, led by the Commander and its general staff. Upon the conclusion of the present research work, despite some differences resulting from the framework of that time and of nowadays, it is possible to state that the concept of the System of Mission-Command were effectively applied by the Commanders in Guinea Theater of Operations, since they proceeded to the analysis of the situation and, consequently, to the identification of the problem, as basis to develop its resolution and, subsequently, transmit to their General Staff the planning and guidance to conduct the operations, in order to achieve the visualized and expected results.N/

Precipitación intensa en la región de Murcia. Distribución espacial y relación con la circulación sinóptica (1980-2000)

Ponencia presentada en: XI Congreso de la Asociación Española de Climatología celebrado en Cartagena entre el 17 y el 19 de octubre de 2018.[ES]La región de Murcia se enmarca en un clima mediterráneo con un régimen de precipitaciones muy variable e irregular. De hecho, la precipitación varía sustancialmente de un año a otro, y períodos de sequía severa a menudo terminan en episodios de lluvia torrencial que, en solo 24 horas, pueden producir cantidades de precipitación que exceden la precipitación anual promedio. El objetivo de este trabajo es analizar la distribución espacial de la precipitación intensa asociada a las advecciones de levante en la región de Murcia y su relación con la circulación sinóptica. Se han trabajado los eventos del período 1980-2000 con más de 100 mm en 24 horas. Los resultados indican la existencia de cinco patrones generales de distribución vinculados a determinadas configuraciones sinópticas. El Litoral Este y la zona Norte del territorio murciano se revelan como las áreas con mayor frecuencia de eventos de precipitaciones intensas en el período analizado.[EN]The region of Murcia is located in a Mediterranean climate with a very variable and irregular rainfall regime. In fact, precipitation varies substantially from one year to another, and severe drought periods often end in episodes of torrential rain that can produce rainfall amounts exceeding the average annual rainfall in just 24 hours. The aim of this research is to analyze the spatial distribution of intense rainfall associated with the East advections in the region of Murcia and its relationship with the synoptic circulation. The events with more than 100 mm in 24 hours within the period 1980-2000 have been consulted. The results indicate the existence of five general patterns of distribution with a close relationship with certain synoptic situations. The East Coast and the north area of the territory of Murcia are revealed as the areas in which there is a greater frequency of intense rainfall events during the analyzed period

Adhesives with different pHs: effect on the MTBS of chemically activated and light-activated composites to human dentin

PURPOSE: To evaluate the bond strength between human dentin and composites, using two light-activated single-bottle total-etch adhesive systems with different pHs combined with chemically activated and light-activated-composites. The tested hypothesis was that the dentin bond strength is not influenced by an adhesive system of low pH, combined with chemically activated or light-activated composites. MATERIAL AND METHOD: Flat dentin surfaces of twenty-eight human third molars were allocated in 4 groups (n=7), depending on the adhesive system: (One Step Plus-OS and Prime & Bond NT-PB) and composite (light-activated Filtek Z-100 [Z100] and chemically activated Bisfil 2B [B2B]). Each adhesive system was applied on acid-etched dentin and then one of the composites was added to form a 5 mm-high resin block. The specimens were stored in tap water (37ºC/24 h) and sectioned into two axes, x and y. This was done with a diamond disk under coolant irrigation to obtain beams with a cross-section area of approximately 0.8 mm². Each specimen was then attached to a custom-made device and submitted to the microtensile test (1 mm.min-1). Data were analyzed using two-way ANOVA and Tukey's tests (

Usability and Usefulness of Circularity Indicators for Manufacturing Performance Management

Advances in industrial digitalization present many opportunities for process and product data exploitation in manufacturing, unlocking new systemic measures of performance beyond a single machine, process, facility area and even beyond the factory gates. However, existing data models and manufacturing systems\u27 performance measures are still focused on productivity, quality and delivery time, which could potentially lead to an accelerated linear economy. To shift to more circular industrial systems, we need to identify and assess circularity opportunities in ways that align the goals of sustainable and industrial development. In this study, micro-level circular indicators were reviewed, selected, analysed and tested in a manufacturing company to evaluate their usability and usefulness to guide process improvements. The aim is to enable circular and eco-efficient solutions towards sustainable production systems. Usability and usefulness of the indicators are essential to their integration into established environmental and operations management systems. The main contribution of this study is in the identification of key features making circularity indicators usable and useful from a manufacturer\u27s perspective. The conclusion also suggests directions for further research on tools and methods to support circular manufacturing

Guidelines for Industrial Symbiosis—a Systematic Approach for Content Definition and Practical Recommendations for Implementation

AbstractThe increase of industrial symbiosis (IS) activities around the world has strongly contributed to promote awareness among companies on the benefits of this business model and, consequently, their interest to apply/incorporate dedicated IS actions in their activities. In most cases, companies assume self-learning and ongoing approaches for the adaption of synergies, ignoring some fundamental aspects as the full spectrum of considerations regarding these processes. Unexpected barriers frequently appear during the implementation process and become hardly overcome due to incomplete systematic approaches and the lack of information. In this context, it is important to promote effective and sequential guidance procedures regarding IS implementation processes to support companies in their transition to full IS processes implementation. This paper aims to advance the synergy implementation emerging process, through the identification, promotion, and definition of the core steps to be considered in an IS implementation process. This study is based on a comprehensive perspective for the definition of contents to be considered in a step-by-step guideline that includes the different theoretical, technical, and strategic approaches for large-scale IS promotion. The main outputs of this paper are a final set of independent and sequential information clusters, their associated contents identification process, and a comprehensive description of the systematic approach used to support companies in the implementation of their pre-identified stages. The guideline methodology proposed in this study is an important support tool for companies, practitioners, and agents intending to initiate IS synergies implementation and also a strong contribution to the development of complementary guidance activities regarding IS implementation process.</jats:p

Effect of dental bleaching on pulp oxygen saturation in maxillary central incisors - a randomized clinical trial

Objective: To assess pulp oxygen saturation levels (SaO2) in maxillary central incisors after dental bleaching. Materials and Methods: 80 participants (160 teeth) were randomly allocated to four groups: G1 In-office bleaching with two applications of 35% hydrogen peroxide (HP) (20 minutes), followed by at-home bleaching with 10% carbamide peroxide (CP) (2 hours/day for 16 days); G2 - Same protocol as G1, plus desensitizing toothpaste; G3 - Inoffice bleaching with 35% HP and one application of placebo gel (20 minutes), followed by at-home bleaching with 10% CP (2 hours/day for 16 days); and G4 - Same protocol as G3, plus desensitizing toothpaste. Pulp SaO2 levels were measured before (T0) and immediately after (T1) in-office bleaching; on the 5th (T2), 8th (T3), 12th (T4), and 16th days of at-home bleaching (T5); and on the 7th (T6) and 30th (T7) days. Mean (SD) pulp SaO2 levels were compared within groups by generalized estimating equations (GEE) and Student’s t-test (P&lt;0.05). Results: Mean pulp SaO2 at T0 was 84.29% in G1, 84.38% in G2, 84.79% in G3, and 85.83% in G4. At T1, these values decreased to 81.96%, 82.06%, 82.19%, and 81.15% in G1, G2, G3, and G4 respectively, with significant difference in G4 (P&lt;0.05). During home bleaching, pulp SaO2 levels varied in all groups, with 86.55%, 86.60%, 85.71%, and 87.15% means at T7 for G1, G2, G3, and G4, respectively; G2 presented significant difference (P&lt;0.05). Conclusions: Pulp SaO2 level in maxillary central incisors was similar at baseline, reducing immediately after in-office bleaching, regardless of using desensitizing toothpaste and increasing at 30 days after dental bleaching

Identification and Functional Studies of Two New Dual-Oxidase 2 (DUOX2) Mutations in a Child with Congenital Hypothyroidism and a Eutopic Normal-Size Thyroid Gland

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Key Issues for Determining the Exploitable Water Resources in a Mediterranean River Basin

[EN] One of the major difficulties in water planning is to determine the water availability in a water resource system in order to distribute water sustainably. In this paper, we analyze the key issues for determining the exploitable water resources as an indicator of water availability in a Mediterranean river basin. Historically, these territories are characterized by heavily regulated water resources and the extensive use of unconventional resources (desalination and wastewater reuse); hence, emulating the hydrological cycle is not enough. This analysis considers the Jucar River Basin as a case study. We have analyzed the different possible combinations between the streamflow time series, the length of the simulation period and the reliability criteria. As expected, the results show a wide dispersion, proving the great influence of the reliability criteria used for the quantification and localization of the exploitable water resources in the system. Therefore, it is considered risky to provide a single value to represent the water availability in the Jucar water resource system. In this sense, it is necessary that policymakers and stakeholders make a decision about the methodology used to determine the exploitable water resources in a river basin. (C) 2014 Elsevier B.V. All rights reserved.The authors wish to thank the Confederacion Hidrografica del Jucar (Spanish Ministry of the Environment) for the data provided in developing this study and the Spanish Ministry of Economy and Competitiveness for its financial support through the projects SCARCE (Consolider-Ingenio 2010 CSD2009-00065) and NUTEGES (CGL2012-34978). We also value the support provided by the European Community's Seventh Framework Program in financing the projects DROUGHT-R82SPI (FP7-ENV-2011, 282769), ENHANCE (FP7-ENV-2012, 308438), WAMCD (EC-DG Environment No. 07.0329/2013/671291/ SUB/ENV.C1) and LIFE ALBUFERA (LIFE12 ENV/ES/000685).Pedro Monzonís, M.; Ferrer Polo, FJ.; Solera Solera, A.; Estrela Monreal, T.; Paredes Arquiola, J. (2015). Key Issues for Determining the Exploitable Water Resources in a Mediterranean River Basin. Science of the Total Environment. 503-504:319-328. https://doi.org/10.1016/j.scitotenv.2014.07.042S319328503-50