Work, malaise, and well-being in Spanish and Latin-American doctors

OBJECTIVE To analyze the relations between the meanings of working and the levels of doctors work well-being in the context of their working conditions. METHOD The research combined the qualitative methodology of textual analysis and the quantitative one of correspondence factor analysis. A convenience, intentional, and stratified sample composed of 305 Spanish and Latin American doctors completed an extensive questionnaire on the topics of the research. RESULTS The general meaning of working for the group located in the quartile of malaise included perceptions of discomfort, frustration, and exhaustion. However, those showing higher levels of well-being, located on the opposite quartile, associated their working experience with good conditions and the development of their professional and personal competences. CONCLUSIONS The study provides empirical evidence of the relationship between contextual factors and the meanings of working for participants with higher levels of malaise, and of the importance granted both to intrinsic and extrinsic factors by those who scored highest on well-being.OBJETIVO Analizar las relaciones entre los significados del trabajo y los niveles de bienestar laboral de los profesionales de la medicina en el contexto de sus condiciones de trabajo. MÉTODOS La investigación combinó la metodología cualitativa del análisis textual, y la cuantitativa del análisis factorial de correspondencias. Una muestra de conveniencia, intencional y estratificada, compuesta por 305 profesionales de la medicina de España y de América Latina, respondió un amplio cuestionario sobre los temas de la investigación. RESULTADOS El significado general del trabajo del grupo situado en el cuartil de malestar se configuró en torno a percepciones de incomodidad, frustración y agotamiento. En cambio, quienes expresaron mayores niveles de bienestar, ubicados en el cuartil opuesto, asociaron su experiencia laboral a buenas condiciones de trabajo y al desarrollo de las propias competencias profesionales y personales. CONCLUSIONES El estudio aporta evidencia empírica acerca de la relación entre factores contextuales y significados de trabajo, en los participantes con mayores niveles de malestar; también, sobre la importancia dada a factores tanto intrínsecos como extrínsecos por quienes obtuvieron mayores puntuaciones en bienestar

Over Engagement, Protective or Risk Factor of Burnout?

Megatrends in the organization and management of work promote intensification and acceleration processes in the form of overload and overtime. These processes, in a framework of deregulation and individualization of labor relations, constitute burnout risk factors. To tackle this contemporary pandemic, the positive occupational psychology proposes engagement as a strategic resource for preventing that syndrome, delaying its appearance, or cushioning its effects. The present study is based on the suspicion that engagement, in addition to functioning as a means of protection against burnout, may also constitute a risk factor for this pathology. The purpose of its exposition is to contextualize, situate, and argue the logic of this approach, and to advance a response proposal to the question about in which circumstances the engagement constitutes a risk factor of burnout: in moderate doses, it works as a protective factor of burnout, while in excessive doses, it acts as a risk factor by hiding the warning signs of the syndrome

El malestar en el empleo temporal involuntario

El objetivo de este estudio fue analizar el papel de la voluntariedad de la situación ocupacional en el malestar psicológico en el empleo temporal. Se aplicó un cuestionario a una muestra de 463 personas incluidas en alguno de los siguientes cuatro tipos ideales de situación ocupacional: empleo estable, empleo temporal voluntario, empleo temporal involuntario y desempleo. Los resultados muestran diferencias significativas entre todos los tipos laborales en la escala de bienestar laboral. De mayor a menor puntuación media en esta escala, el orden de los tipos es: empleo estable, empleo temporal voluntario, desempleo y empleo temporal involuntario. Las respuestas textuales a las preguntas abiertas ponen de manifiesto un alto malestar en el estatus de empleo temporal involuntario, atribuido a la situación ocupacional presente y a la incertidumbre e inseguridad que genera el propio futuro laboral percibidoThe aim of this study was to analyze the occupational situation voluntary on the psychological malaise in temporary employment. A questionnaire was applied to a sample of 463 individuals included in one of the following four ideal types of occupational situation: stable employment, voluntary temporary employment, involuntary temporary employment, and unemployment. Results showed significant different among all occupational types in a scale of labor wellbeing. From higher to lower score in this scale, the ranking of the types is: stable employment, voluntary temporary employment, unemployment, and involuntary temporary employment. The responses to the open questions showed a high malaise in individuals in the condition of involuntary temporary employment, which is attributed to the current occupational situation and to the uncertainty and insecurity generated by the perceived labor futur

Labor conditions and the meanings of nursing work in Barcelona

Objetivo: analizar la relación entre la valoración cuantitativa de las condiciones de trabajo y la percepción cualitativa de la propia experiencia laboral. Método: una muestra de 1.760 profesionales de enfermería de Barcelona respondió a un cuestionario de valoración de sus condiciones de trabajo y resumió en cinco palabras clave su propia experiencia laboral actual. Resultados: el corpus textual de significados del trabajo incluyó 8.043 formas léxicas, que fueron categorizadas y codificadas. Las personas encuestadas que valoraron más alto sus condiciones de trabajo expresaron una visión de su trabajo en términos de autonomía, realización y bienestar; mientras que quienes las valoraron más bajo hablaron sobre todo de agotamiento, despersonalización y clima negativo. Un análisis de correspondencias evidenció una estrecha relación entre las valoraciones cuantitativas de las condiciones laborales y los códigos verbales de significado del trabajo. Conclusiones: los significados dados al trabajo fueron no solo coherentes con las valoraciones numéricas de las condiciones laborales, sino que además las hicieron más comprensibles. La información obtenida plantea desafíos para la reflexión y señala caminos orientados a la promoción de los aspectos positivos y a la prevención de los negativos de las condiciones del trabajo de enfermería.Objetivo: analisar a relação entre a avaliação quantitativa das condições de trabalho e a percepção qualitativa da própria experiência de trabalho. Método: uma amostra de 1760 profissionais de enfermagem de Barcelona respondeu a um questionário para avaliação de suas condições de trabalho e resumiu em cinco palavras-chave sua própria experiência de trabalho atual. Resultados: o corpus textual dos significados do trabalho incluiu 8043 formas lexicais, que foram categorizadas e codificadas. As pessoas pesquisadas que classificaram mais alto as suas condições de trabalho expressaram uma visão do trabalho em termos de autonomia, realização e bem-estar, ao passo que as que o classificavam mais baixo falavam principalmente de exaustão, despersonalização e clima negativo. Uma análise de correspondências evidenciou uma estreita relação entre as avaliações quantitativas das condições de trabalho e os códigos verbais de significado do trabalho. Conclusões: os significados dados ao trabalho foram não só coerentes com as avaliações numéricas das condições de trabalho, mas também as tornaram mais compreensíveis. A informação obtida coloca desafios para reflexão e aponta caminhos para enfrentar a promoção dos aspectos positivos e a prevenção dos negativos das condições do trabalho de enfermagem.Objective: to analyze the relationship between the quantitative assessment of working conditions and the qualitative perception of one’s own work experience. Method: a sample of 1,760 nursing professionals from Barcelona answered a questionnaire assessing their working conditions and summarized their own current work experience in five key words. Results: the textual corpus of the meanings of nursing work included 8043 lexical forms, which were categorized and codified. Respondents who rated their work conditions the highest expressed a vision of their work in terms of autonomy, achievement and well-being, while those who rated their work conditions the lowest talked mostly of exhaustion, depersonalization and negative climate. A correspondence analysis showed a close relationship between the quantitative assessments of working conditions and the verbal codes of the meaning of work. Conclusions: the meanings given to work were not only consistent with the numerical evaluations of the working conditions but also made them more understandable. The information obtained poses challenges for reflection and indicates ways to promote the positive aspects and prevent the negative conditions of nursing work

Effects of a bioactive olive pomace extract from Olea europaea on growth performance, gut function, and intestinal microbiota in broiler chickens

The present study aims to investigate the effects of supplementing broiler diets with a bioactive olive pomace extract (OE) from Olea europaea on growth performance, digestibility, gut microbiota, bile acid composition, and immune response. To this end, three hundred and six 1-day-old broiler chickens (Ross 308) were housed in floor pens (6 pens/treatment, with 17 birds/pen). Animals were fed with a standard non-medicated starter diet for 21 D, and from 22 to 42 D of age with their respective experimental diet: a negative control with no additives (Control), a positive control with 100 ppm of monensin (Monensin) and the basal diet supplemented with 750 ppm of an OE (Lucta S.A., Spain). Feed intake and growth rate were monitored weekly throughout the trial. From 21 to 42 D of age, no significant differences in feed intake were observed among dietary treatments; however, lower average daily gain and higher feed conversion ratio (P < 0.05) was observed in birds fed the Control compared to Monensin and OE groups. Performance of birds fed OE or Monensin was similar throughout the trial. The apparent ileal digestibility of crude protein was higher in birds fed Monensin than Control treatment (P < 0.05). No significant changes on bacterial composition at a family level were observed in the caeca of birds fed the experimental diets. Moreover, no significant differences on plasma and intestinal bile acid composition were observed among treatments. Birds fed the OE showed a significant decrease of IL-8 expression in the ileum (P < 0.05). Additionally, the expression of TGF-β4, and Bu-1 was significantly upregulated (P < 0.01) in broilers fed the OE and Monensin diets compared to those fed the Control. In conclusion, the inclusion of 750 ppm of a bioactive olive pomace extract from Olea europaea in broiler chicken diets improved animal growth likely as result of its anti-inflammatory properties

Regression of advanced diabetic nephropathy by hepatocyte growth factor gene therapy in rats

Diabetic nephropathy is the main cause of end-stage renal disease requiring dialysis in developed countries. In this study, we demonstrated the therapeutic effect of hepatocyte growth factor (HGF) on advanced rather than early diabetic nephropathy using a rat model of streptozotocin-induced diabetes. Early diabetic nephropathy (16 weeks after induction of diabetes) was characterized by albuminuria, hyperfiltration, and glomerular hypertrophy, whereas advanced diabetic nephropathy showed prominent transforming growth factor (TGF)-beta1 upregulation, mesangial expansion, and glomerulosclerosis. An SP1017-formulated human HGF (hHGF) plasmid was administered by intramuscular injection combined with electroporation over a 30-day follow-up in rats with early and advanced diabetic nephropathy. hHGF gene therapy upregulated endogenous rat HGF in the diabetic kidney (rat HGF by RT-PCR was threefold higher than in diabetic rats without therapy). hHGF gene therapy did not improve functional or morphologic abnormalities in early diabetic nephropathy. hHGF gene therapy reduced albuminuria and induced strong regression of mesangial expansion and glomerulosclerosis in advanced diabetic nephropathy. These findings were associated with suppression of renal TGF-beta1 and mesangial connective tissue growth factor (CTGF) upregulation, inhibition of renal tissue inhibitor of metalloproteinase (TIMP)-1 expression, and reduction of renal interstitial myofibroblasts. In conclusion, our results suggest that hHGF gene therapy may be considered as an innovative therapeutic strategy to treat advanced diabetic nephropathy

Pre-transplant donor-specific T-cell alloreactivity is strongly associated with early acute cellular rejection in kidney transplant recipients not receiving T-cell depleting induction therapy

Preformed T-cell immune-sensitization should most likely impact allograft outcome during the initial period after kidney transplantation, since donor-specific memory T-cells may rap- idly recognize alloantigens and activate the effector immune response, which leads to allo- graft rejection. However, the precise time-frame in which acute rejection is fundamentally triggered by preformed donor-specific memory T cells rather than by denovo activated na ï ve T cells is still to be established. Here, preformed donor-specific alloreactive T-cell re- sponses were evaluated using the IFN- γ ELISPOT assay in a large consecutive cohort of kidney transplant patients (n = 90), to assess the main clinical variables associated with cel- lular sensitization and its predominant time-frame impact on allograft outcome, and was fur- ther validated in an independent new set of kidney transplant recipients (n = 67). We found that most highly T-cell sensitized patients were elderly patients with particularly poor HLA class-I matching, without any clinically recognizable sensitizing events. While one-year inci- dence of all types of biopsy-proven acute rejection did not differ between T-cell alloreactive and non-alloreactive patients, Receiver Operating Characteristic curve analysis indicated the first two months after transplantation as the highest risk time period for acute cellular re- jection associated with baseline T-cell sensitization. This effect was particularly evident in young and highly alloreactive individuals that did not receive T-cell depletion immunosup- pression. Multivariate analysis confirmed preformed T-cell sensitization as an independent predictor of early acute cellular rejection. In summary, monitoring anti-donor T-cell sensiti- zation before transplantation may help to identify patients at increased risk of acute cellular rejection, particularly in the early phases after kidney transplantation, and thus guide decision-making regarding the use of induction therapy

Different Storing and Processing Conditions of Human Lymphocytes do not Alter P-Glycoprotein Rhodamine 123 Efflux

P-glycoprotein (Pgp), a protein codified by Multi Drug Resistance (MDR1) gene, has a detoxifying function and might influence the toxicity and pharmacokinetics and pharmacodynamics of drugs. Sampling strategies to improve Pgp studies could be useful to optimize the sensitivity and the reproducibility of efflux assays. This study aimed to compare Pgp expression and efflux activity by measuring Rhodamine123 (Rh123) retention in lymphocytes stored under different conditions, in order to evaluate the potential utility of any of the storing conditions in Pgp functionality. Our results show no change in protein expression of Pgp by confocal studies and Western blotting, nor changes at the mRNA level (qRT-PCR). No differences in Rh123 efflux by Pgp activity assays were found between fresh and frozen lymphocytes after 24 hours of blood extraction, using either of the two Pgp specific inhibitors (VP and PSC833). Different working conditions in the 24 hours post blood extraction do not affect Rh123 efflux. These results allow standardization of Pgp activity measurement in different individuals with different timing of blood sampling and in different geographic areas. ______________

Violencia hacia profesionales de la salud en su lugar de trabajo

Objetivo: Presentar el diseño y los resultados preliminares de la aplicacion del sistema informatizado de Notifi cacion de Incidente Violento (NIV) en el ambito sanitario. Método: A lo largo del bienio 2005-2006, el sistema NIV se ha implementado la web www.violenciaocupacional.net en 38 centros sanitarios de Catalunya que participan voluntariamente en el proyecto. Esta web, que incluye el Cuestionario de Violencia Ocupacional, permite un registro integrado de incidentes violentos contra profesionales de la salud en tiempo real y de modo confi dencial. Una sola persona notifi ca on-line los incidentes de cada centro. El notifi cador pertenece a los departamentos de Recursos Humanos o de Prevencion de Riesgos Laborales y ha sido especialmente designado por su propia institucion para esta funcion. Resultados: En el periodo comprendido entre el 01-01-2005 y el 31-03-07 han sido notifi cados 501 incidentes violentos desde 38 centros en los que trabajan unas 18.000 personas. En el 35% de los casos se da cuenta de agresion fisica y en el 83 % de la de tipo verbal (que a menudo acompana a la anterior). Los incidentes afectan a personal de enfermeria (42%), medico (35%), tecnico y administrativo (16%) y de otros sectores (7%). Conclusión: El sistema NIV constituye una tecnica novedosa de recogida de informacion sobre la violencia ocupacional en el sector sanitario. Los resultados preliminares de su aplicacion piloto reafi rman la importancia del problema investigado, ratifi can tendencias observadas por otros estudios locales e internacionales y senalan elementos clave para la agenda de la investigacion y la intervencion en este campo.Objective: To present the design and preliminary results of application of the computerised Violent Incident Notification (NIV) system in the healthcare sector. Methods: In the 2005-2006 biennium, the www.violenciaocupacional.net website was launched in 38 healthcare centres in Catalonia, all of whom participate voluntarily in this project. This website features a Workplace Violence Questionnaire that allows confidential, real-time, integrated reporting of violent incidents against health care workers. Each centre has a single designated individual, employed in either the human resources or occupational health departments, charged with submitting the online reports. Results: From January 1 2005 through March 31 2007, a total of 501 violent incidents were reported from the 38 healthcare centers, which collectively employ nearly 18,000 persons. Physical assaults accounted for 35% of the cases and verbal aggression (which may occur together with physical assaults) were reported in 83% of cases. These incidents primarily affected nursing (42%), medical (35%), technical and administrative (16%), and other (7%) personnel. Conclusion: The NIV system is a new technique for collecting information on workplace violence in the healthcare sector. Preliminary results of its pilot application underscore the importance of the problem investigated, confirm previously described trends in other local and international studies, and identify some key elements for further investigation and intervention