COMMUNICATION AS A FACTOR IN THE SUCCESS OF DOWNSIZING

In recent years a large number of organizations, both public and private, have implemented downsizing, with the aim of improving productivity, efficiency and competitiveness. But studies show that the results are not always as expected, with firms reporting negative effects among their workers in terms of stress, uncertainty, insecurity and fear of losing their jobs. The current work investigates the relation between internal communication, job satisfaction and organizational commitment in firms implementing this change strategy. Results show that internal communication has a positive effect on job satisfaction, and that job satisfaction, in turn, has a positive effect on organizational commitment

Sintiéndose en riesgo, viviendo en riesgo: mujeres en las maquiladoras

In some parts of the world, women are exposed to atypical acts of violence that include crimes due to war, terrorism, and community violence. Another less prevalent type of violence, not often studied due to its uniqueness, is unpunished female homicides in high-crime cities. Women living under this unusual circumstance may suffer a multitude of effects from “feeling at risk” as a result of direct exposure to community violence and media exposure to female homicide, and by “living the risk” from the effects of domestic violence. These additional effects should be considered when implementing preventive programs in high-crime cities.  En algunas partes del mundo, las mujeres están expuestas a casos atípicos de violencia que incluyen crímenes debido a la guerra, el terrorismo o la violencia comunitaria. Otros tipos menos comunes de exposición a la violencia, incluyen homicidios de mujeres sin resolver en ciudades con alta criminalidad. Las mujeres que viven en estas circunstancias pueden sufrir una multitud de efectos por “sentirse en riesgo” por la violencia que prevalece, la impunidad y las noticias acerca de los crímenes. De forma adicional, algunas de ellas “están en riesgo” por los efectos de la violencia doméstica.  

Diferentes estilos de afrontamiento al estrés entre trabajadores de la Generación Y en empresas en Ciudad Juárez

ResumenObjetivo: Determinar los estilos de afrontamiento al estrés de trabajadores de la Generación Y (millennials) que laboran en Ciudad Juárez.Metodología: Estudio descriptivo transversal incluyendo una muestra de trabajadores de la Generación Y que laboran en empresas en Ciudad Juárez.Resultados: los principales estilos de afrontamiento al estrés reportados en los trabajadores son los enfocados a la resolución de problema. No se encontró una diferencia significativa por género.Discusión: Los resultados son coincidentes con estudios previos donde se observa una variedad de estilos de afrontamiento. No se observaron valores altos en los estilos de afrontamiento enfocados en la emoció

Comics as a Medium for Parent Health Education: Improving Understanding of Normal 9-Month-Old Developmental Milestones

Multimodal literacy, a product of modern technology, can aid in the recall of simple-to-complex information for both children and adults. Health education information presented using educational comics takes advantage of multimodal formats and designs based on theoretical models of learning. In this study, we utilized a quasi-experimental design with both pre- and post-intervention testing. The parents of every other patient that attended the well-child appointments of their child aged <9 months were invited to participate in this study. Participants were drawn from three pediatric clinics, with a total of 280 parents included in the study. Each parent completed a pre-intervention test consisting of an eight-item questionnaire regarding the developmental milestones of a 9-month-old child. After responding to the questionnaire, the parents received a comic about a 9-month-old child reaching age-appropriate developmental milestones. Four to six weeks after the comics were provided to the parents, they responded to the same questionnaire by phone, which consisted of the same eight questions plus an additional question regarding possible additional uses of the comic. Parents significantly increased their recall of information of developmental milestones when the pre- and post-intervention test results were compared, with a significance of p < 0.001 at a 95% confidence level. Additional uses of the comic reported by parents included calling their pediatrician with doubts about their own child's appropriate achievement of milestones, and lending the comics to relatives or friends. The educational comic appeared to assist parents in making meaningful connections between the simplified pictures and the developmental milestones of their child. Comics may provide an alternative for parental education using this multimodal format to explain simple-to-complex issues

Evaluating a wellness intervention including micro-practices for healthcare professionals before and during COVID-19

Objective: To describe, with a mixed design study, healthcare professionals' pre-postdescriptive measures of quality of life (subjective wellness) and prolonged fatigue, as well asan improvement in overall wellness and satisfaction regarding micro-practices as a result ofparticipation in a wellness intervention before and during COVID-19.Material and Methods: This study had a mixed design involving two independent groups ofhealthcare professionals participating in a wellness intervention with micro-practices beforeand during COVID-19. The intervention contained multimodal presentations with animatedcartoon stories, comics, storytelling, readings, breathing, mindfulness and visualizationexercises, adapted from second-order factors in the Indivisible Self model. Pre-postdescriptive measures of quality of life (subjective wellness), prolonged fatigue, as well asimprovement in overall wellness and satisfaction regarding micro-practices were collected.Results: Attending to either wellness interventions before or during COVID-19 hada positive and, in some cases significant, effect on important indicators of quality-of-lifeand prolonged fatigue among healthcare professionals. A qualitative analysis indicateda subjective improvement in overall wellness and satisfaction regarding the use of micropracticesincluded in the wellness interventions, regardless of whether these were presentedin person or virtually. Most participants subjectively indicated that they improved in thetargeted indicators, especially achievement of better wellness.Conclusions: During ordinary and extraordinary circumstances, healthcare professionalsrequire specific interventions that act primarily to provide them with strategies that canimprove physical, emotional, and spiritual health. Use of micro-practices in multimodalworkshops to improve healthcare practitioner wellness is a successful tool for learning orremembering the importance of pausing during daily clinical activities and refocusing theirenergy.Keywords: Holistic health; Health care providers; Health promotion, Working Conditions.Objetivo: Describir, con un estudio de diseño mixto, la medición descriptiva pre-post sobrela calidad de vida (bienestar subjetivo) y la fatiga prolongada entre profesionales de salud,así como su mejora en el bienestar general y satisfacción respecto al uso de micro-prácticascomo resultado de participar en una intervención de bienestar antes y durante COVID-19.Material y métodos: Este estudio tuvo un diseño mixto en el que participaron dos gruposindependientes de profesionales del sector salud en una intervención de bienestar conmicro-prácticas antes y durante el COVID-19. La intervención consistió en presentacionesmultimodales con historias con dibujos animados, cómics, narración de cuentos, lecturas,ejercicios de respiración, mindfulness y visualización, adaptados a partir de los factores desegundo orden del modelo del Yo Indivisible. Se recolectaron medidas descriptivas pre-postde calidad de vida (bienestar subjetivo), fatiga prolongada, así como su mejora en el bienestargeneral y la satisfacción con respecto a las micro-prácticas.Resultados: La asistencia a cualquiera de las intervenciones para el bienestar antes o durantela COVID-19 tuvo un efecto positivo y, en algunos casos, significativo, sobre importantesindicadores de calidad de vida y fatiga prolongada entre los profesionales del ámbito de lasalud. El análisis cualitativo indicó una mejoría subjetiva en cuanto a su bienestar generaly satisfacción con respecto al uso de las micro-prácticas incluidas en las intervencionesde bienestar, independientemente de si éstas se presentaron en persona o virtualmente. Lamayoría de los participantes indicaron subjetivamente que habían mejorado en los indicadoresenfocados, especialmente el logro de un mayor bienestar.Conclusiones: Durante circunstancias ordinarias y extraordinarias, los profesionales de lasalud requieren intervenciones específicas que actúen principalmente para proporcionarlesestrategias que puedan mejorar la salud física, emocional y espiritual. El uso de microprácticasen talleres multimodales para mejorar el bienestar de los profesionales es una herramientaexitosa para aprender o recordar la importancia que tiene hacer una pausa durante lasactividades clínicas diarias y reenfocar su energía

Rationale and Design of the Groningen Intervention Study for the Preservation of Cardiac Function with Sodium Thiosulfate after ST-segment Elevation Myocardial Infarction (GIPS-IV) Trial

RATIONALE: Ischemia and subsequent reperfusion cause myocardial injury in patients presenting with ST-segment elevation myocardial infarction (STEMI). Hydrogen sulfide (H2S) reduces "ischemia-reperfusion injury" in various experimental animal models, but has not been evaluated in humans. This trial will examine the efficacy and safety of the H2S-donor sodium thiosulfate (STS) in patients presenting with a STEMI. STUDY DESIGN: The Groningen Intervention study for the Preservation of cardiac function with STS after STEMI (GIPS-IV) trial (NCT02899364) is a double-blind, randomized, placebo-controlled, multicenter trial, which will enroll 380 patients with a first STEMI. Patients receive STS 12.5 gram intravenously or matching placebo in addition to standard care immediately at arrival at the catheterization laboratory after providing consent. A second dose is administered 6 hours later at the coronary care unit. The primary endpoint is myocardial infarct size as quantified by cardiac magnetic resonance imaging 4 months after randomization. Secondary endpoints include the effect of STS on peak CK-MB during admission and left ventricular ejection fraction and NT-proBNP levels at 4 months follow-up. Patients will be followed-up for 2 years to assess clinical endpoints. CONCLUSIONS: The GIPS-IV trial is the first study to determine the effect of a H2S-donor on myocardial infarct size in patients presenting with STEMI

Communicating genetic information: a difficult challenge for future pediatricians

<p>Abstract</p> <p>Background</p> <p>The role of the pediatrician as genetic counselor is ideal because pediatricians have medical knowledge and experience with genetic disorders (e.g. Down syndrome). Moreover, pediatricians can provide comprehensive care in a medical home to patients with genetic disorders. However, changes in the curriculum of the pediatric resident are necessary to address the future challenges of effectively communicating genetic information to patients. The objective of this study was to explore these challenges and make recommendations for training to adequately prepare pediatricians for their future role as genetic counselors.</p> <p>Methods</p> <p>Three reviewers independently searched PubMed, OVID, and Medline databases to identify articles describing the challenges of communicating genetic information to patients, published from 1960 to December 2005. After the publications were identified and reviewed, four major areas of interest were identified in order to categorize the findings.</p> <p>Results</p> <p>Twenty-five publications were identified during the literature search. From the review, the following categories were selected to organize the findings: (1) Inherent difficulties of communicating and comprehending genetic information; (2) Comprehension of genetic information by pediatricians; (3) Genetics training in residency programs; and (4) The effect of genetic information on the future role of pediatricians and potential legal implications.</p> <p>Conclusion</p> <p>Pediatricians and residents lack essential knowledge of genetics and communication skills for effective counseling of patients. The review indicated that successful communication of genetic information involves a number of important skills and considerations. It is likely that these skills and considerations are universally required for the communication of most complex specialized medical information. In the past, communication skills have not been considered a priority. Today, these skills have become a demanding professional and even legal obligation. However, the challenges involved in communicating complex medical information cannot be successfully addressed with universal, one-size-fits-all recommendations. Residency training programs require changes to adequately prepare future pediatricians for the growing challenge of communicating genetic information. Four important skills should be considered in the training of residents to improve the communication of complex information to patients. These skills are (1) discriminating, (2) understanding, (3) simplifying, and (4) explaining information.</p

Syndromes of self-reported psychopathology for ages 18-59 in 29 societies

This study tested the multi-society generalizability of an eight-syndrome assessment model derived from factor analyses of American adults' self-ratings of 120 behavioral, emotional, and social problems. The Adult Self-Report (ASR; Achenbach and Rescorla 2003) was completed by 17,152 18-59-year-olds in 29 societies. Confirmatory factor analyses tested the fit of self-ratings in each sample to the eight-syndrome model. The primary model fit index (Root Mean Square Error of Approximation) showed good model fit for all samples, while secondary indices showed acceptable to good fit. Only 5 (0.06%) of the 8,598 estimated parameters were outside the admissible parameter space. Confidence intervals indicated that sampling fluctuations could account for the deviant parameters. Results thus supported the tested model in societies differing widely in social, political, and economic systems, languages, ethnicities, religions, and geographical regions. Although other items, societies, and analytic methods might yield different results, the findings indicate that adults in very diverse societies were willing and able to rate themselves on the same standardized set of 120 problem items. Moreover, their self-ratings fit an eight-syndrome model previously derived from self-ratings by American adults. The support for the statistically derived syndrome model is consistent with previous findings for parent, teacher, and self-ratings of 11/2-18-year-olds in many societies. The ASR and its parallel collateral-report instrument, the Adult Behavior Checklist (ABCL), may offer mental health professionals practical tools for the multi-informant assessment of clinical constructs of adult psychopathology that appear to be meaningful across diverse societies

Rationale and Design of the Groningen Intervention Study for the Preservation of Cardiac Function with Sodium Thiosulfate after St-segment Elevation Myocardial Infarction (GIPS-IV) trial

BACKGROUND: Ischemia and subsequent reperfusion cause myocardial injury in patients presenting with ST-segment elevation myocardial infarction (STEMI). Hydrogen sulfide (H2S) reduces "ischemia-reperfusion injury" in various experimental animal models, but has not been evaluated in humans. This trial will examine the efficacy and safety of the H2S-donor sodium thiosulfate (STS) in patients presenting with a STEMI. STUDY DESIGN: The Groningen Intervention study for the Preservation of cardiac function with STS after STEMI (GIPS-IV) trial (NCT02899364) is a double-blind, randomized, placebo-controlled, multicenter trial, which will enroll 380 patients with a first STEMI. Patients receive STS 12.5 grams intravenously or matching placebo in addition to standard care immediately at arrival at the catheterization laboratory after providing consent. A second dose is administered 6 hours later at the coronary care unit. The primary endpoint is myocardial infarct size as quantified by cardiac magnetic resonance imaging 4 months after randomization. Secondary endpoints include the effect of STS on peak CK-MB during admission and left ventricular ejection fraction and NT-proBNP levels at 4 months follow-up. Patients will be followed-up for 2 years to assess clinical endpoints. CONCLUSIONS: The GIPS-IV trial is the first study to determine the effect of a H2S-donor on myocardial infarct size in patients presenting with STEMI

Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission

Abstract Admission procalcitonin measurements and microbiology results were available for 1040 hospitalized adults with coronavirus disease 2019 (from 48 902 included in the International Severe Acute Respiratory and Emerging Infections Consortium World Health Organization Clinical Characterisation Protocol UK study). Although procalcitonin was higher in bacterial coinfection, this was neither clinically significant (median [IQR], 0.33 [0.11–1.70] ng/mL vs 0.24 [0.10–0.90] ng/mL) nor diagnostically useful (area under the receiver operating characteristic curve, 0.56 [95% confidence interval, .51–.60]).</jats:p