FACTORES PSICOSOCIALES Y ESTRÉS EN PERSONAL DE ENFERMERÍA DE UN HOSPITAL PÚBLICO DE TERCER NIVEL DE ATENCIÓN.

Introducción Hay un creciente interés por estudiar los factores psicosociales y el estrés relacionados con el trabajo, debido a la repercusiones que pueden tener sobre la salud; uno de los grupos más afectados lo constituye los profesionales de enfermería. Objetivo: Determinar la relación entre los factores psicosociales laborales y el estrés en personal de enfermería. Objetivo: Investigar si existen diferencias del grupo total, comparándolo con los grupos con FRO ≥80 y de ambos con el valor de FRO ≤70 en las variables utilizadas. Métodos: Estudio transversal y analítico, incluyó al personal de enfermería de un hospital de tercer nivel de atención con más de 6 meses en la institución. Para captar los datos se aplicaron el instrumento de Factores Psicosociales Laborales de Silva y la Escala de Síntomas de Estrés de Seppo Aro, obteniendo la frecuencia de factores psicosociales, la presencia de estrés y la asociación entre ambas variables con el OR, con un intervalo de confianza de 95% y un valor de p <0.05. Resultados Participaron 162 personas, 88.9% mujeres; el 47.5% percibe factores psicosociales negativos, principalmente altas exigencias laborales y condiciones del lugar de trabajo inadecuadas. El 36.4% del personal presentó síntomas de estrés; los más frecuentes, dificultad para quedarse dormido o despertar durante la noche, cefalea y acidez o ardor de estómago. La asociación por dimensiones de factores psicosociales con estrés fue para: Contenido y características de la tarea e Interacción social y aspectos organizacionales. Conclusiones: Para el personal de enfermería de la institución existe asociación entre factores psicosociales negativos y síntomas de estrés, se deben enfatizar las condiciones en que realiza el trabajo y brindar capacitación sobre el manejo del estrés.ABSTRACTIntroduction: There is a growing interest in studying psychosocial factors and work-related stress because of the impact they may have on health; nursing professionals are one of the most affected groups Objectives: To determine the relationship between psychosocial factors and stress in nursing staff. Methods: Cross-sectional and analytical study that included tertiary care hospital nursing staff with more than 6 months at the institution. Silva’s Psychosocial Work Factors and Seppo Aro’s Stress Symptoms Scale were applied to capture the data, obtaining psychosocial factors frequency, the presence of stress symptoms and the association between the two variables with OR, with a range of 95% confidence and a value of p < 0.05. Results: 162 people participated, 88.9% women; 47.5% perceived negative psychosocial factors such as high labor requirements and inadequate working site conditions. A 36.4% of staff presented stress symptoms; the most frequent were difficulty falling asleep or waking up during the night, headache and heartburn. The dimensions association of psychosocial factors with stress was to: Content and Characteristics of the Task and Social Interaction and Organizational Aspects Conclusions: For the nursing staff of the institution there is association between negative psychosocial factors and symptoms of stress, so the conditions of work performance and training in stress management should be emphasizePalabras Clave: Factores psicosociales laborales, estrés, Personal de enfermería, Psychosocial work factors, Stress, Nursing staf

Optimizing strategic blocks with asymmetric bilateral propensities with symmetric propensities

Hay modelos tomados de la física que se han utilizado para explicar la formación de coaliciones o bloques de agentes. Estos modelos son útiles para entender cómo las alianzas (en guerras, partidos políticos, etc.) tienden a agrupar amigos en mismos bloques y a enemigos en bloques separados minimizando la frustración total. Todos estos modelos suponen interacciones recíprocas entre los agentes, ya que este es el caso más común en la física. Sin embargo, se destaca el im-portante hecho de que las interacciones humanas no son, en general, de reciprocidad, es decir, no existe una “tercera ley de Newton social”. Aquí mostramos que este defecto fundamental de los modelos de la coalición puede ser resuelto mediante la construcción de interacciones simétricas efectivas (en las que los modelos físicos bien conocidos funcionan) a partir de interacciones no recíprocas. En los casos de varios modelos con afinidades asimétricas se proponen varias estrategias cualitativas para lograr interacciones simétricas efectivas. En varias de estas estrategias empleamos el valor medio simétrico en el que las afinidades compiten entre sí para mantener cierta información parcial de las tendencias asimétricas

Ibero-American consensus on low- and no-calorie sweeteners: Safety, nutritional aspects and benefits in food and beverages

© 2018 by the authors. Licensee MDPI, Basel, Switzerland. International scientific experts in food, nutrition, dietetics, endocrinology, physical activity, paediatrics, nursing, toxicology and public health met in Lisbon on 2-4 July 2017 to develop a Consensus on the use of low- and no-calorie sweeteners (LNCS) as substitutes for sugars and other caloric sweeteners. LNCS are food additives that are broadly used as sugar substitutes to sweeten foods and beverages with the addition of fewer or no calories. They are also used in medicines, health-care products, such as toothpaste, and food supplements. The goal of this Consensus was to provide a useful, evidence-based, point of reference to assist in efforts to reduce free sugars consumption in line with current international public health recommendations. Participating experts in the Lisbon Consensus analysed and evaluated the evidence in relation to the role of LNCS in food safety, their regulation and the nutritional and dietary aspec

Ibero–American Consensus on Low- and No-Calorie Sweeteners: Safety, Nutritional Aspects and Benefits in Food and Beverages

International scientific experts in food, nutrition, dietetics, endocrinology, physical activity, paediatrics, nursing, toxicology and public health met in Lisbon on 2–4 July 2017 to develop a Consensus on the use of low- and no-calorie sweeteners (LNCS) as substitutes for sugars and other caloric sweeteners. LNCS are food additives that are broadly used as sugar substitutes to sweeten foods and beverages with the addition of fewer or no calories. They are also used in medicines, health-care products, such as toothpaste, and food supplements. The goal of this Consensus was to provide a useful, evidence-based, point of reference to assist in efforts to reduce free sugars consumption in line with current international public health recommendations. Participating experts in the Lisbon Consensus analysed and evaluated the evidence in relation to the role of LNCS in food safety, their regulation and the nutritional and dietary aspects of their use in foods and beverages. The conclusions of this Consensus were: (1) LNCS are some of the most extensively evaluated dietary constituents, and their safety has been reviewed and confirmed by regulatory bodies globally including the World Health Organisation, the US Food and Drug Administration and the European Food Safety Authority; (2) Consumer education, which is based on the most robust scientific evidence and regulatory processes, on the use of products containing LNCS should be strengthened in a comprehensive and objective way; (3) The use of LNCS in weight reduction programmes that involve replacing caloric sweeteners with LNCS in the context of structured diet plans may favour sustainable weight reduction. Furthermore, their use in diabetes management programmes may contribute to a better glycaemic control in patients, albeit with modest results. LNCS also provide dental health benefits when used in place of free sugars; (4) It is proposed that foods and beverages with LNCS could be included in dietary guidelines as alternative options to products sweetened with free sugars; (5) Continued education of health professionals is required, since they are a key source of information on issues related to food and health for both the general population and patients. With this in mind, the publication of position statements and consensus documents in the academic literature are extremely desirable

Correction to: Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry

International audienceIn this article, the name of the GLORIA-AF investigator Anastasios Kollias was given incorrectly as Athanasios Kollias in the Acknowledgements. The original article has been corrected

Patterns of oral anticoagulant use and outcomes in Asian patients with atrial fibrillation: a post-hoc analysis from the GLORIA-AF Registry

Background: Previous studies suggested potential ethnic differences in the management and outcomes of atrial fibrillation (AF). We aim to analyse oral anticoagulant (OAC) prescription, discontinuation, and risk of adverse outcomes in Asian patients with AF, using data from a global prospective cohort study. Methods: From the GLORIA-AF Registry Phase II-III (November 2011-December 2014 for Phase II, and January 2014-December 2016 for Phase III), we analysed patients according to their self-reported ethnicity (Asian vs. non-Asian), as well as according to Asian subgroups (Chinese, Japanese, Korean and other Asian). Logistic regression was used to analyse OAC prescription, while the risk of OAC discontinuation and adverse outcomes were analysed through Cox-regression model. Our primary outcome was the composite of all-cause death and major adverse cardiovascular events (MACE). The original studies were registered with ClinicalTrials.gov, NCT01468701, NCT01671007, and NCT01937377. Findings: 34,421 patients were included (70.0 ± 10.5 years, 45.1% females, 6900 (20.0%) Asian: 3829 (55.5%) Chinese, 814 (11.8%) Japanese, 1964 (28.5%) Korean and 293 (4.2%) other Asian). Most of the Asian patients were recruited in Asia (n = 6701, 97.1%), while non-Asian patients were mainly recruited in Europe (n = 15,449, 56.1%) and North America (n = 8378, 30.4%). Compared to non-Asian individuals, prescription of OAC and non-vitamin K antagonist oral anticoagulant (NOAC) was lower in Asian patients (Odds Ratio [OR] and 95% Confidence Intervals (CI): 0.23 [0.22-0.25] and 0.66 [0.61-0.71], respectively), but higher in the Japanese subgroup. Asian ethnicity was also associated with higher risk of OAC discontinuation (Hazard Ratio [HR] and [95% CI]: 1.79 [1.67-1.92]), and lower risk of the primary composite outcome (HR [95% CI]: 0.86 [0.76-0.96]). Among the exploratory secondary outcomes, Asian ethnicity was associated with higher risks of thromboembolism and intracranial haemorrhage, and lower risk of major bleeding. Interpretation: Our results showed that Asian patients with AF showed suboptimal thromboembolic risk management and a specific risk profile of adverse outcomes; these differences may also reflect differences in country-specific factors. Ensuring integrated and appropriate treatment of these patients is crucial to improve their prognosis. Funding: The GLORIA-AF Registry was funded by Boehringer Ingelheim GmbH

Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation: The GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores >2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores >2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score >2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores >2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores >2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007. © 2020 Hellenic Society of Cardiolog