Características laborales y compromiso con el trabajo: explorando el bienestar laboral

The main purpose of this study was to examine the relationship between psychosocial job characteristics and work engagement, understanding the latter as an affective-motivational state related to work well-being. To analyze this relationship, the psychosocial characteristics of the work presented in the Demand-Control-Support (DCS) model were taken into account. The possible positive effect that social support has as a moderating variable in the relationship between demands, control and work engagement was also evaluated. This study was cross-sectional, involving 463 workers belonging to companies in the industrial and services sectors. The analysis of the data was carried out using the SPSS 22.0 program and hierarchical linear regression was used to test hypothesized relationships. The results indicated statistically significant associations between control, social support and work engagement; however, this type of relationship was not found between demands and work engagement. The predictive capacity of control and social support on work engagement was evidenced. No moderating effect of social support was confirmed in the relationship between control and work engagement. This study highlights the importance of inquiring about the working conditions that the organization must provide to make work a generator of well-being.El objetivo central de este estudio fue examinar la relación entre características laborales psicosociales y el compromiso con el trabajo, entendiendo este último como un estado afectivo- motivacional que favorece el bienestar laboral. Para analizar esta relación, se tomaron en cuenta las características psicosociales del trabajo enunciadas en el modelo Demanda-Control-Apoyo (DCA). Así mismo, se evaluó el posible efecto positivo que el apoyo social tiene como variable moderadora en la relación entre las demandas, el control y el compromiso con el trabajo. Este estudio fue transversal de alcance correlacional, participaron 463 trabajadores pertenecientes a empresas del sector industrial y del sector servicios. El análisis de los datos se efectuó con el programa SPSS 22.0, se usó regresión lineal jerárquica para probar las relaciones hipotetizadas. Los resultados indicaron asociaciones estadísticamente significativas entre el control, el apoyo social y el compromiso con el trabajo, sin embargo, este tipo de relación no se encontró entre las demandas y el compromiso con el trabajo. Se evidenció la capacidad predictora del control y el apoyo social sobre el compromiso con el trabajo. No se confirmó efecto moderador del apoyo social en la relación entre el control y el compromiso con el trabajo. Este estudio destaca la importancia de indagar sobre las condiciones laborales que la organización debe proporcionar para que el trabajo sea un generador de bienestar

Alfabetización médica en la enfermedad pulmonar obstructiva crónica

La alfabetización en salud es un concepto complejo introducido en los años 70. La Organización Mundial de la Salud la define como “las habilidades sociales y cognitivas que determinan el nivel de motivación y la capacidad de una persona para acceder, entender y utilizar la información de forma que le permita promover y mantener una buena salud”. El analfabetismo sanitario es un problema muy extendido, aproximadamente un tercio de las personas de los EEUU no son capaces de leer y comprender materiales básicos relacionados con la salud y hasta un 50% de los adultos comenten errores, o tienen concepciones erróneas que les impiden interpretar completa y correctamente la información médica. En los últimos años se ha producido una intensa producción científica que ha puesto de manifiesto la relación entre el grado de alfabetización médica y los resultados de salud. Así, el analfabetismo sanitario tiene una relación independiente con un peor estado de salud, un mayor riesgo de ingreso hospitalario y un mayor uso de los servicios sanitarios. La alfabetización en salud tendrá un mayor impacto sobre la salud en los colectivos más vulnerables como ancianos, pacientes polimedicados y enfermos con patologías crónicas como la enfermedad pulmonar obstructiva crónica (EPOC). La EPOC es una enfermedad prevalente, y que asocia un elevado consumo de recursos sanitarios. El conocimiento y la actuación sobre la alfabetización médica en esta enfermedad será una premisa necesaria e imprescindible para acometer acciones o estrategias eficientes, encaminadas a que el paciente con EPOC sea capaz de participar de forma activa en el cuidado de su salud..

Clinical examination and X-ray: an old approach to a current problem

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Binary gender and experience of transsexual and transgender people

Varios autores señalan la necesidad de incorporar la voz y la experiencia de las personas trans en la investigación sobre transexualidad. En este trabajo, que se trata de un estudio exploratorio previo a una investigación más amplia, profundizamos en las narrativas biográficas de algunas personas trans a través de su discurso. En un segundo paso, ponemos en relación estas experiencias con los criterios diagnósticos DSM IV TR del Trastorno de la Identidad de Género, explorando las concordancias y disonancias de estas narrativas biográficas con las que se especifican en los requisitos diagnósticos, y realizando un análisis crítico de las conclusionesSeveral authors indicate the need to incorporate the voice and the experience of trans people in transsexuality research. In this work, which is an exploratory study before a wider research, we explore in more detail the biographical narratives of some trans people through their discourse. In a second step, we put in relation these experiences with the diagnostic criteria in the DSM IV TR for the Gender Identity Disorder, exploring the conformities and dissonances of these biographical narratives with those who are specified in the diagnostic requirements, writing a critical analysis of the conclusion

Testing for alpha-1 antitrypsin in COPD in outpatient respiratory clinics in Spain: A multilevel, cross-sectional analysis of the EPOCONSUL study

Background Alpha-1 antitrypsin deficiency (AATD) is the most common hereditary disorder in adults, but is under-recognized. In Spain, the number of patients diagnosed with AATD is much lower than expected according to epidemiologic studies. The objectives of this study were to assess the frequency and determinants of testing serum α1-antitrypsin (AAT) levels in COPD patients, and to describe factors associated with testing. Methods EPOCONSUL is a cross-sectional clinical audit, recruiting consecutive COPD cases over one year. The study evaluated serum AAT level determination in COPD patients and associations between individual, disease-related, and hospital characteristics. Results A total of 4,405 clinical records for COPD patients from 57 Spanish hospitals were evaluated. Only 995 (22.5%) patients had serum AAT tested on some occasion. A number of patient characteristics (being male [OR 0.5, p < 0.001], ≤55 years old [OR 2.38, p<0.001], BMI≤21 kg/m2 [OR 1.71, p<0.001], FEV1(%)<50% [OR 1.35, p<0.001], chronic bronchitis [OR 0.79, p < 0.001], Charlson index ≥ 3 [OR 0.66, p < 0.001], or history or symptoms of asthma [OR 1.32, p<0.001]), and management at a specialized COPD outpatient clinic [OR 2.73,p<0.001] were identified as factors independently associated with ever testing COPD patients for AATD. Overall, 114 COPD patients (11.5% of those tested) had AATD. Of them, 26 (22.8%) patients had severe deficiency. Patients with AATD were younger, with a low pack-year index, and were more likely to have emphysema (p<0.05). Conclusion Testing of AAT blood levels in COPD patients treated at outpatient respiratory clinics in Spain is infrequent. However, when tested, AATD (based on the serum AAT levels ≤100 mg/dL) is detected in one in five COPD patients. Efforts to optimize AATD case detection in COPD are needed.SEPA

Coastal flooding risk associated to tropical cyclones in a changing climate. Application to Port of Spain (Trinidad and Tobago)

The aim of this paper is to provide a methodology to assess flooding risk associated to the combination of extreme flooding levels driven by Tropical Cyclone (TCs) and relative sea level rise (RSLR). The approach is based on the risk conceptual framework where the hazard, exposure, and vulnerability are defined and combined to address flooding socioeconomic consequences in Port of Spain for present and future climate (RCP8.5 in 2050). Hazard and flooding impact are assessed using a combination of statistical methods and dynamical simulations, together with a high resolution Digital Elevation Model (DEM). Combining flooding maps, exposure databases and vulnerability damage functions we have evaluated socioeconomic consequences in terms of affected population and economic damage. Besides, we have quantified the uncertainty in the results coming from the sea level rise projections and vulnerability information. The application of the methodology indicates increasing flooding threat for the future climate that could exacerbate economic losses in case of inaction. The expected annual damage (EAD) in present climate is 12.24 MUSD while in 2050 it will reach 15.22 [14.88- 15.67] MUSD.This paper comes out from the project “Port of Spain Probabilistic Hazard and Vulnerability Assessment based on Climate Change Projections” funded by the Inter-American Development Bank (IDB). We acknowledge the World Climate Research Programme's Working Group on Coupled Modelling, which is responsible for CMIP, and we thank the climate modelling groups for producing and making available their model output

Determinants in the Underdiagnosis of COPD in Spain—CONOCEPOC Study

Respiratory symptoms; Spirometry; UnderdiagnosisSíntomas respiratorios; Espirometría; InfradiagnósticoSímptomes respiratoris; Espirometria; InfradiagnòsticFactors such as seeking medical attention for respiratory symptoms and health professionals ordering spirometry come into play in the underdiagnosis of chronic obstructive pulmonary disease (COPD). The objective of this study was to analyze seeking medical attention and the use of spirometry in individuals with chronic respiratory symptoms and to compare these results with those obtained in the 2005 and 2011 surveys. Material and Methods: A cross-sectional, observational, epidemiological study was conducted via phone interview in December 2020 in Spain, with a representative sample from 17 autonomous communities. The study design was identical to that of the studies carried out in 2005 and 2011 to evaluate the changes that have occurred in seeking medical attention and performing spirometry in Spain, as well as the variability between autonomous communities. Results: From 89,601 phone contacts, a total of 6534 respondents were obtained. A total of 24.8% reported having some chronic respiratory symptom, and 17.9% reported a respiratory disease. Only 51.6% of those who had some chronic respiratory symptom had seen their doctor, which was less likely among current smokers (OR: 0.599, 95% CI: 0.467–0.769, p < 0.001) and those living in a rural setting (OR: 0.797, 95% CI: 0.651–0.975, p = 0.027). A total of 68.7% of the individuals who saw a doctor reported having undergone spirometry, most frequently males (OR: 1.535, 95% CI: 2.074–1.136, p < 0.005), former smokers (OR: 1.696, 95% CI: 2.407–1.195, p < 0.003), and those seen by a pulmonologist (OR: 6.151, 95% CI: 8.869–4.265, p < 0.001). With respect to the 2005 survey, more frequent use of spirometry has been observed (42.6 vs. 68.7%), without any change in seeking medical attention for respiratory symptoms. There is a clear variability according to the autonomous community (p < 0.05). Conclusions: Many individuals with chronic respiratory symptoms do not seek medical attention and although the use of spirometry has increased in the past 15 years, it is still an important area that needs improving in the primary care setting, especially among women. Both of these factors can be determinants in the underdiagnosis of COPD and its variability between autonomous communities.This study has been promoted and sponsored by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). We thank GlaxoSmithKline Spain for its financial support in carrying out the study; grant number 214465. The financing entities did not participate in the design of the study, data collection, analysis, publication, or preparation of this manuscript

Testing for Vitamin D in High-Risk COPD in Outpatient Clinics in Spain: A Cross-Sectional Analysis of the VITADEPOC Study

Background: Vitamin D deficiency has been associated with an accelerated deterioration in lung function and increased exacerbations in chronic obstructive pulmonary disease (COPD). 25(OH) vitamin D levels have been indicated as a potentially useful marker for adverse results related to COPD. Methods: VITADEPOC is a cross-sectional clinical study recruiting consecutive patients with high-risk COPD. The objective of our study was to investigate vitamin D determination frequency in patients with high-risk COPD in clinical practice at outpatient clinics in Spain and to describe the factors associated with vitamin D testing. We also aimed to determine the frequency of vitamin D deficiency in these patients. Results: Only 51 (44%) patients underwent vitamin D determination and 33 (28.4%) had received vitamin D supplements in clinical practice. The patients who underwent testing for vitamin D in clinical practice were more often women (58.8% vs. 26.2%, p < 0.001) with comorbidities such as osteoporosis (19.6% vs. 6.2%, p < 0.001) or chronic renal failure (7.8% vs. 0%, p < 0.001) and with exacerbator phenotype (55% vs. 32.3%, p = 0.015). A total of 63 (54.3%) patients had serum vitamin D levels <20 ng/mL at the inclusion visit. Of these, 29 (46%) had serum vitamin D levels <12 ng/mL (severe deficiency). Having a history of inhaled corticosteroids (OR 3.210, p < 0.016), being treated with a cycle of systemic corticosteroids (OR 2.149, p < 0.002), and having a lower physical activity level (OR 3.840, p < 0.004) showed a statistically significant positive association with vitamin D deficiency. Conclusion: The testing of vitamin D levels in patients with high-risk COPD treated at outpatient respiratory clinics in Spain is infrequent. However, when tested, a severe deficiency is detected in one in four patients. Efforts to optimize case detection in COPD are needed.Depto. de MedicinaFac. de MedicinaTRUESociedad Madrileña de Neumología y Cirugía TorácicaResearch Pharma S.Lpu

Moderación de la Relación Entre Tensión Laboral y Malestar de Profesores Universitarios: Papel del Conflicto y la Facilitación Entre el Trabajo y la Familia

Se evaluó si el conflicto y la facilitación entre trabajo y familia moderan la relación entre tensión laboral y salud psicológica, y si los niveles de conflicto y facilitación varían según el sexo. Se realizó un estudio transversal con 302 profesores de universidades públicas y privadas de Bogotá, quienes respondieron cuestionarios que evaluaban tensión laboral, conflicto y facilitación trabajo-familia y familia-trabajo, ansiedad, depresión, síntomas psicosomáticos, adaptación social y burnout. Los resultados indicaron que el conflicto trabajo-familia modera la relación entre tensión laboral y burnout, mientras que el conflicto familia-trabajo modera la relación entre tensión laboral y depresión. En ambos casos, reportes más altos de tensión laboral y conflicto estuvieron vinculados con mayores experiencias de malestar