Health and well-being at work: The hospital context

Introduction Studies have shown the importance of psychosocial risks for physical and mental health particularly in the medical sector and among hospital workers. Objective The main goal of our study is to measure the magnitude of the six dimensions of the psychosocial work environment in a French hospital. The second goal is to highlight from the six dimensions, which are the most important ones for the hospital workers in order to propose specific actions of improvement of the well-being at work and prevention of social risks. Method Our sample is composed of 1139 hospital workers. (1) A 24-item scale was created, based on the six dimensions identified by the DARES study. This scale allows measuring the degree of psychosocial risk and of well-being at work. (2) Social representations are measured by a free association task based on the target expression: well-being at work in the hospital. (3) Participants also answered an open-ended question, on how to improve well-being at work in the hospital; answers were analyzed by a hierarchical classification. Results Four of the six dimensions extracted from the factorial analysis are equal to those identified by the DARES’ report: Work demand, Emotional demands, Relationships at work and Job insecurity. Quantitative analyses show that, for hospital workers, the level of risk is the highest on the first two. The social representation of well-being at work in the hospital, and the discourse analysis indicate that the dimension which is the most important for the hospital workers is Relationships at work. Conclusion In this study, the use of both quantitative and qualitative assessments allows having some elements to analyze the quality of working conditions in the hospital. Moreover, reducing the level of psychosocial risk has a positive effect on workers’ satisfaction, well-being and health

Characterization of controlled gamblers and pathological gamblers using the social representation theory

Introduction In industrialized countries, gambling disorder tends to become a major issue. The use of the social representation theory provides clues for a better understanding of pathological gamblers. Objective This paper investigates the representation of risk in a gambling context among lay people (Study 1) and among controlled gamblers and probable pathological gamblers (Study 2). Method In the first study, 1106 people answered a free association task based on the target expression ‘risk in a gambling context’. In the second study, a small sample of gamblers, half of them being probable pathological gamblers (based on their score at the SOGS), participated in a semi-structured interview about risk in a gambling context. Interview guidelines were constructed based on the results obtained from Study 1. Results In Study 1, results indicate that the overall representation of risk in a gambling context differs from the one in a general context. The results are interpreted through the prospect theory and the decision-making dual-process model. Results from Study 2 show that, contrarily to those being probable pathological gamblers, controlled gamblers orient their discourse around the notion of pleasure and do not perceive gambling as a threat for their ego. Conclusion Controlled gamblers fear to lose money, while probable pathological gamblers fear to lose the game

How is the economic crisis socially assessed?

Based on the Social Representation Theory, the purpose of this article is to explore how lay-people consider both the economic crisis and risk, and to link these social representations to behavior. The article offers an original approach with the articulation of two studies about the social construction of risk and crises. It also contributes to the development of research methods for studying the connections between representations and practical implications. Based on this, the impact of the social representation of the crisis on the perceived ability to act is approached. The first study focuses on free-association tasks, with two distinct target terms: ‘risk’ and ‘crisis’. The structural approach, with a prototypical analysis, allowed the identification of two different representations: (1) for risk, ‘danger’ is the central element; (2) for crisis, ‘economy’ and ‘money’ constitute the main components of the representation. The second study investigates the links between the two previously detected structures and their relations with the perceived ability to act in a financial crisis context. Some aspects of social knowledge were found to have an impact on perceived ability to act

Contribution d’une catégorisation des RPS à la prédiction du stress et du burnout (ou du mal-être au travail) des soignants

Health-care professionals are strongly affected by distress at work. Our goal is to study the usefulness of a psychosocial risk measure, compared to a measure of psychosocial and organizational work constraints, on the prediction of distress among a population of caregivers. This measure is based on the categorization of psychosocial risk factors issued from the College of experts chaired by Gollac. Seven hundred and fifty-seven health-care professionals filled out a questionnaire composed of measures of psychosocial risks, psychosocial and organizational work constraints specific to caregivers, as well as stress and burnout. Results indicate that the measure of psychosocial risk better predicted the levels of stress and burnout than the measure of psychosocial and organizational work constraints

Innovation Across Cultures: Connecting Leadership, Identification, and Creative Behavior in Organizations

Innovation is considered essential for today's organizations to survive and thrive. Researchers have also stressed the importance of leadership as a driver of followers' innovative work behavior (FIB). Yet, despite a large amount of research, three areas remain understudied: (a) The relative importance of different forms of leadership for FIB; (b) the mechanisms through which leadership impacts FIB; and (c) the degree to which relationships between leadership and FIB are generalizable across cultures. To address these lacunae, we propose an integrated model connecting four types of positive leadership behaviors, two types of identification (as mediating variables), and FIB. We tested our model in a global data set comprising responses of N = 7,225 participants from 23 countries, grouped into nine cultural clusters. Our results indicate that perceived LMX quality was the strongest relative predictor of FIB. Furthermore, the relationships between both perceived LMX quality and identity leadership with FIB were mediated by social identification. The indirect effect of LMX on FIB via social identification was stable across clusters, whereas the indirect effects of the other forms of leadership on FIB via social identification were stronger in countries high versus low on collectivism. Power distance did not influence the relations

Identity Leadership, Employee Burnout and the Mediating Role of Team Identification: Evidence from the Global Identity Leadership Development Project

Do leaders who build a sense of shared social identity in their teams thereby protect them from the adverse effects of workplace stress? This is a question that the present paper explores by testing the hypothesis that identity leadership contributes to stronger team identification among employees and, through this, is associated with reduced burnout. We tested this model with unique datasets from the Global Identity Leadership Development (GILD) project with participants from all inhabited continents. We compared two datasets from 2016/2017 (n = 5290; 20 countries) and 2020/2021 (n = 7294; 28 countries) and found very similar levels of identity leadership, team identification and burnout across the five years. An inspection of the 2020/2021 data at the onset of and later in the COVID-19 pandemic showed stable identity leadership levels and slightly higher levels of both burnout and team identification. Supporting our hypotheses, we found almost identical indirect effects (2016/2017, b = −0.132; 2020/2021, b = −0.133) across the five-year span in both datasets. Using a subset of n = 111 German participants surveyed over two waves, we found the indirect effect confirmed over time with identity leadership (at T1) predicting team identification and, in turn, burnout, three months later. Finally, we explored whether there could be a “too-much-of-a-good-thing” effect for identity leadership. Speaking against this, we found a u-shaped quadratic effect whereby ratings of identity leadership at the upper end of the distribution were related to even stronger team identification and a stronger indirect effect on reduced burnout

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

Factor structure and psychometric properties of the Body Appreciation Scale-2 among adolescents and young adults in Danish, Portuguese, and Swedish

In recent years, the study of body image shifted from focusing on the negative aspects to a more extensive view of body image. The present study seeks to validate a measure of positive body image, the Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015a) in Denmark, Portugal, and Sweden. Participants (N = 1012) were adolescents and young adults aged from 12 to 19. Confirmatory factor analyses confirmed the one-dimensional factor structure of the scale. Multi-group confirmatory factor analyses indicated that the scale was invariant across sex and country. Further results showed that BAS-2 was positively correlated with self-esteem, psychological well-being, and intuitive eating. It was negatively correlated with BMI among boys and girls in Portugal but not in Denmark and Sweden. Additionally, boys had higher body appreciation than girls. Results indicated that the BAS-2 has good psychometric properties in the three languages

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe