Engagement and labour stress in nursing

Engagement is a useful concept in the profession of nursing as it focuses on the positive dimension of human behaviour and visualizes the work context as a positive situation. Evaluate the stress and engagement levels on Portuguese and Spanish nurses and analyse the factors related to the stress and engagement levels in the two sample groups. Comparative exploratory study in a quantitative paradigm. Sample of 867 nurses (504 Portuguese, 363 Spanish), female 83.6% (78.6% Portugal, 90.6% Spain) and average age of 37. Portuguese (77.2%) and Spanish nurses (39.4%), work on average 40 hours per week. 60.6% and 57.7% of the Spanish and Portuguese respectively exercise their profession for 10 years. Sociodemographic questionnaire, the Pamela Gray-Toft’s Nursing Stress Scale (1981) and Schaufeli & Bakker’s Utrecht Work Engagement Scale (2003) were used. In what concerns Engagement there are statistically signiicant differences in the three dimensions, the p-value of the t-Student test were under 5%, highlighting the Spanish nurses for being more vigorous, dedicated and absorbed by their work: vigour, dedication and absorption. The sample of Portuguese nurses experience higher stress levels although the difference with Spanish nurses isn’t statistically signiicant. There are statistically signiicant differences between Portugal and Spain in “Lack of help from colleagues” and also in the psychological domain in general. The Spanish nurses feel more vigorous, dedicated and absorbed by their work. The Portuguese nurses perceive more psychological stress and mention having less help from colleagues.

IVG: Um indutor de alterações psicológicas? Estudo dos níveis de depressão, ansiedade e stress em mulheres no pré e pós I.V.G.

Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica.

Avaliação da resposta ao stress de gatas hospitalizadas no período pós-cirúrgico em distintas condições de macroambiente

Dissertação de Mestrado Integrado em Medicina Veterinária

Erectile dysfunction: prevalence, risk factors and involvement of antihypertensive drugs intervention

Purpose: To explore the literature regarding prevalance, risk factors and the involvement of antihypertensive drugs in erectile dysfunction (ED). Methods: Original research articles, reviews, editorials and case reports published in English language on the prevalence of sexual/erectile dysfunction in hypertensive men taking antihypertensive drugs and risk factors were identified through a search of four bibliographic databases, namely, PubMed, EMBASE, CINAHL and EBSCO Health. Results: Recent analyses suggest that hypertensive men of almost all age groups suffer from ED but it is more prevalent in elderly male patients. The involvement of β-blockers was found to be controversial. Nevertheless, some evidence had been found regarding the use of propranolol in high doses. Conclusion: The present review indicates the need for research to unravel the role of β-blockers in the manifestation of ED in hypertensive males, whom there are no contributory factors such as sedentary lifestyle, aging, stress and anxiety, etc.

Moderating effects of gender in the relationships between daily stress, coping styles and hopelessness depression in adolescents

The hopelessness depression (HD) theory assumes a number of contributing factors to the development of hopelessness expectations and HD symptoms. Studies carried out to test HD theory have generally supported the prediction that a negative attributional style contributes to the development of hopelessness expectations and HD symptoms, although the evidence is less consistent for adolescents. Due to these inconsistent results, as well as the assumption advanced by HD theory that other factors aside from attributional style may contribute to the development of HD, in this study we examined the potential role of adolescents’ daily stress and coping styles as contributing factors to HD at these ages, and the effects of gender on these relationships. Seiffge-Krenke (1995) showed that stress in daily life plays a particularly relevant role during adolescence and described three coping styles used by adolescents to face daily stress: active and internal approach-oriented styles, which are considered functional and complementary, and avoidant style, considered dysfunctional. In this study, secondary students (N = 480; aged 13–17) completed the Hopelessness Scale (Beck, Weissman, Lester, & Trexler, 1974), the Hopelessness Depression Symptoms Questionnaire (Metalsky & Joiner, 1997), the Problem Questionnaire ((Seiffge-Krenke, 1995) and the Coping Across Situations Questionnaire (Seiffge-Krenke, 1995). To test the role of daily stress and coping styles in the prediction of hopelessness expectations and HD symptoms, two four-step hierarchical multiple regression analyses were conducted. In these analyses, gender was introduced first, daily stress was introduced second, the three coping styles were entered in a third step, and the moderating effects of gender on the associations of the predictor variables (daily stress and each coping style) with the criterion variables (hopelessness expectations or HD symptoms) were introduced in a fourth step. Results showed a moderating effect of gender on the relationship between daily stress and hopelessness expectations, which revealed a significant effect for boys despite the fact that girls experienced more daily stress than boys, thus suggesting an inoculation effect in girls. It was also found a gender-dependent role of coping styles in the prediction of HD symptoms, revealing a protective effect for the active style in girls and for the internal style in boys. This suggests that girls would benefit from being more action-prone and boys more reflection-prone in order to prevent HD. These findings indicate that programmes aimed to promote coping skills in adolescents would benefit from being gender-adapted.

The Influence of Neurocognitive Impairment, Alcohol and other Drug (AOD) Use, and Psychosocial Factors on Antiretroviral Treatment Adherence, Service Utilization and Viral Load Among HIV-Seropositive Adults

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) can be affected by problems of neurocognitive (NC) impairment, stress, alcohol and other drug (AOD) abuse, and other barriers. The aims of this research were to: (1) examine factors associated with NC impairment, (2) explore relationships between psychosocial variables with ART adherence and viral load (VL), and (3) evaluate the efficacy of an evidence-based intervention in improving ART adherence, increasing service utilization, and decreasing VL. The first study (n=370) was cross sectional and used structural equation modeling to test whether AOD use, years living with HIV, and time from HIV diagnosis to seeking care were associated with poorer NC functioning. The second study (n=246) used similar methods to test the hypothesis that stress, barriers to adherence, NC impairment, poor social support, and AOD use were related to lower VL mediated by ART adherence. The third study (n=243) evaluated an evidence-based, eight-session program to improve ART adherence, reduce VL, and increase service utilization in a randomized controlled trial. Study participants were PLWH living in South Florida, 18 to 60 years old, with a history of alcohol abuse enrolled from January 2009 through November 2012. Secondary analysis of available data showed: (1) scores on interference with executive functioning increased by 0.32 for each day of marijuana use and 1.18 for each year living with HIV, but no association was found between alcohol use and NC functioning; (2) each barrier to adherence was associated with a 10% decrease in adherence to ART and a 0.42 unit increase in VL (log10) and the relationship between barriers and VL was partially mediated by ART adherence; (3) participants in the evidence-based program were more likely than the comparison group to report an undetectable VL (OR=2.25, p Psychosocial factors affect VL, but ART adherence is essential in achieving an undetectable VL in PLWH.

A retrospective study examining the nature, contributory factors and predictors of dispensing errors in community pharmacy

Introduction: Since 2005, the workload of community pharmacists in England has increased with a concomitant increase in stress and work pressure. However, it is unclear how these factors are impacting on the ability of community pharmacists to ensure accuracy during the dispensing process. This research seeks to extend our understanding of the nature, outcome, and predictors of dispensing errors. Methodology: A retrospective analysis of a purposive sample of incident report forms (IRFs) from the database of a pharmacist indemnity insurance provider was conducted. Data collected included; type of error, degree of harm caused, pharmacy and pharmacist demographics, and possible contributory factors. Results: In total, 339 files from UK community pharmacies were retrieved from the database. The files dated from June 2006 to November 2011. Incorrect item (45.1%, n = 153/339) followed by incorrect strength (24.5%, n = 83/339) were the most common forms of error. Almost half (41.6%, n = 147/339) of the patients suffered some form of harm ranging from minor harm (26.7%, n = 87/339) to death (0.3%, n = 1/339). Insufficient staff (51.6%, n = 175/339), similar packaging (40.7%, n = 138/339) and the pharmacy being busier than normal (39.5%, n = 134/339) were identified as key contributory factors. Cross-tabular analysis against the final accuracy check variable revealed significant association between the pharmacy location (P < 0.024), dispensary layout (P < 0.025), insufficient staff (P < 0.019), and busier than normal (P < 0.005) variables. Conclusion: The results provide an overview of some of the individual, organisational and technical factors at play at the time of a dispensing error and highlight the need to examine further the relationships between these factors and dispensing error occurrence.

Effect of investigation intensity and treatment differences on prostate cancer survivor's physical symptoms, psychological well-being and health-related quality of life: a two country cross-sectional study.

Aim: To investigate effects on men's health and well-being of higher prostate cancer (PCa) investigation and treatment levels in similar populations. Participants: PCa survivors in Ireland where the Republic of Ireland (RoI) has a 50% higher PCa incidence than Northern Ireland (NI). Method: A cross-sectional postal questionnaire was sent to PCa survivors 2–18 years post-treatment, seeking information about current physical effects of treatment, health-related quality of life (HRQoL; EORTC QLQ-C30; EQ-5D-5L) and psychological well-being (21 question version of the Depression, Anxiety and Stress Scale, DASS-21). Outcomes in RoI and NI survivors were compared, stratifying into ‘late disease’ (stage III/IV and any Gleason grade (GG) at diagnosis) and ‘early disease’ (stage I/II and GG 2–7). Responses were weighted by age, jurisdiction and time since diagnosis. Between-country differences were investigated using multivariate logistic and linear regression. Results: 3348 men responded (RoI n=2567; NI n=781; reflecting population sizes, response rate 54%). RoI responders were younger; less often had comorbidities (45% vs 38%); were more likely to present asymptomatically (66%; 41%) or with early disease (56%; 35%); and less often currently used androgen deprivation therapy (ADT; 2%; 28%). Current prevalence of incontinence (16%) and impotence (56% early disease, 67% late disease) did not differ between RoI and NI. In early disease, only current bowel problems (RoI 12%; NI 21%) differed significantly in multivariate analysis. In late disease, NI men reported significantly higher levels of gynaecomastia (23% vs 9%) and hot flashes(41% vs 19%), but when ADT users were analysed separately, differences disappeared. For HRQoL, in multivariate analysis, only pain (early disease: RoI 11.1, NI 19.4) and financial difficulties (late disease: RoI 10.4, NI 7.9) differed significantly between countries. There were no significant between-country differences in DASS-21 or index ED-5D-5L score. Conclusions: Treatment side effects were commonly reported and increased PCa detection in RoI has left more men with these side effects. We recommended that men be offered a PSA test only after informed discussion.

Demanda y control de la tarea y presencia de síntomas de estrés y osteo-musculares en personal de una institución hospitalaria de IV nivel, Bogotá, 2016.

El ejercicio de labores asistenciales en el personal de la salud, las largas horas de trabajo y la responsabilidad en la ejecución de sus tareas, llevan consigo la exposición a riesgos psicosociales; que de no ser debidamente controlados pueden llevar al individuo a generar respuestas inadecuadas a nivel cognitivo, emocional e intelectual, las cuales se manifiestan en algunos casos con la aparición de sintomatología osteomuscular y/o asociada al estrés. OBJETIVO Identificar la relación entre las demandas de la tarea, el control sobre las mismas y la presencia e intensidad de síntomas de estrés y osteo-musculares en médicos, especialistas y personal de enfermería de una institución hospitalaria de IV nivel en Bogotá. Métodos Estudio de corte transversal en una muestra de 100 profesionales de la salud. Se utilizaron tres instrumentos: cuestionario Nórdico para la detección y análisis de síntomas músculo esqueléticos, cuestionario Karasek para identificar la percepción del trabajo y la relación del entorno profesional y el cuestionario de Estrés del Ministerio de la Protección Social validado para la población colombiana. Se obtuvo previa autorización del Comité de Investigaciones y Comité de Ética del Hospital. El análisis estadístico se realizó con el IBM SPSS Statistics versión 2.0 Resultados Se observó que los síntomas osteomusculares con mayor prevalencia estuvieron relacionados con afectaciones en espalda 43% y cuello 36%; no se observan diferencias estadísticamente significativas entre los distintos profesionales. En cuanto a presencia de sintomatología asociada al estrés, la mayor prevalencia se presentó en síntomas osteomusculares en cuello y espalda en el 84% de los casos, dolor de cabeza en el 74%, trastornos del sueño y cansancio en el 64% y percepción de sobrecarga laboral en el 63%. Para el análisis de prevalencia de los factores psicosociales laborales se utilizó la clasificación de la combinación de altas o bajas demandas y alto o bajo control, el resultado de estos teniendo en cuenta el modelo Demanda-control fue la siguiente: trabajo de alta tensión 34%; trabajo activo 40%; trabajo aburrido 13% y trabajo pasivo 13%. Se encontró una asociación entre la sintomatología y las variables toma de decisiones en médicos especialistas (OR 3,12; IC 95%: 2,80 – 3,49) lo que ratifica que este tipo de profesional tiene una mayor libertad para generar decisiones en su actuar médico y control sobre la tarea para especialistas (OR 3,23; IC 95%: 2,82 – 3,70) y enfermeros jefes (OR 3,36; IC 95%: 2,91 – 3,89); lo que permite inferir que cada uno de estos profesionales posee las herramientas para asumir las exigencias y dar respuesta a los distintos aspectos que están ligados a la tarea. Conclusiones: La presencia de síntomas osteo musculares en zonas como cuello y espalda son propios de la actividad del personal de la salud y se asocia a las posturas inadecuadas y el puesto de trabajo, así como al estrés. En cuanto a la sintomatología asociada al estrés se ratifica la presencia de sintomatología osteo muscular (cuello y espalda), como manifestaciones asociadas al cansancio, trastornos del sueño, sobrecarga laboral, dolor de cabeza y en menor porcentaje dificultades para relacionarse con otros. Respecto a los factores de riesgo psicosocial, se observó que el trabajo activo es la condición predominante en el personal de la salud, pero se observa además que un porcentaje importante experimenta episodios de tensión laboral, asociados a condiciones propias de las demandas psicológicas y el control sobre la tarea. Por lo anterior, se deben establecer acciones encaminadas a favorecer espacios saludables, y programas tendientes a la mejora de las condiciones de tal manera que disminuya la presencia de sintomatología osteomuscular y/o sintomatología derivada del estrés.

Effect of heat stress on milk production of goats from Alpine and Saanen breeds in Brazil.

The purpose of this bibliography review was to approach the thermal comfort rates on milk production of goats from Alpine and Saanen breeds in Brazil. The caloric stress caused by weather changes to which the animals are submitted, influence on the mechanisms of normal physiological processes of the body. Thus, the effect on the lactation process in goats can be mentioned, where it decreases the amount of water in the body with the consequent decrease in synthesis and milk ejection interfering in the production of hormone prolactin and growth hormone. The animal?s interaction with the environment must be considered when the aim in livestock farming is welfare, because the different responses of the animal to the peculiarities of each region are crucial for the success of the animal adaptation. So, the correct identification of the factors that influence the productive life of the animal, such as the stress caused by the seasonal fluctuations of the environment, allow production systems management, making it possible to make them sustainable and viable. The maintenance of these parameters in normal levels is very important, to the point of being used in the evaluation of climate adaptability of breeds to a certain environmental condition. In this way, the concerns about animal welfare and environmental comfort are due to the climatic variables and the behavioral, physiological and productive responses are prevailing when implementing the suitability of certain production systems.

Modeling Alzheimer disease with iPSCs and mouse model for the identification of risk factors, new targets, and potential therapeutical strategies

Alzheimer's disease (AD) is the most common neurodegenerative disease in elderly. Donepezil is the first-line drug used for AD. In section one, the experimental activity was oriented to evaluate and characterize molecular and cellular mechanisms that contribute to neurodegeneration induced by the Aβ1-42 oligomers (Aβ1-42O) and potential neuroprotective effects of the hybrids feruloyl-donepezil compound called PQM130. The effects of PQM130 were compared to donepezil in a murine AD model, obtained by intracerebroventricular (i.c.v.) injection of Aβ1-42O. The intraperitoneal administration of PQM130 (0.5-1 mg/kg) after i.c.v. Aβ1-42O injection improved learning and memory, protecting mice against spatial cognition decline. Moreover, it reduced oxidative stress, neuroinflammation and neuronal apoptosis, induced cell survival and protein synthesis in mice hippocampus. PQM130 modulated different pathways than donepezil, and it is more effective in counteracting Aβ1-42O damage. The section two of the experimental activity was focused on studying a loss of function variants of ABCA7. GWA studies identified mutations in the ABCA7 gene as a risk factor for AD. The mechanism through which ABCA7 contributes to AD is not clear. ABCA7 regulates lipid metabolism and critically controls phagocytic function. To investigate ABCA7 functions, CRISPR/Cas9 technology was used to engineer human iPSCs and to carry the genetic variant Y622*, which results in a premature stop codon, causing ABCA7 loss-of-function. From iPSCs, astrocytes were generated. This study revealed the effects of ABCA7 loss in astrocytes. ABCA7 Y622* mutation induced dysfunctional endocytic trafficking, impairing Aβ clearance, lipid dysregulation and cell homeostasis disruption, alterations that could contribute to AD. Though further studies are needed to confirm the PQM130 neuroprotective role and ABCA7 function in AD, the provided results showed a better understanding of AD pathophysiology, a new therapeutic approach to treat AD, and illustrated an innovative methodology for studying the disease.

Effects of stochastic hypoxia events on the benthic communities of transitional waters

Hypoxia is one of the most important and faster spreading threats to marine life and its occurrence has significantly increased in the last century. The effects of hypoxia on marine organisms and communities has mostly been studied in light of the intensity of the disturbance but not a lot of attention has been given to its interaction with other stressors and the timing of its appearance. In this thesis I started to explore these topics through laboratory and manipulative field experiments. I studied the interactive effects of thermal stress and hypoxia on a European native bivalve species (Cerastoderma edule; Linnaeus, 1758 ) and a non native one (Ruditapes philippinarum; Adams & Reeve, 1850) through a laboratory experiment performed in the Netherlands. The non native species displayed a greater tolerance to oxygen depletion than the native one. The first field experiment was performed in an Italian brackish coastal lagoon (Pialassa Baiona) and tested the effects of different timing regimes of hypoxia on the benthic community. It emerged that the main factor affecting the community is the duration of the hypoxia. The ability of the communities to recover after repeated hypoxic periods was explored in the second manipulative field experiment. We imposed three different timing regimes of hypoxia on sediment patches in Pialassa Baiona and we monitored the changes of both the benthic and the microbial communities after the disturbances. The preliminary analyses of the data from this last work suggest that the experimental manipulations caused limited detrimental effects on the communities. Overall this thesis work suggests that the duration of hypoxic events, their repetitive nature and the associated thermal stress are key factors in determining their effects on the communities and that management measures should point towards a reduction of the duration of the single hypoxic periods more than their frequency.

Investigating the mechanisms of Moraxella catarrhalis resistance to oxidative stress

Moraxella catarrhalis (Mcat) represents a human pathogen implicated in debilitating diseases, such as Chronic Obstructive Pulmonary Disease (COPD). One of the hallmarks of COPD is the excessive neutrophil oxidative stress mediated by reactive oxygen species (ROS). Mcat shows a higher innate level of resistance to exogenous oxidative stress compared to the co-infecting human airways pathogens such as non-typeable Haemophilus influenzae (NTHi) but the underlying mechanisms are currently not well defined. In this thesis, we demonstrated that, differently from NTHi, Mcat was able to directly interfere with ROS production and ROS-related responses such as neutrophil extracellular traps (NET) and autophagy in differentiated neutrophilic-like dHL-60 cells and primary cells. The underlying mechanisms were shown to be phagocytosis/opsonins-independent but contact-dependent, due to the engagement of the immunosuppressive receptors. Indeed, we identified that through OmpCD porin, Mcat was able to engage Siglec inhibitory receptors suppressing ROS generation by the host cells. Furthermore, Mcat provided a safer niche for the co-infecting NTHi bacterium which was otherwise susceptible to the host antimicrobial arsenal. Subsequently, to deeply characterize the Mcat global transcriptional response to oxidative stress, an RNA-Seq experiment was performed on exponentially growing bacteria exposed to sublethal amounts of H2O2 or CuSO4, stimuli that the pathogens experienced once they are phagocytosed. We unraveled a previously unidentified common transcriptional program following H2O2 and CuSO4 exposure, demonstrating a similar defense mechanism to the stress conditions encountered in neutrophils. We ascertained new crucial factors for this pathogen response and established a novel in vivo Mcat infection model, using the invertebrate Galleria mellonella. Actually, we observed that deletion mutants of genes implicated in oxidative stress resistance exhibited reduced virulence. In conclusion, this work represents an important step in the understanding of Mcat innate resistance mechanisms to oxidative stress and further elucidate the virulence mechanisms during infection.

Effect Of Platform Connection And Abutment Material On Stress Distribution In Single Anterior Implant-supported Restorations: A Nonlinear 3-dimensional Finite Element Analysis.

Although various abutment connections and materials have recently been introduced, insufficient data exist regarding the effect of stress distribution on their mechanical performance. The purpose of this study was to investigate the effect of different abutment materials and platform connections on stress distribution in single anterior implant-supported restorations with the finite element method. Nine experimental groups were modeled from the combination of 3 platform connections (external hexagon, internal hexagon, and Morse tapered) and 3 abutment materials (titanium, zirconia, and hybrid) as follows: external hexagon-titanium, external hexagon-zirconia, external hexagon-hybrid, internal hexagon-titanium, internal hexagon-zirconia, internal hexagon-hybrid, Morse tapered-titanium, Morse tapered-zirconia, and Morse tapered-hybrid. Finite element models consisted of a 4×13-mm implant, anatomic abutment, and lithium disilicate central incisor crown cemented over the abutment. The 49 N occlusal loading was applied in 6 steps to simulate the incisal guidance. Equivalent von Mises stress (σvM) was used for both the qualitative and quantitative evaluation of the implant and abutment in all the groups and the maximum (σmax) and minimum (σmin) principal stresses for the numerical comparison of the zirconia parts. The highest abutment σvM occurred in the Morse-tapered groups and the lowest in the external hexagon-hybrid, internal hexagon-titanium, and internal hexagon-hybrid groups. The σmax and σmin values were lower in the hybrid groups than in the zirconia groups. The stress distribution concentrated in the abutment-implant interface in all the groups, regardless of the platform connection or abutment material. The platform connection influenced the stress on abutments more than the abutment material. The stress values for implants were similar among different platform connections, but greater stress concentrations were observed in internal connections.

Diet Carotenoid Lutein Modulates The Expression Of Genes Related To Oxygen Transporters And Decreases Dna Damage And Oxidative Stress In Mice.

Lutein (LT) is a carotenoid obtained by diet and despite its antioxidant activity had been biochemically reported, few studies are available concerning its influence on the expression of antioxidant genes. The expression of 84 genes implicated in antioxidant defense was quantified using quantitative reverse transcription polymerase chain reaction array. DNA damage was measured by comet assay and glutathione (GSH) and thiobarbituric acid reactive substances (TBARS) were quantified as biochemical parameters of oxidative stress in mouse kidney and liver. cDDP treatment reduced concentration of GSH and increased TBARS, parameters that were ameliorated in treatment associated with LT. cDDP altered the expression of 32 genes, increasing the expression of GPx2, APC, Nqo1 and CCs. LT changed the expression of 37 genes with an induction of 13 mainly oxygen transporters. In treatments associating cDDP and LT, 30 genes had their expression changed with a increase of the same genes of the cDDP treatment alone. These results suggest that LT might act scavenging reactive species and also inducing the expression of genes related to a better antioxidant response, highlighting the improvement of oxygen transport. This improved redox state of the cell through LT treatment could be related to the antigenotoxic and antioxidant effects observed.