Mental disorders and long-term labour market outcomes: nationwide cohort study of 2 055 720 individuals.

OBJECTIVE: To examine the associations between an onset of serious mental disorders before the age of 25 with subsequent employment, income and education outcomes. METHODS: Nationwide cohort study including individuals (n = 2 055 720) living in Finland between 1988-2015, who were alive at the end of the year they turned 25. Mental disorder diagnosis between ages 15 and 25 was used as the exposure. The level of education, employment status, annual wage or self-employment earnings, and annual total income between ages 25 and 52 (measurement years 1988-2015) were used as the outcomes. RESULTS: All serious mental disorders were associated with increased risk of not being employed and not having any secondary or higher education between ages 25 and 52. The earnings for individuals with serious mental disorders were considerably low, and the annual median total income remained rather stable between ages 25 and 52 for most of the mental disorder groups. CONCLUSIONS: Serious mental disorders are associated with low employment rates and poor educational outcomes, leading to a substantial loss of total earnings over the life course.

Factors Influencing Medical Student Interest in a Career in Neurosurgery.

BACKGROUND: Exposure to neurosurgery at the undergraduate level is an important factor in determining future interest in and applications to the specialty. Given the high competition for training posts, this exposure is also becoming an almost essential addition to an applicant's portfolio. We organized a neurosurgical conference aimed at undergraduate medical students. The aim of this study was to determine factors attracting and deterring students from the specialty before and after the conference. METHODS: Responses were collected prospectively from students attending a national neurosurgical conference organized by medical students with support from the local neurosurgical unit. Questionnaires were distributed before and after the conference examining students' perceptions of a career in neurosurgery using free-text responses. RESULTS: Poor lifestyle or work-life balance was the most important factor deterring students from a career in the specialty both before (29.7%) and after (60%) the conference. The most important factor attracting students to the specialty before the conference was the practical (surgical approaches and techniques) aspect (21.9%). After the conference, the most important attracting factor was the rewarding nature of the specialty (18.9%). CONCLUSIONS: The most notable factor deterring students from a career in neurosurgery was work-life balance. Other deterring factors were much less prevalent following the conference. Understanding how exposure to neurosurgery influences students' perceptions is important for developing future initiatives to prevent misconceptions and allow students to make informed choices as well as encourage the right candidates to apply.

Estudio comparativo de los usos del tiempo en las ciudades de Rosario y Buenos Aires, Argentina / Comparative study of the uses of time in the cities of Buenos Aires and Rosario, Argentina

El presente trabajo estudia los patrones de uso del tiempo de la población de las ciudades de Buenos Aires y Rosario, Argentina, sobre la base de las Encuestas de Uso del Tiempo realizadas en 2005 y 2010, respectivamente. Ambos relevamientos utilizan en su metodología el "diario de actividades" del día anterior y el mismo codificador de actividades, el cual es una reformulación del Clasificador Internacional de Actividades de Uso del Tiempo (ICATUS) de Naciones Unidas. A partir de un estudio comparativo de los principales resultados, se pretende determinar cuáles son las similitudes y diferencias en el "día promedio" de los habitantes de las ciudades de Rosario y Buenos Aires, desagregando por género y diferenciando días "laborables" y "no laborables". De este modo, se busca visibilizar los nexos entre los usos del tiempo (o cantidad de vida) y la calidad de vida. Además, se estudian los tiempos simples y compuestos y el vínculo entre trabajo no remunerado y los patrones demográficos. (AU)

¿Cuál es la relación entre el síndrome de burnout, el sentido de la vida y el proyecto de vida laboral en los médicos residentes?: una perspectiva logoterapéutica / What is the relationship between burnout syndrome, the meaning of life and the project of working life in resident physicians ?: a logotherapeutic perspective

Introducción: el síndrome de burnout (BO) suele afectar a médicos residentes, debido al estrés laboral crónico. Desde un marco logoterapéutico, la pérdida de un sentido de la vida (SV) es el denominador más común de todas las formas de perturbación emocional, y el BO podría enmarcarse dentro de un proyecto de vida laboral (PVL) con enrolamiento enajenante. El objetivo principal del trabajo es evaluar la relación entre el BO, el SV y el PVL, en los programas de residencia del Hospital Italiano de Buenos Aires. Población y métodos: se evaluaron residentes de 6 programas de residencia del Hospital Italiano de Buenos Aires, a través de un cuestionario. El BO se midió con el "Maslach Burnout Inventory" (MBI). El SV se midió con el "Purpose in Life Test" (PIL Test). El PVL se midió con la Escala de PVL de la Dra. Isabel Pérez Jáuregui. Resultados: participaron 104 residentes. El 28,8% de los evaluados mostraron BO, el 18,3% falta de SV y el 30,8% un PVL inauténtico con sobreadaptación. Tanto la falta de SV como el PVL inauténtico con sobreadaptación se asociaron en forma estadísticamente significativa con BO (p < 0,01), y la presencia de cualquiera de estas alteraciones aumentó en casi 18 veces (odds ratio [OR] crudo) la probabilidad de presentar el síndrome. Los OR ajustados de falta de SV (6,28) y PVL inauténtico (9,57) para la presencia de BO continuaron siendo estadísticamente significativos. Por último, en esta investigación pudimos determinar que las subescalas del MBI agotamiento y despersonalización se correlacionaron negativamente con el PIL Test (r=-0,41 y r=-0,53, respectivamente) y la Escala de PVL (r=-0,45 y r=-0,42, respectivamente), mientras que la subescala de realización se correlacionó positivamente en forma significativa con estas dos últimas (r=0,63 y r=0,61, respectivamente). Conclusiones: se encontró una relación estadísticamente significativa entre BO, falta de SV y PVL inauténtico, en la residencia. (AU)

Introduction: The Burnout Syndrome (BO) usually affects medical residents because they are exposed to chronic labour stress. From a logotherapeutic view, the loss of meaning and purpose in life (ML) is the common denominator of all types of emotional distress, and the BO could belong to an altered labour life project (LLP) with overadaptation. The objective of this study was to evaluate the relationship between the BO, the ML, and the LLP, in residency programs at a university hospital. Population and methods: residents from six programs at Hospital Italiano de Buenos Aires were evaluated. The BO was measured with the Maslach Burnout Inventory (MBI). The ML was measured with the Purpose in Life Test (Pil Test). The LLP was measured with the LLP Scale created by Doctor Isabel Pérez Jáuregui. Results: one hundred and four residents participated. Out of the evaluated residentes, 28.8% showed BO. The loss of ML was observed in 18.3%, and an altered LLP with overadaptation affected the 30.8% of the sample. Loss of ML and altered LLP with overadaptation were associated in a statistically significant way with BO (p<0.01), and the presence of any of this alterations increased the odds ratio almost 18 times to suffer BO. The adjusted odds ratio of loss of ML (6.28) and altered LLP (9.57) to suffer BO, were also statistically significant. Finally, a negative correlation was observed between exhaustion and despersonalization (MBI) and the Pil Test (r=-0.41 and r=-0.53, respectively) and the LLP Scale (r=-0.45 and r=-0.42, respectively), while a positive significant correlation was observed between the personal accomplishment (MBI) and the Pil Test and LLP Scale (r=0.63 and r=0.61, respectively). Conclusions: in the residency, we found a statistically significant relationship between BO, loss of ML and altered LLP. (AU)

Work-family life conflict and mental well-being.

BACKGROUND: The promotion and maintenance of workers' mental health is an increasingly important issue, both for employers and society. Previous research has shown that job characteristics (i.e. demands, control and support) are significantly associated with employees' mental well-being. However, changes in work characteristics have given rise to the emergence of new job demands, leading to work-family life conflict. AIMS: To investigate the association between work-family life conflict and employee mental well-being. METHODS: A cross-sectional study with two samples: one sample comprising clothes store sales employees and the other comprising call centre operators. Logistic regression models were used to examine the effects of work-family life conflict on employee well-being. RESULTS: After controlling for job demands, job control, supervisory support and co-workers support, work-family life conflict was associated with employee mental well-being. CONCLUSIONS: Work-family life conflict is an important factor to explain employee well-being and productivity and should be addressed as well as work factors.

Map Changes and Theme Evolution in Work Hours: A Co-Word Analysis.

(1) Background: Work hours are the basic carrier impacting employees' work⁻life experience and organizational performance, and employees have greater anxiety in relation to work hours as new technology requires an increasingly faster work rhythm. However, scientific research on this topic lags far behind the practice, calling to attention the need for research on work hours from the perspective of historical evolution; (2) Methods: The Bibliometric method is used to analyze the 6364 articles and their contained 77 high-frequency keywords related to work hours from the Web of Science published between 1901 and 2017. Additionally, an individual⁻organization⁻society integrative perspective was adopted to describe the map changes and theme evolution of work hours; (3) Results and conclusions: The hot spots of research at the organizational level changed significantly around 1990, with the theme of "long work hours" becoming the core issue in recent years. Studies on the individual level have gradually moved from physiological aspects to the issues of burnout and psychological distress. Research topics related to the social level are somewhat loose, and mainly focused on work⁻life conflict areas. In addition, the cluster analysis based on the high-frequency keywords classifies six research types according to their research themes. Based on these findings, future trends are proposed to provide theoretical and practical reference for future studies.

Faustino Pérez Hernández, honestidad y entrega / Faustino Pérez Hernández, honesty and consecration

La historia de Cuba la han hecho sus mejores hijos. Entre los que contribuyeron protagónicamente a la etapa que condujo al triunfo de 1959 y la construcción de la sociedad socialista se destaca Faustino Pérez Hernández, fruto de la tierra espirituana ligado a la historia matancera por más de una página de honestidad y entrega. El principal hospital de la provincia de Matanzas, ubicado en su capital, lleva su nombre. El presente trabajo pretende, en su brevedad, despertar la necesidad de conocer más profundamente su vida y su obra (AU).

Cuban history has been made by its best children. Faustino Perez, born in Sancti Spiritus and linked to Matanzas by more than one page of honesty and devotion, is among the ones who played the most important roles in the stage leading to the triumph of 1959 revolution and the socialist construction. The main hospital of the province of Matanzas, located in its capital, is named after him. The current work pretends to arouse the necessity of knowing deeply his life and his work (AU).

Negotiating Work-Life Integration.

Introduction: Integrating work and home domains is a constant challenge for medical professionals. Only half of physicians report positive work-life satisfaction, implying that negotiating the inherent conflicts between work and home may not be intuitive. Early teaching of skills focused on professional sustainability may best prepare physicians to navigate conflicts between work and home domains. Methods: This interactive workshop targets trainees and junior faculty. It aims to highlight the current state of physician career satisfaction, to bring awareness to the risk of physician burnout, and to apply strategies that promote work-life integration as a lifelong practice for sustained career satisfaction. It includes a detailed presentation with structured resources to reinforce skill development. Results: This workshop was delivered five times to trainees and junior faculty. Workshop evaluations (n = 50) revealed that all participants believed the information presented was useful, addressed competencies relevant to their training, and increased their knowledge about how to create better work-life integration; all anticipated improvement in their professional work. They all recommended this program to a colleague. Discussion: This workshop offers an effective way to teach a skill set that enhances physicians' abilities to negotiate conflicting work and life domain boundaries. Our results indicate that learners intend to apply newly acquired strategies for work-life integration so as to improve career satisfaction and wellness. Such skill sets may mitigate physician burnout and promote career sustainability, both critical issues with far-reaching implications for the delivery of safe, high-quality health care at the provider and system levels.