Fatiga laboral y ausentismo en el trabajo en mujeres auxiliares de enfermería de un hospital de alta complejidad, Chile / Occupational fatigue and work absenteeism in female assistant nurses of a high-complexity hospital, Chile

Resumen Esta investigación ignifi la asociación entre la fatiga y el absentismo en el trabajo en 110 asistentes de enfermería de un hospital altamente complejo en Chile. Se ignifi un cuestionario sociodemográfico y la escala Check Strength Individual Strength. Los resultados mostraron que el ignific de absentismo predominante fue de 11 a 29 días. Los mayores promedios de fatiga se presentaron en los mayores de 2 años, con más de 10 pacientes en el consultorio y con contrato annual. No hubo diferencias significativas entre la fatiga media en relación con el absentismo, pero hubo una asociación ignificative entre la fatiga física (p = 0,040; OR = 1,054) y la antigüedad en el trabajo (p = 0,001; OR = 1,084) con el absentismo laboral. Finalmente, se concluye que la fatiga física y la antigüedad en el servicio clínico representaron un factor de riesgo significativo para el absentismo.

Abstract This research examined the association between occupational fatigue and work absenteeism in 110 female assistant nurses of a high-complexity hospital in Chile. A sociodemographic questionnaire and the Checklist Individual Strength (CIS) scale were used. The results showed that the predominant absenteeism range was 11-29 days. The highest means of fatigue occurred in those with seniority above 2 years, with more than 10 patients in charge and an annual contract. No significant difference was observed between the fatigue means concerning absenteeism, but a significant association was observed between physical fatigue (p = 0.040, OR = 1.054) and service seniority (p = 0.001, OR = 1.084) with work absenteeism. Finally, we can conclude that physical fatigue and seniority in the clinical service are significant risk factors for the occurrence of absenteeism.

Occupational fatigue and work absenteeism in female assistant nurses of a high-complexity hospital, Chile. / Fatiga laboral y ausentismo en el trabajo en mujeres auxiliares de enfermería de un hospital de alta complejidad, Chile.

This research examined the association between occupational fatigue and work absenteeism in 110 female assistant nurses of a high-complexity hospital in Chile. A sociodemographic questionnaire and the Checklist Individual Strength (CIS) scale were used. The results showed that the predominant absenteeism range was 11-29 days. The highest means of fatigue occurred in those with seniority above 2 years, with more than 10 patients in charge and an annual contract. No significant difference was observed between the fatigue means concerning absenteeism, but a significant association was observed between physical fatigue (p = 0.040, OR = 1.054) and service seniority (p = 0.001, OR = 1.084) with work absenteeism. Finally, we can conclude that physical fatigue and seniority in the clinical service are significant risk factors for the occurrence of absenteeism.

Esta investigación ignifi la asociación entre la fatiga y el absentismo en el trabajo en 110 asistentes de enfermería de un hospital altamente complejo en Chile. Se ignifi un cuestionario sociodemográfico y la escala Check Strength Individual Strength. Los resultados mostraron que el ignific de absentismo predominante fue de 11 a 29 días. Los mayores promedios de fatiga se presentaron en los mayores de 2 años, con más de 10 pacientes en el consultorio y con contrato annual. No hubo diferencias significativas entre la fatiga media en relación con el absentismo, pero hubo una asociación ignificative entre la fatiga física (p = 0,040; OR = 1,054) y la antigüedad en el trabajo (p = 0,001; OR = 1,084) con el absentismo laboral. Finalmente, se concluye que la fatiga física y la antigüedad en el servicio clínico representaron un factor de riesgo significativo para el absentismo.

Social Reactions to Sexual Assault Disclosure: A Qualitative Study of Informal Support Dyads.

This interview study examined 45 informal support dyads where sexual assault was disclosed. Analysis showed social reactions and appraisals of reactions varied by relationship type (family, friend, significant other). Themes identified were role reversal or "parentification" of supporters, reactions of anger and aggression toward perpetrators, supporters using their own trauma experiences to respond to survivors, and reactions of betrayal. Results revealed the potential for identifying relational patterns and dynamics occurring in social reactions through dyadic analysis not otherwise captured by a survivor-only perspective. This approach helps understand and address distinct relationship contexts to improve supporters' reactions to sexual assault disclosure.

Sexual Assault Survivors' Experiences with Mental Health Professionals: A Qualitative Study.

An interview study of 15 sexual assault survivors' narratives examined positive and negative post-assault experiences with mental health professionals. Survivors who told one professional had more positive experiences than those who told multiple professionals. Qualitative analyses revealed how help seeking experiences were related to the context and nature of disclosures, survivors' readiness to disclose, trust building, social reactions received from providers, type of therapy, perceived control over recovery, and mental health system factors impacting access and quality of care. Themes from survivor's accounts illustrate how survivors perceived therapists, which can be used in training mental health professionals encountering survivors in clinical settings.

Mediators of sexual revictimization risk in adult sexual assault victims.

This study examined sexual risk behaviors and sexual refusal assertiveness in relationship to child sexual abuse, emotion dysregulation, and adult sexual revictimization. Path analyses of 1,094 survivors who had sex in the past year were done to examine sexual risk behavior and sexual refusal assertiveness mediational pathways by which child sexual abuse severity and emotion dysregulation may affect revictimization over one year in adult female sexual assault survivors. Exchanging sex for money and sexual refusal assertiveness were significantly associated with emotion dysregulation, whereas exchanging sex for money, and not sexual refusal assertiveness, was only significantly related to child sexual abuse severity. Both exchanging sex for money and sex refusal assertiveness mediated the relationship between emotion dysregulation and adult sexual revictimization. Exchanging sex for money mediated the child sexual abuse severity-revictimization relationship. These findings demonstrate the importance of considering both risky and protective sexual behaviors in research and prevention programming that address sexual revictimization in women.

Trauma histories, substance use coping, PTSD, and problem substance use among sexual assault victims.

Sexual assault history is associated with higher risk of problem drinking and drug use in women, yet little is known about mechanisms linking trauma histories in general to women's drinking or drug use problems. This study examined how various types of trauma, substance use coping, and PTSD relate to past-year problem drinking and drug use in women who experienced sexual assault. Data from a large, diverse sample of women who had experienced adult sexual assault were analyzed with structural equation modeling to test a theoretical model of the relationship between trauma types, substance use coping, PTSD symptoms, and past-year drinking and drug use (N=1863). Results show that PTSD symptoms fully mediated the association between non-interpersonal trauma and the use of substances to cope. However, the association between both interpersonal trauma and child sexual abuse severity on substance use to cope was only partially mediated by PTSD symptoms. In turn, use of substances to cope fully mediated the relationship between PTSD and problem drug use as well as partially mediated the effect of PTSD on problem drinking. These results suggest that different trauma types and substance use coping may be important risk factors distinguishing sexually assaulted women who develop PTSD and problematic substance use from those who do not. Identifying women's histories of different traumas may help to identify those at greater risk for substance use problems.

Effect of adipose tissue-derived osteogenic and endothelial cells on bone allograft osteogenesis and vascularization in critical-sized calvarial defects.

The use of processed bone allograft to repair large osseous defects of the skull has been limited, given that it lacks the osteogenic cellularity and intrinsic vascular supply which are essential elements for successful graft healing and, at the same time, the areas to be targeted through tissue-engineering applications. In this study, we investigated the effect of predifferentiated rat adipose tissue-derived osteoblastic cells (OBs) and endothelial cells (ECs) on calvarial bone allograft healing and vascularization using an orthotopic critical-sized calvarial defect model. For this purpose, thirty-seven 8 mm critical calvarial defects in Lewis rats were treated with bone allografts seeded with no cells, undifferentiated adipose tissue-derived stem cells (ASC), OBs, ECs, and OBs and ECs simultaneously. After 8 weeks, the bone volume and mineral density were calculated using microcomputed tomography and the microvessel formation using immunohistochemical staining and imaging software. The amount of bone within the 8 mm defect was significantly higher for the allografts treated with ECs compared with the allografts treated with OBs (p=0.05) and simultaneously with the two cell lineages (p=0.02). There were no significant differences in bone formation between the latter two groups and the control groups (allografts treated with no cells and undifferentiated ASC). There were no significant differences in bone mineral density among the groups. The amount of microvessels was significantly higher in the group treated with ECs relative to all groups (p=< 0.05). Our results show that the implantation of ASC-derived ECs improves the vascularization of calvarial bone allografts at 8 weeks after treatment. This cell-based vascularization strategy can be used to improve the paucity of perfusion in allogenic bone implants. However, in this study, the treatment of allografts with OBs alone or in combination with ECs did not support bone formation or vascularization.

Lupus eritematoso sistémico de inicio juvenil: detección de enfermedad vascular y factores de riesgo asociados / Childhood onset systemic lupus erythematous detection of vascular disease and associated risk factors

Durante las dos últimas décadas, se ha comunicado una alta tasa de mortalidad por enfermedad cardiovascular en pacientes con lupus eritematoso sistémico (LES), relacionada con la presencia de aterosclerosis prematura y enfermedad arterial coronaria. Objetivos: 1) determinar la prevalencia de anormalidades de la perfusión miocárdica en pacientes juveniles con LES, 2) determinar la frecuencia de aterosclerosis carotídea subclínica, 3)analizar los factores de riesgo asociados a ellas. Métodos: se incluyeron en forma consecutiva pacientes con LES (ACRï82) de inicio juvenil. Se analizaron variables clínicoserológicas y terapéuticas, puntuación de SLEDAI, antecedente de enfermedad coronaria, presencia de nefritis, hipertensión y factores de riesgo asociados con el desarrollo de aterosclerosis. En todos los pacientes, se realizó SPECT gatillada, electrocardiograma y ecocardiograma bidimensional. El engrosamiento carotídeo intimal-medial (CIM) fue medido a través de ecografía bidimensional modo B en pacientes y controles sanos apareados por sexo y edad. Análisis estadístico: se utilizó la prueba de ji2, la prueba t de Student y el análisis de regresión logística. Resultados: Fueron evaluados 38 pacientes con LES de comienzo juvenil, con una edad media al estudio de 16,2 años (DE3,8), y un tiempo medio de duración de la enfermedad de 48,9 meses (DE36). Todos los pacientes se hallaban libres de síntomas cardiológicos al momento del estudio. Diez (26,8 por ciento) presentaron anormalidades de la perfusión miocárdica; en 6, la isquemia fue significativa. Ocho de 34 (23,5) por ciento tenían un CIM mayor que los controles (0,57 mm vs 0,43; p= 0,0003). A pesar de que la proteinuria en rango nefrótico y la hipertensión fueron más frecuentes en pacientes con CIM patológico (p= 0,03), en el modelo de análisis multivariado, se halló que la duración de la enfermedad y la hiperfibrinogenemia fueron los únicos factores de riesgo asociados a anormalidades de la perfusión y aterosclerosis carotídea (OR 1,1 y 6,6, respectivamente, p= 0,03). Conclusión: la aterosclerosis subclínica y la enfermedad coronaria son un hallazgo y una complicación frecuentes en pacientes juveniles con LES