Brain functional changes across the different phases of bipolar disorder.

BACKGROUND: Little is known about how functional imaging changes in bipolar disorder relate to different phases of the illness. AIMS: To compare cognitive task activation in participants with bipolar disorder examined in different phases of illness. METHOD: Participants with bipolar disorder in mania (n = 38), depression (n = 38) and euthymia (n = 38), as well as healthy controls (n = 38), underwent functional magnetic resonance imaging during performance of the n-back working memory task. Activations and de-activations were compared between the bipolar subgroups and the controls, and among the bipolar subgroups. All participants were also entered into a linear mixed-effects model. RESULTS: Compared with the controls, the mania and depression subgroups, but not the euthymia subgroup, showed reduced activation in the dorsolateral prefrontal cortex, the parietal cortex and other areas. Compared with the euthymia subgroup, the mania and depression subgroups showed hypoactivation in the parietal cortex. All three bipolar subgroups showed failure of de-activation in the ventromedial frontal cortex. Linear mixed-effects modelling revealed a further cluster of reduced activation in the left dorsolateral prefrontal cortex in the patients; this was significantly more marked in the mania than in the euthymia subgroup. CONCLUSIONS: Bipolar disorder is characterised by mood state-dependent hypoactivation in the parietal cortex. Reduced dorsolateral prefrontal activation is a further feature of mania and depression, which may improve partially in euthymia. Failure of de-activation in the medial frontal cortex shows trait-like characteristics.

Structural brain changes associated with tardive dyskinesia in schizophrenia.

BACKGROUND: The pathological basis of tardive dyskinesia is unknown. Although its clinical features implicate the basal ganglia, imaging studies have not found clear evidence that it is associated with volume changes in these or other brain structures. AIMS: To determine, using voxel-based structural imaging, whether there are regions of grey matter volume change in people with schizophrenia who also have tardive dyskinesia compared with those without tardive dyskinesia. METHOD: A total of 81 people with chronic schizophrenia, 32 with tardive dyskinesia and 49 without, were examined using magnetic resonance imaging (MRI) and whole-brain, optimised voxel-based morphometry. A comparison group of 61 healthy controls was also examined. RESULTS: Compared with those without tardive dyskinesia, patients with tardive dyskinesia showed a pattern of volume reductions in predominantly subcortical regions, including the basal ganglia and the thalamus. Within the basal ganglia, volume reductions were seen in the caudate nucleus, to a lesser extent in the putamen, and only marginally in the globus pallidus. The patients with tardive dyskinesia, but not those without, showed significant volume reductions in the basal ganglia compared with the healthy controls but both groups had smaller volumes than controls in other affected areas. CONCLUSIONS: The pathological process or processes that underlie the development of tardive dyskinesia are not just neurochemical in nature, but affect brain structure.

Prevalence and Characterization of Psychological Trauma in Patients with Fibromyalgia: A Cross-Sectional Study.

Background: Preliminary evidence suggests that psychological trauma, especially childhood trauma, is a risk factor for the onset of fibromyalgia (FM). Objective: The main objective of this study consisted of evaluating the prevalence and detailed characteristics of psychological trauma in a sample of patients with FM, the chronology of trauma across the lifespan, and its clinical symptoms. We also calculated whether childhood trauma could predict the relationship with different clinical variables. Method: Eighty-eight females underwent an interview to assess sociodemographic data, psychiatric comorbidities, level of pain, FM impact, clinical symptoms of anxiety, depression, insomnia, quality of life, and psychological trauma. Results: The majority of participants (71.5%) met the diagnostic criteria for current post-traumatic stress disorder (PTSD). Participants reported having suffered traumatic events throughout their lifespan, especially in childhood and early adolescence, in the form of emotional abuse, emotional neglect, sexual abuse, and physical abuse. Traumatic events predict both poor quality of life and a level of pain in adulthood. All patients showed clinically relevant levels of anxiety, depression, insomnia, suicidal thoughts, and pain, as well as somatic comorbidities and poor quality of life. Pain levels predicted anxiety, depression, dissociation, and insomnia symptoms. 84% of the sample suffered one or more traumatic events prior to the onset of pain. Conclusions: Our data highlight the clinical complexity of patients with FM and the role of childhood trauma in the onset and maintenance of FM, as well as the high comorbidity between anxiety, depression, somatic symptoms, and FM. Our data also supports FM patients experiencing further retraumatization as they age, with an extremely high prevalence of current PTSD in our sample. These findings underscore the need for multidisciplinary programs for FM patients to address their physical pain and their psychiatric and somatic conditions, pay special attention to the assessment of psychological trauma, and provide trauma-focused interventions. Trial registration: ClinicalTrials.gov NCT04476316. Registered on July 20th, 2020.

Combined therapy with idebenone and deferiprone in patients with Friedreich's ataxia.

Iron chelators are a new therapeutical approach for patients with Friedreich's ataxia, on the basis that oxidative cell damage that occurs in these patients is due to the increasing deposits of mitochondrial iron pools. The objective of the study was to evaluate the effects of the combined therapy of idebenone and low oral doses of deferiprone on the neurological signs and cardiac function parameters. This study was designed as a prospective open-label single-arm study. Twenty Friedreich's ataxia patients were treated with idebenone (20 mg/kg/day) and deferiprone (20 mg/kg/day) for 11 months. Patients were evaluated before the start and throughout the study with the International Cooperative Ataxia Rating Scale (ICARS) scores, echocardiographic measurements and MRI (magnetic resonance imaging) techniques to asses brain iron deposits in the dentate nucleus. No significant differences were observed in total ICARS scores when comparing baseline status and the end of the study in the whole group of patients. Posture and gait scores increased significantly after 11 months of therapy (Wilcoxon's test, p = 0.04) and kinetic function improved significantly (Wilcoxon's test, p = 0.015). Echocardiography data showed a significant reduction of the interventricular septum thickness (Wilcoxon's test, p = 0.04) and in the left ventricular mass index (Wilcoxon's test, p = 0.038) after the start of the therapy. The MRI values in the dentate nucleus showed a statistically significant reduction (Wilcoxon's test p = 0.007) between baseline conditions and after 11 months of the therapy. Combined therapy with idebenone and deferiprone in patients with FDRA indicates a stabilizing effect in neurologic dysfunctions due to an improvement in the kinetic functions, with a worsening of gait and posture scores. Heart hypertrophy parameters and iron deposits in dentate nucleus improved significantly. Combined therapy was well tolerated with mild side effects, apart from the risk of neutropenia and progressive reduction of plasma iron parameters.

[Psychophysiological distress among health care professionals working in Chilean public hospitals]. / Malestar psicofisiológico en profesionales de la salud pública de la Región Metropolitana.

BACKGROUND: The public health reform in Chile resulted in changes in working conditions and organization of health centers. AIM: To examine the presence of psychophysiological symptoms in professionals of public hospitals in the Metropolitan Region and their association with current working conditions. MATERIAL AND METHODS: A questionnaire of quality of working life was applied to a sample of 80 physicians and 110 nurses. The questionnaire considers scales and open questions. RESULTS: Nurses had a higher level of discomfort than physicians (p < 0.01) and had significantly higher scores for emotional distress, physical fatigue, digestive disorders, headache, insomnia, back pain and muscle tension (p < 0.01). There were statistically significant negative correlations between psychophysiological distress and working conditions (r = -0.418), social climate (r = -0.395), satisfaction with the organization (r = -0.337) and psychosocial well-being (r = -0.267). A regression model showed that 21% of the variance in psychophysiological distress was explained by working conditions, psychosocial well-being and adaptation to the organization. CONCLUSIONS: There is a relationship between the high prevalence of psychophysiological symptoms and bad working conditions of public health professionals.

Instantaneous and historical temperature effects on alpha-pinene emissions in Pinus halepensis and Quercus ilex.

We compared the role of instantaneous temperature and temperature history in the determination of alpha-pinene emissions in Mediterranean conifer Pinus halepensis that stores monoterpenes in resin ducts, and in Mediterranean broad-leaved evergreen Quercus ilex that lacks such specialized storage structures. In both species, alpha-pinene emission rates (E) exhibited a significant exponential correlation with leaf temperature and the rates of photosynthetic electron transport (Jco2+o2) started to decrease after an optimum at approximately 35 degrees C. However, there was a higher dependence of E on mean temperature of previous days than on mean temperature of current day for P. halepensis but not for Q. ilex. Jco2+o2 showed a maximum relationship to mean temperature of previous 3 and 5 days for P. halepensis and Q. ilex respectively. We conclude that although the best correlation of emission rates were found for instantaneous foliar temperatures, the effect of accumulated previous temperature conditions should also be considered in models of monoterpene emission, especially for terpene (see text) species.

[Risk factors of new fractures after vertebroplasty]. / Factores predictivos de nueva fractura tras vertebroplastia.

PURPOSE: To evaluate the risk factors of new fractures after vertebroplasty (VP). PATIENTS AND METHOD: Prospective, non-randomized study including patients with acute osteoporotic fractures treated with VP. Baseline visit included clinical and densitometric data. At 30, 90 and 180 days, changes in clinical data and side effects (cement leakage and new fractures) were recorded. To establish the predictive factors of a new fracture, differences between the group of patients with new fractures (R1) and those without fractures (R0) were evaluated. RESULTS: Vertebroplasty was performed in 43 patients (82 vertebrae). Cement leakage into a disc appeared in 11 cases (11,5%) and 12 new fractures occurred in 9 patients. No statistical differences were detected between groups R1 and R0 in the following variables: sex, age, vitamin D levels, T-score, kyphosis angle, primary/secondary osteoporosis, preexisting fractures, number of treated vertebrae and amount of cement injected. A positive, statistical significant correlation, was established between cement leakage into a disk and incidence of adjacent new fractures (p<0.001). CONCLUSIONS: Cement leakage into a disc increases the risk of adjacent new fractures after vertebroplasty.

Work, family, and gender: elements for a theory of work-family balance.

Over last century, work was not only a means of economic survival, but also a very strong factor of psychological structuring and of organization of personal, family, and everyday life. The new world of work provides new challenges to the balance of work and family life. A questionnaire was administered to a sample of 453 people with the aim of analyzing the relation between variables such as family burdens and domestic responsibilities, and the appraisal of work and family, values involved in work-family balance. The results of this study show that, in the present economic and cultural context, assuming family burdens and domestic responsibilities increases the positive appraisal of work and family, both in men and women. This has theoretical and practical implications concerning the challenge of work-family balance.

Testing the effects of gentle vibrotactile stimulation on symptom relief in fibromyalgia.

BACKGROUND: Sensory disturbances in fibromyalgia extend beyond nociception. It has been proposed that imbalance in the mutual competition between painful input and non-painful sensory activity may, to a significant extent, account for the augmented subjective perception of pain. In this context, non-nociceptive somatosensory stimulation could arguably attenuate fibromyalgia symptoms by restoring the sensory balance. We specifically tested the effect of vibrotactile stimulation on symptom relief in fibromyalgia patients with a randomized, double-blind, sham-controlled, crossover clinical trial. METHODS: Seventy-seven female patients were randomized and data from 63 valid cases were analyzed. Active intervention involved extensive body stimulation with gentle mechanical vibrations administered during 3 h at night for 3 weeks, and the placebo effect was controlled using identical instruments to simulate an alternative treatment option. The primary outcome measure combined pain, fatigue, and complaints of poor cognition. RESULTS: Vibrotactile stimulation was significantly superior to sham in alleviating fibromyalgia symptoms globally. However, univariate analyses showed that the effect was not universal. Benefits were perceived on unpleasant somatic sensations such as generalized pain and fatigue, but not on poor cognition, anxiety, and depression. Vibrotactile stimulation was notably well tolerated and sleep quality significantly improved despite the fact that vibrations were administered at night. CONCLUSIONS: Results thus provide new evidence that non-nociceptive somatosensory stimulation may favorably act upon altered somatosensory balance in fibromyalgia. From a clinical perspective, both the degree of improvement and the easy application of our proposal would seem to support a potential role for vibrotactile stimulation in the symptomatic treatment of fibromyalgia. TRIAL REGISTRATION: ClinicalTrials.gov registration number NCT03227952 . Registered 24 July, 2017.

Zoledronate in the prevention of Paget's (ZiPP): protocol for a randomised trial of genetic testing and targeted zoledronic acid therapy to prevent SQSTM1-mediated Paget's disease of bone.

INTRODUCTION: Paget's disease of bone (PDB) is characterised by increased and disorganised bone remodelling affecting one or more skeletal sites. Complications include bone pain, deformity, deafness and pathological fractures. Mutations in sequestosome-1 (SQSTM1) are strongly associated with the development of PDB. Bisphosphonate therapy can improve bone pain in PDB, but there is no evidence that treatment alters the natural history of PDB or prevents complications. The Zoledronate in the Prevention of Paget's disease trial (ZiPP) will determine if prophylactic therapy with the bisphosphonate zoledronic acid (ZA) can delay or prevent the development of PDB in people who carry SQSTM1 mutations. METHODS AND ANALYSIS: People with a family history of PDB aged >30 years who test positive for SQSTM1 mutations are eligible to take part. At the baseline visit, participants will be screened for the presence of bone lesions by radionuclide bone scan. Biochemical markers of bone turnover will be measured and questionnaires completed to assess pain, health-related quality of life (HRQoL), anxiety and depression. Participants will be randomised to receive a single intravenous infusion of 5 mg ZA or placebo and followed up annually for between 4 and 8 years at which point baseline assessments will be repeated. The primary endpoint will be new bone lesions assessed by radionuclide bone scan. Secondary endpoints will include changes in biochemical markers of bone turnover, pain, HRQoL, anxiety, depression and PDB-related skeletal events. ETHICS AND DISSEMINATION: The study was approved by the Fife and Forth Valley Research Ethics Committee on 22 December 2008 (08/S0501/84). Following completion of the trial, a manuscript will be submitted to a peer-reviewed journal. The results of this trial will inform clinical practice by determining if early intervention with ZA in presymptomatic individuals with SQSTM1 mutations can prevent or slow the development of bone lesions with an adverse event profile that is acceptable. TRIAL REGISTRATION NUMBER: ISRCTN11616770.

Labor conditions and the meanings of nursing work in Barcelona.

OBJECTIVE: to analyze the relationship between the quantitative assessment of working conditions and the qualitative perception of one's own work experience. METHOD: a sample of 1,760 nursing professionals from Barcelona answered a questionnaire assessing their working conditions and summarized their own current work experience in five key words. RESULTS: the textual corpus of the meanings of nursing work included 8043 lexical forms, which were categorized and codified. Respondents who rated their work conditions the highest expressed a vision of their work in terms of autonomy, achievement and well-being, while those who rated their work conditions the lowest talked mostly of exhaustion, depersonalization and negative climate. A correspondence analysis showed a close relationship between the quantitative assessments of working conditions and the verbal codes of the meaning of work. CONCLUSIONS: the meanings given to work were not only consistent with the numerical evaluations of the working conditions but also made them more understandable. The information obtained poses challenges for reflection and indicates ways to promote the positive aspects and prevent the negative conditions of nursing work.

Anomalous venous drainage preventing safe posterior fossa decompression in patients with chiari malformation type I and multisutural craniosynostosis. Report of two cases and review of the literature.

The authors report on two children in whom an anomalous posterior fossa venous drainage pattern prevented safe posterior fossa decompression. Both patients had Chiari malformation Type I, multisutural craniosynostosis, and crowded posterior fossa structures. Both patients had been treated with ventriculoperitoneal shunts for hydrocephalus. Pfeiffer syndrome had been diagnosed in one of the patients, and the other was suspected to have osteogenesis imperfecta. Although both patients were believed to have symptoms resulting from brainstem compression, posterior fossa decompression was not offered due to profound venous anomalies noted on imaging studies that greatly increased the expected risks associated with surgery. These cases are presented to alert neurosurgeons to carefully evaluate the posterior fossa venous anatomy prior to considering posterior fossa decompression with or without occipitocervical fusion or calvarial vault remodeling procedures in patients with multisutural craniosynostosis.

Sensitivity of terpene emissions to drought and fertilization in terpene-storing Pinus halepensis and non-storing Quercus ilex.

We studied the effects of water stress, fertilization and time course on foliar volatile terpene emission rates by Quercus ilex and Pinus halepensis in a garden experiment. The terpenes mostly emitted by both species were alpha-pinene, beta-pinene, beta-myrcene and Delta(3)-carene. P. halepensis emission rates (average 31.45 microg g(-1) DM h(-1)) were similar to those of Q. ilex (average 31.71 microg g(-1) DM h(-1)). The effects of drought (reduction to one-third of full watering) and fertilization (250 kg N ha(-1), 250 kg P ha(-1), or both) were different depending on the species: the drought treatment significantly increased the terpene emissions from Q. ilex by 33%, and the fertilization treatments reduced the terpene emissions from P. halepensis by 38%. Terpene emission rates increased with time course in parallel to raising summer temperatures in P. halepensis and Q. ilex, whose emission rates were temperature related (r = 0.42 and r = 0.68, respectively) and light related (r = 0.32 and r = 0.57, respectively). There was a positive relationship for P. halepensis, and a negative relationship for Q. ilex, between emission rates and relative water contents. No relationship was found between emission rates and N or P foliar concentrations. The results of this study show complex species-specific responses with stronger and faster short-term responses in terpene-non-storing than in storing species and indicate that terpene emissions may significantly change in the warmer, drier and more fertilized conditions predicted for the next decades in the Mediterranean region.

Condições de Trabalho e Significados da Experiência Laboral: O Caso dos Trabalhadores da Justiça / Working Conditions and Meanings of Working Experience: The Case of the Justice Workers / Condiciones de Trabajo y Significados de la Experiencia Laboral: El Caso de los Trabajadores de la Justicia

O funcionamento ideal das organizações requer que os trabalhadores estejam satisfeitos com suas condições de trabalho e atribuam significados positivos à sua atividade de trabalho. As reformas do sistema judiciário brasileiro criaram oportunidades para melhorar os serviços e o atendimento ao cliente. O objetivo desta investigação foi o de analisar a relação que os trabalhadores da justiça estabelecem entre a avaliação de suas condições de trabalho e a subjetivação de sua própria experiência profissional, entendida como o conjunto de significados que dão a este trabalho. Método. Uma amostra de 1.537 trabalhadores do setor respondeu ao Questionário sobre Condições de Trabalho (qCT) e a uma pergunta sobre o significado da própria experiência laboral. A análise de correspondência permitiu representar em tabelas de contingência as relações entre as categorias de avaliação quantitativa das condições de trabalho e os significados qualitativos atribuídos à experiência de trabalho. Resultados. Aqueles que pontuaram negativamente em condições de trabalho avaliaram sua experiência de trabalho em termos de desconforto, fadiga, injustiça e pouco comprometimento. Aqueles que os avaliaram positivamente avaliaram sua experiência em termos de oportunidades, relacionamentos e compromisso. Conclusões. O estudo fornece fundamentos empíricos e critérios teóricos para um redesenho das condições de trabalho do sistema de justiça que minimizem os riscos psicossociais para os servidores públicos.

The optimal functioning of organizations requires that workers be satisfied with their work-ing conditions and assign positive meanings to their work activity. The reforms of the Brazilian judicial system created opportunities to improve services and customer service. The objective of this investigation was to analyze the relationship that justice workers establish between the evaluation of their working conditions and the subjectivation of their own professional experience, understood as the set of meanings they give to this work. Method. A sample of 1,537 workers in the sector answered the Questionnaire on Working Conditions (QWC) and a question about the meaning of their own work experience. A correspon-dence analysis made it possible to represent the relationships between the categories of a quantitative assessment of working conditions and the qualitative meanings attributed to work experience in contin-gency tables. Results. Those who scored negatively on working conditions evaluated their work experience in terms of discomfort, fatigue, injustice, and little commitment. Those who rated them positively judged their experience in terms of opportunities, relationships, and commitment. Conclusions. The study pro-vides empirical foundations and theoretical criteria for a redesign of the working conditions of the justice system that minimizes psychosocial risks for civil servants

Work, malaise, and well-being in Spanish and Latin-American doctors.

OBJECTIVE: To analyze the relations between the meanings of working and the levels of doctors work well-being in the context of their working conditions. METHOD: The research combined the qualitative methodology of textual analysis and the quantitative one of correspondence factor analysis. A convenience, intentional, and stratified sample composed of 305 Spanish and Latin American doctors completed an extensive questionnaire on the topics of the research. RESULTS: The general meaning of working for the group located in the quartile of malaise included perceptions of discomfort, frustration, and exhaustion. However, those showing higher levels of well-being, located on the opposite quartile, associated their working experience with good conditions and the development of their professional and personal competences. CONCLUSIONS: The study provides empirical evidence of the relationship between contextual factors and the meanings of working for participants with higher levels of malaise, and of the importance granted both to intrinsic and extrinsic factors by those who scored highest on well-being.

Effects of Platelet-Rich Plasma (PRP) on a Model of Renal Ischemia-Reperfusion in Rats.

Renal ischemia-reperfusion injury is a major cause of acute renal failure, causing renal cell death, a permanent decrease of renal blood flow, organ dysfunction and chronic kidney disease. Platelet-rich plasma (PRP) is an autologous product rich in growth factors, and therefore able to promote tissue regeneration and angiogenesis. This product has proven its efficacy in multiple studies, but has not yet been tested on kidney tissue. The aim of this work is to evaluate whether the application of PRP to rat kidneys undergoing ischemia-reperfusion reduces mid-term kidney damage. A total of 30 monorrenal Sprague-Dawley male rats underwent renal ischemia-reperfusion for 45 minutes. During ischemia, PRP (PRP Group, n = 15) or saline solution (SALINE Group, n = 15) was administered by subcapsular renal injection. Control kidneys were the contralateral organs removed immediately before the start of ischemia in the remaining kidneys. Survival, body weight, renal blood flow on Doppler ultrasound, kidney weight, kidney volume, blood biochemistry and histopathology were determined for all subjects and kidneys, as applicable. Correlations between these variables were searched for. The PRP Group showed significantly worse kidney blood flow (p = 0.045) and more histopathological damage (p<0.0001). Correlations were found between body weight, kidney volume, kidney weight, renal blood flow, histology, and serum levels of creatinine and urea. Our study provides the first evidence that treatment with PRP results in the deterioration of the kidney's response to ischemia-reperfusion injury.

Brain abnormalities in adults with Attention Deficit Hyperactivity Disorder revealed by voxel-based morphometry.

UNLABELLED: Attention Deficit Hyperactivity Disorder (ADHD) commonly affects children, although the symptoms persist into adulthood in approximately 50% of cases. Structural imaging studies in children have documented both cortical and subcortical changes in the brain. However, there have been only a few studies in adults and the results are inconclusive. METHOD: Voxel-based morphometry (VBM) was applied to 44 adults with ADHD, Combined subtype, aged 18-54 years and 44 healthy controls matched for age, sex and IQ. RESULTS: ADHD patients showed reduced gray matter (GM) volume in the right supplementary motor area (SMA). Using more lenient thresholds we also observed reductions in the subgenual anterior cingulate (ACC) and right dorsolateral prefrontal (DLPFC) cortices and increases in the basal ganglia, specifically in the left caudate nucleus and putamen. There was a positive correlation between the cumulative stimulant dose and volume in the right SMA and DLPFC clusters. CONCLUSIONS: The findings suggest that adults with ADHD show brain structural changes in regions belonging to the so-called cool executive function network. Long-term stimulant medication may act to normalize these GM alterations.

Expert Consensus on the Management of Patients with Postmenopausal Osteoporosis in the Spanish Healthcare System.

INTRODUCTION: The management of postmenopausal osteoporosis (PMO) in routine clinical practice differs considerably from guideline recommendations. The objective of our study was to reach a consensus on the management of PMO, considering prevention, diagnosis, treatment and follow-up, according to expert opinion in Spain. METHODS: A two-round Delphi technique was conducted, including 38 experts. The questionnaire contained 35 sections, each one including 1-10 questions (n = 308) based on a literature review and contributions from the scientific steering committee. Each question was scored by experts from the current (1 = no occurrence, 9 = occurrence in all cases), wish (1 = total rejection; 9 = wish) and prediction (1 = no occurrence at all; 9 = occurs with maximum probability) perspectives. Consensus (wish and prediction perspectives) was considered when ≥75% of experts scored 7-9 (agreement) or 1-3 (disagreement). RESULTS: Overall, consensus was achieved on 75% of questions. While protocols of clinical management and consultation/referral should be followed, their implementation is unlikely. Furthermore, the medical specialties currently involved in PMO management are poorly defined. PMO patients without fracture should be managed (prevention, diagnosis, treatment and follow-up) in both primary care and rheumatology settings; however, experts predicted that only treatment and follow-up will be assumed by these specialties. A multidisciplinary team should be involved in patients with fracture. No assessment tools are usually applied, and prediction indicated that they will not be used. CONCLUSION: Efforts should be focused on questions with high divergence between wishes and predictions, defining actions that will improve PMO management. Collaboration between scientific societies and health authorities to address the identified opportunities of improvement is proposed. FUNDING: Amgen S.A.

Labor conditions and the meanings of nursing work in Barcelona / Condições de trabalho e significados do trabalho em enfermagem em Barcelona / Condiciones laborales y significados del trabajo en enfermería en Barcelona

ABSTRACT Objective: to analyze the relationship between the quantitative assessment of working conditions and the qualitative perception of one's own work experience. Method: a sample of 1,760 nursing professionals from Barcelona answered a questionnaire assessing their working conditions and summarized their own current work experience in five key words. Results: the textual corpus of the meanings of nursing work included 8043 lexical forms, which were categorized and codified. Respondents who rated their work conditions the highest expressed a vision of their work in terms of autonomy, achievement and well-being, while those who rated their work conditions the lowest talked mostly of exhaustion, depersonalization and negative climate. A correspondence analysis showed a close relationship between the quantitative assessments of working conditions and the verbal codes of the meaning of work. Conclusions: the meanings given to work were not only consistent with the numerical evaluations of the working conditions but also made them more understandable. The information obtained poses challenges for reflection and indicates ways to promote the positive aspects and prevent the negative conditions of nursing work.

RESUMO Objetivo: analisar a relação entre a avaliação quantitativa das condições de trabalho e a percepção qualitativa da própria experiência de trabalho. Método: uma amostra de 1760 profissionais de enfermagem de Barcelona respondeu a um questionário para avaliação de suas condições de trabalho e resumiu em cinco palavras-chave sua própria experiência de trabalho atual. Resultados: o corpus textual dos significados do trabalho incluiu 8043 formas lexicais, que foram categorizadas e codificadas. As pessoas pesquisadas que classificaram mais alto as suas condições de trabalho expressaram uma visão do trabalho em termos de autonomia, realização e bem-estar, ao passo que as que o classificavam mais baixo falavam principalmente de exaustão, despersonalização e clima negativo. Uma análise de correspondências evidenciou uma estreita relação entre as avaliações quantitativas das condições de trabalho e os códigos verbais de significado do trabalho. Conclusões: os significados dados ao trabalho foram não só coerentes com as avaliações numéricas das condições de trabalho, mas também as tornaram mais compreensíveis. A informação obtida coloca desafios para reflexão e aponta caminhos para enfrentar a promoção dos aspectos positivos e a prevenção dos negativos das condições do trabalho de enfermagem.

RESUMEN Objetivo: analizar la relación entre la valoración cuantitativa de las condiciones de trabajo y la percepción cualitativa de la propia experiencia laboral. Método: una muestra de 1.760 profesionales de enfermería de Barcelona respondió a un cuestionario de valoración de sus condiciones de trabajo y resumió en cinco palabras clave su propia experiencia laboral actual. Resultados: el corpus textual de significados del trabajo incluyó 8.043 formas léxicas, que fueron categorizadas y codificadas. Las personas encuestadas que valoraron más alto sus condiciones de trabajo expresaron una visión de su trabajo en términos de autonomía, realización y bienestar; mientras que quienes las valoraron más bajo hablaron sobre todo de agotamiento, despersonalización y clima negativo. Un análisis de correspondencias evidenció una estrecha relación entre las valoraciones cuantitativas de las condiciones laborales y los códigos verbales de significado del trabajo. Conclusiones: los significados dados al trabajo fueron no solo coherentes con las valoraciones numéricas de las condiciones laborales, sino que además las hicieron más comprensibles. La información obtenida plantea desafíos para la reflexión y señala caminos orientados a la promoción de los aspectos positivos y a la prevención de los negativos de las condiciones del trabajo de enfermería.