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1.
BMC Public Health ; 24(1): 1099, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38649890

RESUMO

BACKGROUND: Self-initiated and proactive changes in working conditions through crafting are essential for shaping work and improving work-related well-being. Recently, the research stream of job crafting has been extended to other life domains. The present paper aims to study a novel crafting concept-work-nonwork balance crafting-investigating the role of its antecedents and identifying relevant outcomes. Work-nonwork balance crafting is defined as individuals' unofficial techniques and activities to shape their work-nonwork balance, here considering their life domain boundary preferences. METHODS: In the study, 1,060 employees in three European countries (Austria, Germany and Switzerland) were surveyed in a longitudinal three-wave study with three-month intervals. We explored the influences of job/home demands and resources as antecedents of work-nonwork balance crafting. Important constructs for employee health and well-being (i.e., work engagement, work-related burnout, mental well-being and detachment from work) were investigated as outcomes. RESULTS: The findings suggest that resources and demands in the context of work or home are key antecedents of work-nonwork balance crafting. Work-nonwork balance crafting was also predictive for important employee health and well-being outcomes over three months, mainly in a positive and health-promoting way. CONCLUSION: This study provides insights into the antecedents of proactive efforts to balance the complex interplay of life domains. By studying work-nonwork balance crafting, we provide a new perspective on crafting beyond job crafting, which may help maintain or improve employees' mental health and well-being.


Assuntos
Equilíbrio Trabalho-Vida , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Alemanha , Estudos Longitudinais , Suíça , Inquéritos e Questionários , Áustria , Esgotamento Profissional/psicologia , Engajamento no Trabalho , Satisfação no Emprego , Saúde Ocupacional
2.
Health Promot Int ; 38(3)2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35134907

RESUMO

The COVID-19 pandemic induced considerable changes regarding our working and private lives. This study aimed to examine the psychosocial effects of the COVID-19 crisis on German and Swiss employees. We analyzed the impact of the crisis on working and private life, well-being and health indicators. We tried to understand how the salutogenic behavior of crafting helps to overcome adversities during the COVID-19 pandemic and to maintain well-being and health. Therefore, we conducted a follow-up online survey from 9 to 22 April 2020 among 597 employees that had participated in the first wave of the survey in June 2019. This follow-up study design offered the opportunity to compare the situation of survey participants before and after the COVID-19 outbreak. This pre-post comparison was possible through the design of our study, which allowed us to link participants in an individual, yet anonymized way from t0 to t1. Results of the study showed that the situation concerning psychosocial factors at work and in private life and several well-being and health indicators was stable or even improved. Many study variables even remarkably improved among high crafters-a group of employees who tend to regularly craft their job and private life. Our findings indicate that employees are coping with the crisis surprisingly well. Moreover, there seem to exist beneficial, salutogenic behaviors (i.e. crafting) that allow people to better cope with crises such as the COVID-19 pandemic. These behaviors should be induced and promoted by interventions as they could be especially beneficial for low crafters.


Assuntos
COVID-19 , Senso de Coerência , Humanos , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Seguimentos , Suíça/epidemiologia
3.
Int J Mol Sci ; 24(17)2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37686388

RESUMO

The aim of this study was to evaluate selected parameters of redox signaling and inflammation in the granulocytes of COVID-19 patients who recovered and those who died. Upon admission, the patients did not differ in terms of any relevant clinical parameter apart from the percentage of granulocytes, which was 6% higher on average in those patients who died. Granulocytes were isolated from the blood of 15 healthy people and survivors and 15 patients who died within a week, and who were selected post hoc for analysis according to their matching gender and age. They differed only in the lethal outcome, which could not be predicted upon arrival at the hospital. The proteins level (respective ELISA), antioxidant activity (spectrophotometry), and lipid mediators (UPUPLC-MS) were measured in the peripheral blood granulocytes obtained via gradient centrifugation. The levels of Nrf2, HO-1, NFκB, and IL-6 were higher in the granulocytes of COVID-19 patients who died within a week, while the activity of cytoplasmic Cu,Zn-SOD and mitochondrial Mn-SOD and IL-2/IL-10 were lower in comparison to the levels observed in survivors. Furthermore, in the granulocytes of those patients who died, an increase in pro-inflammatory eicosanoids (PGE2 and TXB2), together with elevated cannabinoid receptors 1 and 2 (associated with a decrease in the anti-inflammatory 15d-PGJ2), were found. Hence, this study suggests that by triggering transcription factors, granulocytes activate inflammatory and redox signaling, leading to the production of pro-inflammatory eicosanoids while reducing cellular antioxidant capacity through SOD, thus expressing an altered response to COVID-19, which may result in the onset of systemic oxidative stress, ARDS, and the death of the patient.


Assuntos
Antioxidantes , COVID-19 , Humanos , Granulócitos , Estresse Oxidativo , Centrifugação
4.
J Med Virol ; 94(1): 186-196, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34427932

RESUMO

In classical viral infections, the avidity of immunoglobulin G (IgG) is low during acute infection and high a few months later. As recently reported, SARS-CoV-2 infections are not following this scheme, but they are rather characterized by incomplete avidity maturation. This study was performed to clarify whether infection with seasonal coronaviruses also leads to incomplete avidity maturation. The avidity of IgG toward the nucleoprotein (NP) of the seasonal coronaviruses 229E, NL63, OC43, HKU1 and of SARS-CoV-2 was determined in the sera from 88 healthy, SARS-CoV-2-negative subjects and in the sera from 70 COVID-19 outpatients, using the recomLine SARS-CoV-2 assay with recombinant antigens. In the sera from SARS-CoV-2-negative subjects, incomplete avidity maturation (persistent low and intermediate avidity indices) was the lowest for infections with the alpha-coronaviruses 229E (33.3%) and NL63 (61.3%), and the highest for the beta-coronaviruses OC43 (77.5%) and HKU1 (71.4%). In the sera from COVID-19 patients, the degree of incomplete avidity maturation of IgG toward NP of 223E, OC43, and HKU1 was not significantly different from that found in SARS-CoV-2-negative subjects, but a significant increase in avidity was observed for IgG toward NP of NL63. Though there was no cross-reaction between SARS-CoV-2 and seasonal coronaviruses, higher concentrations of IgG directed toward seasonal coronaviruses seemed to indirectly increase avidity maturation of IgG directed toward SARS-CoV-2. Our data show that incomplete IgG avidity maturation represents a characteristic consequence of coronavirus infections. This raises problems for the serological differentiation between acute and past infections and may be important for the biology of coronaviruses.


Assuntos
Alphacoronavirus/imunologia , Afinidade de Anticorpos , Betacoronavirus/imunologia , COVID-19/imunologia , Infecções por Coronavirus/imunologia , Imunoglobulina G/imunologia , SARS-CoV-2/imunologia , Adolescente , Adulto , Idoso , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Coronavirus Humano NL63/imunologia , Proteínas do Nucleocapsídeo de Coronavírus/imunologia , Coronavirus Humano OC43/imunologia , Reações Cruzadas , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Fosfoproteínas/imunologia , Estações do Ano , Adulto Jovem
5.
J Med Virol ; 94(11): 5294-5303, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35851961

RESUMO

The avidity (binding strength) of IgG directed towards the receptor-binding domain (RBD) of spike protein has been recognized as a central marker in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology. It seems to be linked to increased infection-neutralization potential and therefore might indicate protective immunity. Using a prototype line assay based on the established recomLine SARS-CoV-2 assay, supplemented with RBD of the delta and the omicron variant, differential avidity determination of IgG directed towards RBD of wild-type (WT) SARS-CoV-2 and distinct variants was possible within one assay. Our data confirm that natural SARS-CoV-2 infection or one vaccination step lead to low avidity IgG, whereas further vaccination steps gradually increase avidity to high values. High avidity is not reached by infection alone. After infection with WT SARS-CoV-2 or vaccination based on mRNA WT, the avidity of cross-reacting IgG directed towards RBD of the delta variant only showed marginal differences compared to IgG directed towards RBD WT. In contrast, the avidity of IgG cross-reacting with RBD of the omicron variant was always much lower than for IgG RBD WT, except after the third vaccination step. Therefore, parallel avidity testing of RBD WT and omicron seems to be mandatory for a significant assessment of protective immunity towards SARS-CoV-2.


Assuntos
COVID-19 , SARS-CoV-2 , Anticorpos Antivirais , COVID-19/diagnóstico , Humanos , Imunoglobulina G , SARS-CoV-2/genética , Glicoproteína da Espícula de Coronavírus/genética
6.
Health Promot Int ; 37(6)2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36440899

RESUMO

Our study examines the core concept of salutogenesis-sense of coherence (SOC)-in relation to off-job crafting (OJC) and mental well-being (MWB). The original salutogenic model of health mainly addresses the protective function of SOC against adversity. In our study, we focus on the recently proposed path of positive health development that captures how SOC can contribute to positive health and thriving. We present and test our theoretical assumptions about one such path, examining OJC as a possible mechanism how SOC translates into MWB. We tested our proposed model using cross-lagged panel model with three waves of panel data from Swiss and German employees (N = 2217). We compared our model to alternative nested models and conducted indirect effect analysis to test longitudinal mediation. Our hypothesized model fitted the data well and we found support for our main hypothesis that OJC partially mediates the relationship between SOC and MWB. Further, we identified positive reciprocal relationships between SOC and MWB, as well as between OJC and MWB. Overall, our study provides evidence that OJC is one mechanism underlying the recently postulated path of positive health development in the salutogenic model. For health promotion, this implies that promoting SOC and OJC may help to strengthen individual well-being and lead to positive feedback loops that foster personal development and thriving.


Assuntos
Senso de Coerência , Humanos , Saúde Mental , Promoção da Saúde
7.
J Med Virol ; 93(1): 311-322, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32633840

RESUMO

Data on the serological response toward severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 16 recent reports were analyzed and a high degree of variability was shown. Immunoglobulin M (IgM) responses were either found earlier than IgG, or together with IgG, later than IgG, or were missing. Therefore, clear distinctions between early, intermediate, and past infections are obviously not possible merely on the basis of IgM and IgG determinations. A review of publications on the serology of other virus groups shows that variable IgM responses can be found as well and therefore are not unique for SARS-CoV-2 infections. A model to explain this variability is proposed. The inclusion of avidity determination into regular diagnostic procedures has allowed to resolve such "atypical" serological constellations. The potential use of avidity determination for the diagnosis of COVID-19, for risk assessment, epidemiological studies, analysis of cross reactions, as well as for the control of vaccination programs is suggested and discussed.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/sangue , COVID-19/diagnóstico , SARS-CoV-2/imunologia , Testes Sorológicos , Afinidade de Anticorpos , Teste Sorológico para COVID-19 , Humanos
8.
J Med Virol ; 93(5): 3092-3104, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33565617

RESUMO

The serological responses towards severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleoprotein, receptor-binding domain (RBD), and spike protein S1 are characterized by incomplete avidity maturation. Analysis with varying concentrations of urea allows to determine distinct differences in avidity maturation, though the total process remains at an unusually low level. Despite incomplete avidity maturation, this approach allows to define early and late stages of infection. It therefore can compensate for the recently described irregular kinetic patterns of immunoglobulin M and immunoglobulin G (IgG) directed towards SARS-CoV-2 antigens. The serological responses towards seasonal coronaviruses neither have a negative nor positive impact on SARS-CoV-2 serology in general. Avidity determination in combination with measurement of antibody titers and complexity of the immune response allows to clearly differentiate between IgG responses towards seasonal coronaviruses and SARS-CoV-2. Cross-reactions seem to occur with very low probability. They can be recognized by their pattern of response and through differential treatment with urea. As high avidity has been shown to be essential in several virus systems for the protective effect of neutralizing antibodies, it should be clarified whether high avidity of IgG directed towards RBD indicates protective immunity. If this is the case, monitoring of avidity should be part of the optimization of vaccination programs.


Assuntos
Afinidade de Anticorpos/fisiologia , Teste para COVID-19/métodos , COVID-19/diagnóstico , Proteínas do Nucleocapsídeo/imunologia , Testes Sorológicos/métodos , Glicoproteína da Espícula de Coronavírus/imunologia , COVID-19/virologia , Humanos , Imunoglobulina G/fisiologia , Domínios Proteicos , SARS-CoV-2
9.
J Med Virol ; 93(12): 6765-6777, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34387884

RESUMO

Avidity is defined as the binding strength of immunoglobulin G (IgG) toward its target epitope. Avidity is directly related to affinity, as both processes are determined by the best fit of IgG to epitopes. We confirm and extend data on incomplete avidity maturation of IgG toward severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleoprotein (NP), spike protein-1 (S1), and its receptor-binding domain (RBD) in coronavirus disease 2019 (COVID-19) patients. In SARS-CoV-2-infected individuals, an initial rise in avidity maturation was ending abruptly, leading to IgG of persistently low or intermediate avidity. Incomplete avidity maturation might facilitate secondary SARS-CoV-2 infections and thus prevent the establishment of herd immunity. Incomplete avidity maturation after infection with SARS-CoV-2 (with only 11.8% of cases showing finally IgG of high avidity, that is, an avidity index > 0.6) was contrasted by regular and rapid establishment of high avidity in SARS-CoV-2 naïve individuals after two vaccination steps with the BioNTech messenger RNA (mRNA) Vaccine (78% of cases with high avidity). One vaccination step was not sufficient for induction of complete avidity maturation in vaccinated SARS-CoV-2 naïve individuals, as it induced high avidity only in 2.9% of cases within 3 weeks. However, one vaccination step was sufficient to induce high avidity in individuals with previous SARS-CoV-2 infection.


Assuntos
COVID-19/imunologia , Imunoglobulina G/imunologia , SARS-CoV-2/imunologia , Anticorpos Antivirais/imunologia , Formação de Anticorpos/imunologia , COVID-19/virologia , Vacinas contra COVID-19/imunologia , Epitopos/imunologia , Humanos , Imunidade Coletiva/imunologia , Testes Imunológicos/métodos , Glicoproteína da Espícula de Coronavírus/imunologia , Vacinação/métodos , Vacinas Sintéticas/imunologia , Vacinas de mRNA
10.
BMC Public Health ; 21(1): 1935, 2021 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-34689731

RESUMO

BACKGROUND: Research shows that leaders influence the health and well-being of employees, by being either a buffer or major source of employee's work stressors. Various leadership behaviors and their relation to employee outcomes have been examined. Yet, a satisfactory explanation of how leaders' behavior influences health has not been found. A new line of research investigates the construct of "health-oriented leadership", that is, the health awareness of leaders towards themselves ("self-care") and towards their employees ("staff-care"). It is hypothesized that this health-orientation has a direct effect on both leader's and employees' health, as well as an indirect effect mediated by their working conditions. METHODS: Data were derived from four company research projects, that involved employee and leader surveys on work, health, and well-being. The sample consisted of 50 teams, with 191 leaders and 604 team members. To test the relation between a leader's self-care and his/her engagement, exhaustion, as well as staff-care, multiple regression analyses and mediation analyses were conducted. The relation between a leader's staff-care, the team's job resources and demands, and the individual employee outcomes engagement and exhaustion were tested with multilevel analyses. RESULTS: Regression analysis showed that the stronger a leader's health-orientation towards him/-herself ("self-care"), the stronger was the health-orientation towards his/her employees ("staff-care"). A leader's self-care was also associated with higher work engagement and lower exhaustion and this relation was mediated by his/her job resources and demands, respectively. Multilevel analysis showed that a leader's staff-care was associated with employee work engagement and exhaustion, and that this relation was mediated by team-level job resources and demands, respectively. CONCLUSIONS: The health-orientation of leaders relates to their own as well as their teams' engagement and exhaustion, which is partly mediated by job demands and resources. Thus the construct of health-orientation may prove worthy of further exploration. For practical conclusions, this study provides support for researching not different leadership styles with very specific facets, but a general orientation towards health, which can be implemented into coaching and consulting sessions for organizations.


Assuntos
Liderança , Organizações , Feminino , Humanos , Masculino , Análise Multinível
11.
BMC Public Health ; 21(1): 741, 2021 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-33865354

RESUMO

BACKGROUND: The COVID-19 crisis has radically changed the way people live and work. While most studies have focused on prevailing negative consequences, potential positive shifts in everyday life have received less attention. Thus, we examined the actual and perceived overall impact of the COVID-19 crisis on work and private life, and the consequences for mental well-being (MWB), and self-rated health (SRH) in German and Swiss employees. METHODS: Cross-sectional data were collected via an online questionnaire from 2118 German and Swiss employees recruited through an online panel service (18-65 years, working at least 20 h/week, various occupations). The sample provides a good representation of the working population in both countries. Using logistic regression, we analyzed how sociodemographic factors and self-reported changes in work and private life routines were associated with participants' perceived overall impact of the COVID-19 crisis on work and private life. Moreover, we explored how the perceived impact and self-reported changes were associated with MWB and SRH. RESULTS: About 30% of employees reported that their work and private life had worsened, whereas about 10% reported improvements in work and 13% in private life. Mandatory short-time work was strongly associated with perceived negative impact on work life, while work from home, particularly if experienced for the first time, was strongly associated with a perceived positive impact on work life. Concerning private life, younger age, living alone, reduction in leisure time, and changes in quantity of caring duties were strongly associated with perceived negative impact. In contrast, living with a partner or family, short-time work, and increases in leisure time and caring duties were associated with perceived positive impact on private life. Perceived negative impact of the crisis on work and private life and mandatory short-time work were associated with lower MWB and SRH. Moreover, perceived positive impact on private life and an increase in leisure time were associated with higher MWB. CONCLUSION: The results of this study show the differential impact of the COVID-19 crisis on people's work and private life as well as the consequences for MWB and SRH. This may inform target groups and situation-specific interventions to ameliorate the crisis.


Assuntos
COVID-19/psicologia , Saúde Mental , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Alemanha , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Suíça , Local de Trabalho , Adulto Jovem
12.
J Med Internet Res ; 23(4): e27121, 2021 04 02.
Artigo em Inglês | MEDLINE | ID: mdl-33632675

RESUMO

BACKGROUND: Work stress affects individual health and well-being. These negative effects could be mitigated through regular monitoring of employees' stress. Such monitoring becomes even more important as the digital transformation of the economy implies profound changes in working conditions. OBJECTIVE: The goal of this study was to investigate the association between computer mouse movements and work stress in the field. METHODS: We hypothesized that stress is associated with a speed-accuracy trade-off in computer mouse movements. To test this hypothesis, we conducted a longitudinal field study at a large business organization, where computer mouse movements from regular work activities were monitored over 7 weeks; the study included 70 subjects and 1829 observations. A Bayesian regression model was used to estimate whether self-reported acute work stress was associated with a speed-accuracy trade-off in computer mouse movements. RESULTS: There was a negative association between stress and the two-way interaction term of mouse speed and accuracy (mean -0.32, 95% highest posterior density interval -0.58 to -0.08), which means that stress was associated with a speed-accuracy trade-off. The estimated association was not sensitive to different processing of the data and remained negative after controlling for the demographics, health, and personality traits of subjects. CONCLUSIONS: Self-reported acute stress is associated with computer mouse movements, specifically in the form of a speed-accuracy trade-off. This finding suggests that the regular analysis of computer mouse movements could indicate work stress.


Assuntos
Movimento , Desempenho Psicomotor , Teorema de Bayes , Computadores , Humanos , Motivação
13.
Health Promot Int ; 35(5): 1168-1179, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31711151

RESUMO

Sense of coherence (SoC) has been identified as an important health resource and is associated with various health-related outcomes, especially perceived health and mental health. SoC has also been found to be relevant in the work context. Our study examined whether job resources, such as autonomy or social support, can contribute to the development of SoC. We also examined the role of the setting-specific work-related sense of coherence (Work-SoC) as well as reciprocal relationships between the three variables. Participants (941) from Germany, Switzerland and Austria completed our questionnaires at three waves of data collection. Structural equation modeling was used to identify the best fitting model and interpret the relationships between variables. Our first hypothesis that job resources predict Work-SoC and that Work-SoC predicts SoC was confirmed. We also found support for our second hypothesis that SoC predicts Work-SoC and that Work-SoC predicts job resources. The indirect effects through Work-SoC were only marginally significant in both directions. Our findings illustrate complex and multidirectional relationships between the variables. Job resources seem to contribute to the strengthening of Work-SoC, which seems to set in motion a gain cycle of improved job resources, which again contribute to a higher Work-SoC. Over time, this might contribute to strengthening general SoC. However, our findings showed that SoC was highly stable over the observed 3-month interval, limiting the effect any other variable could exert on it. Future research should further examine the mechanisms and timeframes over which a setting-specific SoC contributes to the development of overall SoC.


Assuntos
Senso de Coerência , Áustria , Alemanha , Humanos , Inquéritos e Questionários , Suíça
14.
J Interprof Care ; 34(2): 211-217, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31329001

RESUMO

The relevance of interprofessional collaboration (IPC) is widely acknowledged. Given the lack of a fully validated instrument in the German language for measuring the level of IPC, we built upon the current, albeit psychometrically weak, German-language version of the instrument to devise a new version with improved wording and for subsequent psychometric testing. In a tertiary hospital in German-speaking Switzerland, 160 physicians and 374 nurses completed the revised Collaborative Practice Scales in German (CPS-G) and additional scales regarding positive and negative activation at work and regarding job demands and job resources. A confirmatory factor analysis of the CPS-G was performed, and internal consistency estimates were computed. Partial correlations between the CPS-G and the additional scales were examined for criterion validity. The model fit of the CPS-G was good for physicians (χ2/df = 2.38, p < .001; CFI = .923; RMSEA = .051, 90%-CI (0.037-0.065)) and moderate for nurses (χ2/df = 5, p < .001; CFI = .919; RMSEA = .087, 90%-CI (0.072-0.102)) supporting the two-factor structure of the original English version. Reliability was acceptable in all sub-scales for physicians (inclusion, α = 0.79; consensus, α = 0.80) and nurses (assertiveness, α = 0.77; understanding α = 0.82). As expected, the CPS-G physicians' subscales correlated positively with positive activation and job resources and negatively with negative activation and job demands, albeit not always statistically significantly. Similar correlations were found with the CPS-G nurses' subscales other than in one instance. The CPS-G showed good construct and criterion validity and acceptable internal consistency. It consequently represents a valid instrument ready for application to measure the level of interprofessional collaboration between nurses and physicians in acute care settings.


Assuntos
Comportamento Cooperativo , Relações Interprofissionais , Enfermeiras e Enfermeiros/psicologia , Médicos/psicologia , Inquéritos e Questionários/normas , Adulto , Atitude do Pessoal de Saúde , Comunicação , Feminino , Processos Grupais , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Comportamento Social , Suíça , Centros de Atenção Terciária , Tradução
15.
J Surg Res ; 239: 92-97, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30822696

RESUMO

BACKGROUND: In recent years, laparoscopic liver resection has elicited growing attention as a safe procedure for various forms of hepatic resection. In the context of an aging population, this study aims to evaluate outcomes in elderly patients (>70 y) compared with younger patients (≤70 y). METHODS: All consecutive patients undergoing minimally invasive liver resections between December 2013 and January 2018 at the Department of Surgery, Charité-Universitätsmedizin Berlin, were included in this analysis. Patients' characteristics, such as body mass index, American Society of Anesthesiologists classification, as well as underlying liver disease and function, were examined and the perioperative outcomes of patients aged >70 y (group 1; G1) contrasted with patients aged ≤ 70 y (group 2; G2). RESULTS: Of 250 patients, 67 were >70 y old (G1) and 183 were ≤70 y old (G2). Patients in G1 were characterized by a higher body mass index (27.6 kg/m2versus 24.9 kg/m2; P = 0.004) and impaired physical states (American Society of Anesthesiologists score III/IV; 60% versus 37%; P = 0.002) when compared with group 2. G1 also exhibited higher rates of primary and secondary hepatic malignancies (G1: n = 62; 92.5%; G2: n = 115, 62.8%; P = 0.031) in addition to higher rates of cirrhosis (G1: n = 30, 44.8%; G2: n = 38, 20.8%; P = <0.001). The rate of major complications (Dindo-Clavien grade ≥ III) was similar between both groups (P = 0.58), with no differences regarding resection extent (P = 0.469). No difference was evident with regard to the median intensive care unit (median 1 versus 1 d; range, G1, 0-8 d, G2, 0-23 d; P = 0.1). However, we observed a significant longer hospital stay in G1 of 1 d (median 8 versus 9 d; G1 range: 4-35 d: G2 range: 4-59 d; P = 0.015). CONCLUSIONS: Minimally invasive liver resection is a feasible and safe procedure in elderly patients despite this age group exhibiting a higher rate of primary and secondary malignancy and cirrhosis, as well as an overall more severely compromised physical health when compared with patients under the age of 70 y. Therefore, it stands to reason that patients in poorer general health might particularly benefit from a minimally invasive approach.


Assuntos
Hepatectomia/efeitos adversos , Laparoscopia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Sistema Biliar/cirurgia , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Criança , Neoplasias Colorretais/patologia , Estudos de Viabilidade , Feminino , Hepatectomia/métodos , Humanos , Laparoscopia/métodos , Tempo de Internação/estatística & dados numéricos , Fígado/patologia , Fígado/cirurgia , Cirrose Hepática/cirurgia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Adulto Jovem
16.
Scand J Public Health ; 46(7): 711-717, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28825350

RESUMO

AIM: The aim of this study was to investigate the psychometric properties of the Norwegian version of the work-related sense of coherence scale, which measures the perceived comprehensibility, manageability, and meaningfulness of an individual's current work situation. METHODS: Factorial validity, convergent and discriminant validity of the factors, as well as scale reliability were tested with confirmatory factor analyses among two samples of employees in higher education institutions ( N = 6951) and nursing homes ( N = 558). Factorial invariance across occupational groups was also investigated. RESULTS: A modified three-factor structure was shown to be valid and reliable in both samples and invariant across occupational groups. However, problems were detected regarding the discriminant validity between the factors comprehensibility and manageability. CONCLUSIONS: The Norwegian version of the work-related sense of coherence scale seems to have good properties. Further development is needed to better distinguish between the comprehensibility and manageability dimensions.


Assuntos
Senso de Coerência , Inquéritos e Questionários , Trabalho/psicologia , Adolescente , Adulto , Idoso , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Psicometria , Reprodutibilidade dos Testes , Adulto Jovem
17.
Pflege ; 30(1): 29-38, 2017 01.
Artigo em Alemão | MEDLINE | ID: mdl-27808659

RESUMO

Background: Due to scarce resources in health care, staff deployment has to meet the demands. To optimise skill-grade-mix, a Swiss University Hospital initiated a project based on principles of Lean Management. The project team accompanied each participating nursing department and scientifically evaluated the results of the project. Aim: The aim of this qualitative sub-study was to identify critical success factors of this project. Method: In four focus groups, participants discussed their experience of the project. Recruitment was performed from departments assessing the impact of the project retrospectively either positive or critical. In addition, the degree of direct involvement in the project served as a distinguishing criterion. Results: While the degree of direct involvement in the project was not decisive, conflicting opinions and experiences appeared in the groups with more positive or critical project evaluation. Transparency, context and attitude proved critical for the project's success. Conclusions: Project managers should ensure transparency of the project's progress and matching of the project structure with local conditions in order to support participants in their critical or positive attitude towards the project.


Assuntos
Competência Clínica/economia , Alocação de Recursos para a Atenção à Saúde/economia , Alocação de Recursos para a Atenção à Saúde/organização & administração , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/organização & administração , Equipe de Enfermagem/economia , Equipe de Enfermagem/organização & administração , Atitude do Pessoal de Saúde , Redução de Custos/economia , Redução de Custos/métodos , Educação/organização & administração , Grupos Focais , Hospitais Universitários/economia , Hospitais Universitários/organização & administração , Humanos , Inovação Organizacional/economia , Estudos Retrospectivos , Suíça
18.
Carcinogenesis ; 36(3): 400-11, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25653236

RESUMO

Salicylic acid and anthocyanidins are known as plant-derived antioxidants, but also can provoke paradoxically seeming prooxidant effects in vitro. These prooxidant effects are connected to the potential of salicylic acid and anthocyanidins to induce apoptosis selectively in tumor cells in vitro and to inhibit tumor growth in animal models. Several epidemiological studies have shown that salicylic acid and its prodrug acetylsalicylic acid are tumor-preventive for humans. The mechanism of salicylic acid- and anthocyanidin-dependent antitumor effects has remained enigmatic so far. Extracellular apoptosis-inducing reactive oxygen species signaling through the NO/peroxynitrite and the HOCl signaling pathway specifically induces apoptosis in transformed cells. Tumor cells have acquired resistance against intercellular reactive oxygen species signaling through expression of membrane-associated catalase. Here, we show that salicylic acid and anthocyanidins inactivate tumor cell protective catalase and thus reactive apoptosis-inducing intercellular reactive oxygen species signaling of tumor cells and the mitochondrial pathway of apoptosis Salicylic acid inhibits catalase directly through its potential to transform compound I of catalase into the inactive compound II. In contrast, anthocyanidins provoke a complex mechanism for catalase inactivation that is initiated by anthocyanidin-mediated inhibition of NO dioxygenase. This allows the formation of extracellular singlet oxygen through the reaction between H(2)O(2) and peroxynitrite, amplification through a caspase8-dependent step and subsequent singlet oxygen-mediated inactivation of catalase. The combination of salicylic acid and anthocyanidins allows for a remarkable synergistic effect in apoptosis induction. This effect may be potentially useful to elaborate novel therapeutic approaches and crucial for the interpretation of epidemiological results related to the antitumor effects of secondary plant compounds.


Assuntos
Antocianinas/farmacologia , Catalase/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Ácido Salicílico/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Apoptose/efeitos dos fármacos , Linhagem Celular Tumoral/efeitos dos fármacos , Membrana Celular/efeitos dos fármacos , Sinergismo Farmacológico , Ativação Enzimática/efeitos dos fármacos , Humanos , Ácido Peroxinitroso/metabolismo , Transdução de Sinais/efeitos dos fármacos , Oxigênio Singlete/metabolismo
19.
Biol Chem ; 396(12): 1339-56, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26140730

RESUMO

Oncogenic transformation is dependent on activated membrane-associated NADPH oxidase (NOX). However, the resultant extracellular superoxide anions are also driving the NO/peroxynitrite and the HOCl pathway, which eliminates NOX-expressing transformed cells through selective apoptosis induction. Tumor progression is dependent on dominant interference with intercellular apoptosis-inducing ROS signaling through membrane-associated catalase, which decomposes H2O2 and peroxynitrite and oxidizes NO. Particularly, the decomposition of extracellular peroxynitrite strictly requires membrane-associated catalase. We utilized small interfering RNA (siRNA)-mediated knockdown of catalase and neutralizing antibodies directed against the enzyme in combination with challenging H2O2 or peroxynitrite to determine activity and localization of catalase in cells from three distinct steps of multistage oncogenesis. Nontransformed cells did not generate extracellular superoxide anions and only showed intracellular catalase activity. Transformed cells showed superoxide anion-dependent intercellular apoptosis-inducing ROS signaling in the presence of suboptimal catalase activity in their membrane. Tumor cells exhibited tight control of intercellular apoptosis-inducing ROS signaling through a high local concentration of membrane-associated catalase. These data demonstrate that translocation of catalase to the outside of the cell membrane is already associated with the transformation step. A strong local increase in the concentration of membrane-associated catalase is achieved during tumor progression and is controlled by tumor cell-derived H2O2 and by transglutaminase.


Assuntos
Catalase/metabolismo , Transformação Celular Neoplásica , Peróxido de Hidrogênio/toxicidade , Animais , Apoptose/efeitos dos fármacos , Catalase/genética , Bovinos , Linhagem Celular Transformada , Eritrócitos/enzimologia , Humanos , Fígado/enzimologia , Membranas/enzimologia , NADPH Oxidases/metabolismo , Transporte Proteico , Espécies Reativas de Oxigênio , Transdução de Sinais
20.
J Public Health (Oxf) ; 37(1): 89-96, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24687243

RESUMO

BACKGROUND: The World Health Organization recommends uniform comprehensive smoking bans in public places. In Switzerland, regulations differ between various areas and are mostly incomplete for hospitality venues. As ambiguous regulations offer more leeway for implementation, we evaluated the Swiss regulations with respect to their effects on implementation, acceptance and compliance among hospitality workers. METHODS: In our longitudinal study, a standardized, self-administered questionnaire was mailed to a sample of 185 hospitality workers before and 4-6 month after the smoking ban came into effect. The matched longitudinal sample comprised 71 participants (repeated response rate 38.4%). We developed a seven-item acceptance scale. Logistic regressions were performed to explore the factors associated with acceptance. RESULTS: Acceptance of smoking bans was influenced by smoking status and perceived annoyance with second-hand smoke in private. Although not statistically significant (P = 0.09), we found some indications that post-ban acceptance increased in an area with strict regulations, whereas it decreased in two areas with less stringent regulations. CONCLUSIONS: Tobacco bans in Swiss hospitality venues are still in a period of consolidation. The incomplete nature of the law may also have had a negative impact on the development of greater acceptance.


Assuntos
Poluição do Ar em Ambientes Fechados/legislação & jurisprudência , Poluição do Ar em Ambientes Fechados/prevenção & controle , Exposição Ocupacional/legislação & jurisprudência , Exposição Ocupacional/prevenção & controle , Prevenção do Hábito de Fumar , Fumar/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Adulto , Idoso , Feminino , Fidelidade a Diretrizes , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Restaurantes/legislação & jurisprudência , Inquéritos e Questionários , Suíça , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Uso de Tabaco/legislação & jurisprudência , Local de Trabalho/legislação & jurisprudência
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