RESUMEN
Idle time at work is a phase of involuntary downtime during which employees experience that they cannot carry out their work tasks. In contrast to breaks, interruptions, procrastination, or withdrawal behavior, employees cannot work because of the absence of work-related tasks. Based on action regulation theory, we develop an integrative conceptual model on the antecedents and consequences of the subjective experience of idle time. We propose that work constraints (i.e., regulation problems) have negative effects on occupational well-being and task performance, and that these effects are mediated by subjective idle time. The strength of these effects is further assumed to be influenced by individuals' use of proactive (i.e., prevention) and adaptive (i.e., coping) strategies. Results of a supplemental qualitative study, for which we interviewed 20 employees from different occupations, provided preliminary support for the propositions. Finally, we develop theory on how individual, situational, and organizational characteristics may influence the proposed effects on and of idle time. Overall, this conceptual development paper contributes to a better theoretical understanding of idle time at work by extending its definition and applying action regulation theory to this practically important phenomenon.
Asunto(s)
ADN (Citosina-5-)-Metiltransferasas/genética , Trasplante de Células Madre Hematopoyéticas/métodos , Leucemia Mieloide Aguda/genética , Mutación , Adulto , Anciano , ADN Metiltransferasa 3A , Humanos , Leucemia Mieloide Aguda/terapia , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Acondicionamiento Pretrasplante/métodos , Resultado del TratamientoRESUMEN
In acute myeloid leukemia (AML), leukemia-initiating cells exist within the CD34+/CD38- cell compartment. They are assumed to be more resistant to chemotherapy, enriched in minimal residual disease cell populations, and responsible for relapse. Here we evaluated clinical and biological associations and the prognostic impact of a high diagnostic CD34+/CD38- cell burden in 169 AML patients receiving an allogeneic stem cell transplantation in complete remission. Here, the therapeutic approach is mainly based on immunological graft-versus-leukemia effects. Percentage of bone marrow CD34+/CD38- cell burden at diagnosis was measured using flow cytometry and was highly variable (median 0.5%, range 0%-89% of all mononuclear cells). A high CD34+/CD38- cell burden at diagnosis associated with worse genetic risk and secondary AML. Patients with a high CD34+/CD38- cell burden had shorter relapse-free and overall survival which may be mediated by residual leukemia-initiating cells in the CD34+/CD38- cell population, escaping the graft-versus-leukemia effect after allogeneic transplantation. Evaluating the CD34+/CD38- cell burden at diagnosis may help to identify patients at high risk of relapse after allogeneic transplantation. Further studies to understand leukemia-initiating cell biology and develop targeting therapies to improve outcomes of AML patients are needed.
