¿Está la virtud en el punto medio? La incertidumbre del CIN2 y el papel del VPH / Is virtue at the midpoint? The uncertainty of CIN2 and the role of HPV

Objetivo: La biopsia guiada por colposcopia (BGC) marca el manejo de la neoplasia intraepitelial cervical. El objetivo de este estudio fue evaluar la concordancia de los resultados entre la BGC y la escisión amplia de la zona de transformación (LLETZ, large loop excision of the transformation zone), y la utilidad del genotipado del virus del papiloma humano (VPH) para seleccionar a las pacientes con riesgo de lesión intraepitelial escamosa de alto grado/neoplasia intraepitelial cervical 3 (HSIL/CIN3). Método: Se compararon los resultados de la BGC y de la LLETZ, siendo esta última el método de referencia. Se evaluó la relación del genotipo del VPH con el diagnóstico final de HSIL/CIN3. Resultados: La precisión de la biopsia comparada con LLETZ fue del 61,4%. La tasa de concordancia fue del 64,4% para CIN1, del 31,4% para CIN2 y del 77,4% para CIN3. La tasa global de sobrediagnóstico fue del 18,68% y la de subdiagnóstico del 19,89%. En mujeres menores de 30 años, la concordancia fue del 62,79% (CIN1 65%, CIN2 39,58% y CIN3 73,08%), la tasa de sobrediagnóstico del 22,67% y la tasa de subdiagnóstico del 15,11%. La infección por VPH16 tuvo una odds ratio de 3,86 para el diagnóstico final de HSIL/CIN3+. Conclusiones: El diagnóstico de CIN2 por BGC parece insuficiente para seleccionar a las pacientes para tratamiento escisional, principalmente en mujeres jóvenes. El hallazgo de VPH16 es un factor de riesgo de HSIL/CIN3+ independientemente del resultado de la biopsia.

Objective: Colposcopy-guided biopsy (CGB) is a basic tool for the management of cervical intraepithelial neoplasia. The aim of this study is to evaluate the concordance of results between CGB and large loop excision of the transformation zone (LLETZ), and the usefulness of human papillomavirus (HPV) genotyping to select patients at risk of H-SIL/CIN3. Method: The results of colposcopy-guided biopsy and LLETZ were compared, with LLETZ being the gold standard. The relationship of HPV genotype to the final diagnosis of CIN3 was assessed. Results: The accuracy of CGB compared to LLETZ was 61.4%. The concordance rate was 64.4% for CIN1, 31.4% for CIN2 and 77.4% for CIN3. The overall overdiagnosis rate was 18.68% and underdiagnosis rate was 19.89%. In women under 30 years of age the concordance rate was 62.79% (CIN1 65%, CIN2 39.58% and CIN3 73.08%), and the rate of overdiagnosis and underdiagnosis was 22.67% and 15.11%, respectively. HPV16 infection had an odds ratio of 3.86 for the final diagnosis of CIN3+ and the result was significant regardless of the biopsy result. Conclusions: The CGB result as CIN2 is inaccurate and seems insufficient to select patients for excisional treatment, mainly in young women. HPV16 infection is a risk factor for CIN3+ regardless of the colposcopy-guided biopsy result.

Self-care at Work Matters: How Job and Personal Resources mediate between Self-Care and Psychological Well-being / El autocuidado en el trabajo es importante: como los recursos personales y del puesto median entre el autocuidado y el bienestar psicológico

The aim of this study is to analyze the relationship between self-care activities (mindfulness and physical exercise) and the use of personal and work resources and their relationship with well-being. The sample consisted of 294 workers recruited from 20 organizations from different socioeconomic sectors in Spain. Results showed that mindfulness is positively related to well-being through the mediating role of work resources and personal resources. However, whereas personal resources showed a full mediating role in the hypothesized model, work resources did not show a significant relationship with mindfulness. Finally, results showed positive and significant relationships between the mindfulness x physical exercise interaction and all the dependent variables, and also the interaction between physical exercise and mindfulness had a significant effect on each of these three dependent variables.(AU)

El objetivo de este estudio es analizar la relación entre las actividades de autocuidado (mindfulness y ejercicio físico) y el uso de recursos personales y laborales y su relación con el bienestar. La muestra está formada por 294 trabajadores contratados de 20 organizaciones de diferentes sectores socioeconómicos en España. Los resultados muestran que el mindfulness se relaciona positivamente con el bienestar a través del papel mediador de los recursos laborales y personales. Sin embargo, mientras que los últimos muestran un papel mediador completo en el modelo hipotético, los primeros no muestran una relación significativa con el mindfulness. Finalmente, los resultados presentan una relación positiva y significativa entre la interacción mindfulness-ejercicio físico y todas las variables dependiente; igualmente la interacción entre ejercicio físico y mindfulness tiene un efecto significativo en cada una de estas tres variables dependientes.(AU)

Group Positive Affect and Beyond: An Integrative Review and Future Research Agenda.

Group positive affect is defined as homogeneous positive affect among group members that emerges when working together. Considering that previous research has shown a significant relationship between group positive affect and a wide variety of group outcomes (e.g., behaviors, wellbeing, and performance), it is crucial to boost our knowledge about this construct in the work context. The main purpose is to review empirical research, to synthesize the findings and to provide research agenda about group positive affect, in order to better understand this construct. Through the PsycNET and Proquest Central databases, an integrative review was conducted to identify articles about group positive affect published between January 1990 and March 2019. A total of 44 articles were included and analyzed. Finding suggests that scholars have been more interested in understanding the outcomes of group positive affect and how to improve the productivity of groups than in knowing what the antecedents are. A summary conclusion is that group positive affect is related to leadership, job demands, job resources, diversity/similarity, group processes, and contextual factors, all of which influence the development of several outcomes and different types of wellbeing at the individual and group levels. However, with specific combinations of other conditions (e.g., group trust, negative affect, and interaction), high levels of group positive affect could cause harmful results. Conclusions shed light on group positive affect research and practice and might help Human Resources professionals to initiate empirically-based strategies related to recruitment, group design and leadership training.

Our boss is a good boss!. Cross-level effects of transformational leadership on work engagement in service jobs / ¡Nuestro jefe es un buen jefe!. Los efectos transnivel del liderazgo transformacional sobre el engagement en el trabajo en puesto de servicio

In service work, emotional demands are important due to their effects on social interactions with customers, patients, pupils, etc. The purpose of this study is to examine how emotional demands and leadership are related to engagement of the team members. The sample consists of 1,079 employees nested in 124 work teams from four Spanish public organizations. Multilevel analyses showed: 1) a positive effect of emotional demands on work engagement, 2) a cross-level effect of leadership on work engagement, and 3) a cross-level moderation effect of leadership on the relationship between emotional demands and work engagement. Results suggest that shared perceptions of leadership by teams affect their work engagement levels directly and through an interaction effect on the emotional demands-engagement relationship. When employees feel emotionally overloaded, their leaders can relieve this negative impact on their levels of work engagement. Practical and theoretical implications are presented

En el trabajo de servicio, las demandas emocionales son importantes debido a sus efectos sobre las interacciones sociales con clientes, pacientes, alumnos, etc. El propósito de este estudio es examinar cómo se relacionan las demandas emocionales y el liderazgo con el engagement en el trabajo de los miembros del equipo. La muestra consiste en 1,079 empleados anidados en 124 equipos de trabajo de cuatro organizaciones públicas españolas. Los análisis multinivel mostraron: 1) un efecto positivo de las demandas emocionales sobre el engagement en el trabajo, 2) un efecto, a través de los niveles, del liderazgo sobre el engagement en el trabajo y 3) un efecto de moderación, a través de los niveles, del liderazgo sobre la relación entre las demandas emocionales y el engagement en el trabajo. Los resultados sugieren que las percepciones compartidas sobre el liderazgo que tiene el equipo afectan a sus niveles de engagement en el trabajo directamente y a través de un efecto de interacción sobre la relación demandas emocionales-engagement. Cuando los empleados se sienten emocionalmente sobrecargados, sus líderes pueden aliviar este impacto negativo en sus niveles de engagement en el trabajo. Se presentan implicaciones teóricas y prácticas

Epidemiological Study and Cost Analysis of Suicide in Spain: Over 100 Years of Evolution.

OBJECTIVE: Society has changed during the last 100 years of evolution; however, some problems, such as suicide, remain. The objective here is to carry out a long-term epidemiological study in Spain, and to calculate the social and labor costs of 2016. METHOD: Epidemiological data were obtained from official data obtained between 1906 - 2016. The calculation of the costs of suicides included the social costs and the costs of production losses (labor costs). The latter were obtained by the human capital method, taking into account the unemployment rate. The economic growth rate stood at 2.6% per year. RESULTS: The suicide rate was between 4 and 8% per year. The evolution during these 100 years had three periods. Until 1940 it had slight increases, and then it decreased until 1980 and, subsequently, the rate increased until it reached almost 8% in 2016. The costs of the suicides were 2,167 million € of economic losses for society, or its equivalent of 607 € for suicide. CONCLUSIONS: Public health policies aimed at the prevention of suicide should be increased, and supported by the economic costs they mean for society.

Coaching-Based Leadership Intervention Program: A Controlled Trial Study.

In spite of the potential benefits that coaching-based leadership interventions can bring to organizations, basic questions remain about their impact on developing coaching skills and increasing psychological capital (PsyCap), work engagement and in- and extra-role performance. In a controlled trial study, 41 executives and middle managers (25 in the experimental group and 16 in the waiting-list control group) from an automotive sector company in Spain received pre-assessment feedback, a coaching-based leadership group workshop, and three individual executive coaching sessions over a period of 3 months. The intervention program used a strengths-based approach and the RE-GROW model, and it was conducted by executive coaching psychologists external to the organization. Participants (N = 41) and their supervisors (N = 41) and employees (N = 180) took part in a pre-post-follow up 360-degree assessment during the research period. Quantitative data were analyzed using Analyses of Variance (ANOVA) with a 2 × 2 design, paired-samples t-tests, and univariate analyses between groups. Results indicated that the intervention program was successful in increasing the participants' coaching-based leadership skills, PsyCap, work engagement, and in- and extra-role performance. Qualitative measures were also applied, and results from individual responses provided additional support for the study hypotheses. Regarding practical implications, the results suggest that the Coaching-based Leadership Intervention Program can be valuable as an applied positive intervention to help leaders develop coaching skills and enhance well-being and optimal functioning in organizations.

Analyzing the risk factors influencing surgical site infections: the site of environmental factors.

BACKGROUND: Addressing surgical site infection (SSI) is accomplished, in part, through studies that attempt to clarify the nature of many essential factors in the control of SSI. We sought to examine the link between multiple risk factors, including environmental factors, and SSI for prevention management. METHODS: We conducted a longitudinal prospective study to identify SSIs in all patients who underwent interventions in 2014 in 8 selected hospitals on the Mediterranean coast of Spain. Risk factors related to the operating theatre included level of fungi and bacterial contamination, temperature and humidity, air renewal and differential air pressure. Patient-related variables included age, sex, comorbidity, nutrition level and transfusion. Other factors were antibiotic prophylaxis, electric versus manual shaving, American Society of Anaesthesiologists physical status classification, type of intervention, duration of the intervention and preoperative stay. RESULTS: Superficial SSI was most often associated with environmental factors, such as environmental contamination by fungi (from 2 colony-forming units) and bacteria as well as surface contamination. When there was no contamination in the operating room, no SSI was detected. Factors that determined deep and organ/space SSI were more often associated with patient characteristics (age, sex, transfusion, nasogastric feeding and nutrition, as measured by the level of albumin in the blood), type of intervention and preoperative stay. Antibiotic prophylaxis and shaving with electric razor were protective factors for both types of infection, whereas the duration of the intervention and the classification of the intervention as "dirty" were shared risk factors. CONCLUSION: Our results suggest the importance of environmental and surface contamination control to prevent SSI.

CONTEXTE: La lutte contre les infections du site opératoire (ISO) passe entre autres par des études visant à clarifier la nature de nombreux facteurs essentiels de contrôle. Nous avons donc cherché à examiner le lien entre divers facteurs de risque, notamment de nature environnementale, et les ISO, dans une optique de prévention. MÉTHODES: Nous avons mené une étude longitudinale prospective afin de recenser les ISO parmi tous les patients ayant subi une intervention chirurgicale en 2014 dans 8 hôpitaux de la côte méditerranéenne de l'Espagne. Nous nous sommes penchés sur les facteurs de risque liés au bloc opératoire, soit le degré de contamination fongique et bactérienne, la température et l'humidité ambiantes, le renouvellement de l'air et la pression d'air différentielle, et sur les variables liées aux patients, soit l'âge, le sexe, la comorbidité, l'état nutritionnel et le fait d'avoir reçu ou non une transfusion. Les autres facteurs pris en compte ont été l'antibioprophylaxie, le type de rasage (électrique ou manuel), la santé physique d'après la classification de l'American Society of Anesthesiologists, le type et la durée d'intervention et le séjour préopératoire. RÉSULTATS: Les ISO superficielles étaient le plus souvent associées à des facteurs environnementaux, comme la contamination fongique (par 2 unités formant colonies) et bactérienne ou la contamination de surface. En absence de contamination du bloc opératoire, il n'y a eu aucune ISO. Les facteurs déterminants d'une ISO profonde ou touchant un organe ou une cavité étaient plus souvent associés aux caractéristiques du patient (âge, sexe, transfusion, alimentation par sonde nasogastrique et état nutritionnel mesuré par la concentration sanguine d'albumine), au type d'intervention et au séjour préopératoire. Enfin, l'antibioprophylaxie et le rasage électrique étaient des facteurs de protection contre les 2 types d'infection, tandis que la durée de l'intervention et la catégorisation de l'intervention comme étant « sale ¼ étaient des facteurs de risques communs. CONCLUSION: Nos résultats indiquent que le contrôle de la contamination environnementale et de surface est important pour prévenir les ISO.

Aportaciones desde la psicología organizacional positiva para desarrollar organizaciones saludables y resilientes / Contributions from positive organizational psychology to develop healthy and resilient organizations

El objetivo de este trabajo es presentar los principales resultados obtenidos por el equipo de investigación WANT Prevención Psicosocial y Organizaciones Saludables sobre el Modelo HERO (HEalthy & Resilient Organizations) para conceptualizar, evaluar e intervenir en el desarrollo de personas, grupos y organizaciones positivas. En primer lugar, se presenta el modelo teórico, metodología y herramientas para la evaluación de HEROs. Estas herramientas se administran a nivel colectivo y se aplican a diferentes stakeholders o agentes clave en la organización: entrevistas a dirección, y cuestionarios dirigidos a empleados distribuidos en grupos naturales, supervisores, y clientes. En segundo lugar, se presentan los principales resultados obtenidos de la aplicación de la metodología HERO en diferentes contextos socioeconómicos. En la última parte del trabajo se muestran distintas opciones de intervenciones positivas, así como recientes experiencias de intervención HERO que se han llevado a cabo desde nuestro equipo bajo el paradigma de la Psicología Organizacional Positiva

The aim of the current paper is to show the main results obtained by the WANT Research team on the HERO Model (HEalthy & Resilient Organizations) to conceptualize, evaluate and intervene in the development of healthy and positive people, groups and organizations. First, we present the theoretical model, methodology and tools to evaluate HEROs. These tools are collectively administered and applied to different stakeholders in the organization: interviews with CEOs, and questionnaires aimed at employees distributed in natural groups, supervisors and clients. Secondly, we present the main results obtained from the application of the HERO methodology in different socio-economic contexts. The last part of the paper is dedicated to highlighting the different options of positive interventions, as well as recent experiences in the HERO’s intervention carried out by WANT based on Positive Organizational Psychology

Individual and group antecedents of job satisfaction: a one-lab multilevel study / Antecedentes individuales y grupales de satisfacción en el trabajo: un estudio multinivel de laboratorio

This study examines the simultaneous effect of individual (selfefficacy) and group variables (cohesion and gender diversity) on satisfaction. A laboratory study was conducted involving 373 college students randomly distributed across 79 small groups, who performed a laboratory task in about five hours. Two-level Hierarchical Linear Modeling (HLM) method was used. Results show the main effect from individual selfefficacy to satisfaction (both level 1), the cross-level effect from group cohesion (level 2) to individual satisfaction (level 1), and the interaction effect between self-efficacy and gender diversity to satisfaction. These results suggest that in a work group, satisfaction has a background in individual and group variables. Group cohesion and gender diversity have important effects on satisfaction. The article concludes with practical strategies and with limitations and suggestions for future research

Este estudio examina el efecto simultaneo de variables individuales (autoeficacia) y grupales (cohesión y diversidad de género) en la satisfacción. Se llevó a cabo un estudio de laboratorio con 373 estudiantes universitarios distribuidos en 79 pequeños grupos, que llevaron a cabo una tarea durante cinco horas. Se utilizaron dos niveles de análisis mediante Modelos Lineales Jerárquicos. Los resultados muestran el efecto principal de la autoeficacia en la satisfacción (ambos de nivel 1) el efecto transnivel de la cohesión grupal (nivel 2) sobre la satisfacción (nivel 1) y un efecto de interacción entre autoeficacia y diversidad de género en la satisfacción. Estos resultados sugieren que en el trabajo en grupo, la satisfacción tiene antecedentes en variables individuales y grupales. La cohesión grupal y el género tienen un importante efecto en la satisfacción. El artículo concluye con estrategias prácticas y limitaciones y sugerencias para futuras investigaciones

How personal resources predict work engagement and self-rated performance among construction workers: a social cognitive perspective.

Traditionally, research focussing on psychosocial factors in the construction industry has focused mainly on the negative aspects of health and on results such as occupational accidents. This study, however, focuses on the specific relationships among the different positive psychosocial factors shared by construction workers that could be responsible for occupational well-being and outcomes such as performance. The main objective of this study was to test whether personal resources predict self-rated job performance through job resources and work engagement. Following the predictions of Bandura's Social Cognitive Theory and the motivational process of the Job Demands-Resources Model, we expect that the relationship between personal resources and performance will be fully mediated by job resources and work engagement. The sample consists of 228 construction workers. Structural equation modelling supports the research model. Personal resources (i.e. self-efficacy, mental and emotional competences) play a predicting role in the perception of job resources (i.e. job control and supervisor social support), which in turn leads to work engagement and self-rated performance. This study emphasises the crucial role that personal resources play in determining how people perceive job resources by determining the levels of work engagement and, hence, their self-rated job performance. Theoretical and practical implications are discussed.

Una mirada más "positiva" a la salud ocupacional desde la psicología organizacional positiva en tiempos de crisis: equipo de investigación wont / A more "positive" look at occupational helath from positive organizational psychology during crisis times: Contributions form the wont research tema

El objetivo de este trabajo es presentar una síntesis de las principales aportaciones prácticas basadas en la evidencia científica que el equipo WoNT de la Universitat Jaume I ha llevado a cabo en materia de Psicología de la Salud Ocupacional y Psicología Organizacional Positiva en contextos de crisis. En concreto, se presenta la metodología RED (Recursos-Experiencias-Demandas) para la evaluación de riesgos y daños psicosociales, y estados emocionales positivos. Además, se muestra una metodología heurística basada en la Psicología Organizacional Positiva, que apuesta por la evaluación e intervención en Organizaciones Saludables y Resilientes (HEROs) (HEalthy & Resilient Organizations) como una estrategia para ofrecer resultados más cercanos a la realidad laboral y social de la crisis

The objective of the current paper is to summarize the main evidence-based practical contributions of the WoNT team from Universitat Jaume I carried out on Occupational Health Psychology and Positive Organizational Psychology in crises settings. Specifically, we show the RED (Resources-Experiences- Demands) methodology that allows assessing risks and psychosocial damages, and emotional positive states. Furthermore, we also propose a heuristic methodology that, focused on Positive Psychology, facilitates the evaluation and intervention of HEROs (HEalthy & Resilient Organizations) as a way to adapt to the occupational and social reality of the crisis

The dark and bright sides of self-efficacy in predicting learning, innovative and risky performances.

The objective of this study is to analyze the different role that efficacy beliefs play in the prediction of learning, innovative and risky performances. We hypothesize that high levels of efficacy beliefs in learning and innovative performances have positive consequences (i.e., better academic and innovative performance, respectively), whereas in risky performances they have negative consequences (i.e., less safety performance). To achieve this objective, three studies were conducted, 1) a two-wave longitudinal field study among 527 undergraduate students (learning setting), 2) a three-wave longitudinal lab study among 165 participants performing innovative group tasks (innovative setting), and 3) a field study among 228 construction workers (risky setting). As expected, high levels of efficacy beliefs have positive or negative consequences on performance depending on the specific settings. Unexpectedly, however, we found no time x self-efficacy interaction effect over time in learning and innovative settings. Theoretical and practical implications within the social cognitive theory of A. Bandura framework are discussed.

The dark and bright sides of self-efficacy in predicting learning, innovative and risky performances

The objective of this study is to analyze the different role that efficacy beliefs play in the prediction of learning, innovative and risky performances. We hypothesize that high levels of efficacy beliefs in learning and innovative performances have positive consequences (i.e., better academic and innovative performance, respectively), whereas in risky performances they have negative consequences (i.e., less safety performance). To achieve this objective, three studies were conducted, 1) a two-wave longitudinal field study among 527 undergraduate students (learning setting), 2) a three-wave longitudinal lab study among 165 participants performing innovative group tasks (innovative setting), and 3) a field study among 228 construction workers (risky setting). As expected, high levels of efficacy beliefs have positive or negative consequences on performance depending on the specific settings. Unexpectedly, however, we found no time × self-efficacy interaction effect over time in learning and innovative settings. Theoretical and practical implications within the social cognitive theory of A. Bandura framework are discussed (AU)

El objetivo de este estudio es analizar el papel de las creencias de eficacia en la predicción del desempeño en situaciones de aprendizaje, innovadoras y arriesgadas. Nuestra hipótesis es que los altos niveles de autoeficacia en situaciones de aprendizaje e innovadoras tienen consecuencias positivas (es decir, un mejor desempeño académico e innovador, respectivamente), mientras que en situaciones de riesgo tienen consecuencias negativas (es decir, menor rendimiento en seguridad). Para lograr este objetivo, se llevaron a cabo tres estudios, 1) un estudio de campo longitudinal de dos tiempos con 527 estudiantes de pregrado (situación de aprendizaje), 2) un estudio de laboratorio longitudinale de tres tiempos con 165 participantes que realizaron tareas innovadoras en grupo (situación de innovación), y 3) un estudio de campo con 228 trabajadores de la construcción (situación de riesgo). Como era de esperar, los altos niveles de autoeficacia tienen consecuencias positivas o negativas en el desempeño en función de la situación o ambiente específico. Inesperadamente, sin embargo, no encontramos efecto de la interacción tiempo × autoeficacia en situaciones de aprendizaje e innovadoras. Se discuten las implicaciones teóricas y prácticas de este estudio en el marco de la teoría social cognitiva de Albert Bandura (AU)

Physical properties, mechanical behavior, and electron microscopy study of a new α-TCP block graft with silicon in an animal model.

This study reports the characterization process and in vivo application of a new block bone graft of α-TCP with silicate in three different percentages in the aim of determining the influence of the silicate. Three groups of cylindrical implants (6 ± 0.01 mm diameter, 8 ± 0.01 mm length) with varying Si composition were studied: A: 3 wt % C(2) S; B: 1.5 wt % C(2) S; C: 100 wt % TCP-0 wt % C(2) S. These were implanted randomly in critical size defects in New Zealand rabbits. X-ray diffraction analysis was performed to determine the crystalline phases of the different compositions. Histomorphometric analysis produced one measurement of bone-to-implant contact. Comparing the α-TCPss ceramics, the trial found improved mechanical properties due to the silicon content in solid solution as well as densification. Previous studies have shown that the mechanical strengths of sintered ceramics correlate to densification as well as grain size and mechanical properties. Because of its mechanical and biological behavior, the study has shown α-TCP with C(2) S to be an alternative to other bone graft substitutes for use in bone reconstructive surgery in the fields of veterinary, medicine, and oral and maxillofacial surgery.

Linking transformational leadership to nurses' extra-role performance: the mediating role of self-efficacy and work engagement.

AIMS: This paper is a report of a social cognitive theory-guided study about the link between supervisors' transformational leadership and staff nurses' extra-role performance as mediated by nurse self-efficacy and work engagement. BACKGROUND: Past research has acknowledged the positive influence that transformational leaders have on employee (extra-role) performance. However, less is known about the psychological mechanisms that may explain the links between transformational leaders and extra-role performance, which encompasses behaviours that are not considered formal job requirements, but which facilitate the smooth functioning of the organization as a social system. METHODS: Seventeen supervisors evaluated nurses' extra-role performance, the data generating a sample consisting of 280 dyads. The nurses worked in different health services in a large Portuguese hospital and the participation rate was 76·9% for nurses and 100% for supervisors. Data were collected during 2009. A theory-driven model of the relationships between transformation leadership, self-efficacy, work engagement and nurses' extra-role performance was tested using Structural Equation Modelling. RESULTS: Data analysis revealed a full mediation model in which transformational leadership explained extra-role performance through self-efficacy and work engagement. A direct relationship between transformational leadership and work engagement was also found. CONCLUSION: Nurses' supervisors with a transformational leadership style enhance different 'extra-role' performance in nurses and this increases hospital efficacy. They do so by establishing a sense of self-efficacy but also by amplifying their levels of engagement in the workplace.

Long-term clinical experience with pure bicarbonate peritoneal dialysis solutions.

OBJECTIVES: The aim of this prospective study was to collect long-term experience in incident peritoneal dialysis (PD) patients treated with pure bicarbonate-buffered PD fluids. METHODS: The metabolic parameters acidosis, acid-base status, adequacy, fluid balance, nutritional markers, calcium, phosphorus, parathyroid hormone (PTH), and general laboratory work and medication were compared between incident PD patients in two groups: one treated with a 34 mmol/L bicarbonate-buffered PD fluid (BIC), the other with a 35 mmol/L lactate-buffered PD fluid (LAC). The observation period included 5 visits from 1 month (visit 1) until 12 months (visit 5) after the start of dialysis treatment. For the descriptive analysis, means and standard deviations were calculated. Student's t-test and linear mixed models were used to compare the two treatment groups. RESULTS: 36 patients were followed for 12 months, 18 in the BIC group and 18 in the LAC group. Statistically significant differences between the groups (at the end of study) were found. In BIC group, venous plasma bicarbonate was 27.4 +/- 2.3 mmol/L, base excess 0.8 +/- 2.2 mmol/L, and pH 7.31 +/- 0.05; in LAC group, venous bicarbonate was 25.9 +/- 2.4 mmol/L, base excess -0.6 +/- 2.1 mmol/L, and pH 7.30 +/- 0.04. No patient from the BIC group needed oral bicarbonate, in contrast to 4 patients in the LAC group. Whereas peritoneal urea and creatinine clearances did not differ between the groups, there was better renal solute clearance in the BIC group, accompanied by better-preserved diuresis at 12 months (1333 +/- 935 mL with BIC vs 839 +/- 556 mL with LAC). The reverse was true for ultrafiltration. CONCLUSIONS: Pure bicarbonate-buffered PD solutions were superior in correcting metabolic acidosis and they allowed omission of oral bicarbonate. The minor ultrafiltration with bicarbonate-buffered PD solutions was counterbalanced by better-preserved residual renal function with these solutions.

Demandas laborales y conductas de afrontamiento: el rol modulador de la autoeficacia profesional / Job demands and coping behaviour: the moderating role of professional self-efficacy

La conducta de afrontamiento es considerada, en el ámbito de la investigación del estrés, como una variable moduladora entre las demandas del trabajo y sus efectos negativos o positivos (ansiedad, satisfacción, etc.). Sin embargo, desde la teoría social cognitiva, las creencias de eficacia juegan un papel modulador entre los estresores o demandas del trabajo y la conducta de afrontamiento. De manera que, en contextos de estrés, las personas con elevado nivel de autoeficacia utilizarán más conductas de afrontamiento activo centradas en la solución del problema, que las personas con niveles menores de autoeficacia. Mediante análisis de regresión múltiple y sobre una muestra de 625 trabajadores españoles de diferentes ocupaciones, en este trabajo se examina el papel que la autoeficacia profesional juega en esta relación, considerando su efecto modulador entre las demandas del trabajo (sobrecarga laboral cuantitativa y conflicto de rol) y conducta de afrontamiento (activa y pasiva). También se ha estudiado el efecto de interacción entre dos demandas laborales (sobrecarga laboral cuantitativa y conflicto de rol) y la eficacia profesional, en donde se muestra que las personas con elevadas creencias de autoeficacia, ante ambas demandas laborales, muestran más conductas de afrontamiento activo o centrado en el problema que las personas con niveles menores de autoeficacia. Las conductas de afrontamiento centradas en el problema se manifiestan cuando existen altas demandas y alto nivel de autoeficacia. Los resultados son discutidos también en el marco del modelo demandas-control de Karasek, cuando el control se sustituye por la autoeficacia (AU)

Job demands and coping behaviour: the moderating role of professional self-efficacy. Coping behaviour is mainly considered in the stress research as a moderator variable between job demands and negative or positive outcomes (i.e. anxiety, satisfaction). However, from the Social Cognitive Theory, self-efficacy beliefs play a moderating role between stressors or job demands and coping behaviours.In that sense, in stressful job settings people with high self-efficacy will behave in a more proactive way using problem centred coping, that people with low self-efficacy. This study examines the moderating role of self-efficacy between job demands (i.e., quantitative overload and role conflict) and coping behaviour (i.e. information seeking, problem centred and ‘wait y see’ coping strategies). Hierarchical regression analysis in a sample of 625 Spanish workers from different occupational fields provides strong evidence for the main assumption of this study, i.e., the moderating role of self-efficacy between job demands and problem centred coping. A three-way interaction effect among overloadX role conflict X self-efficacy was found and so, people with high levels of self-efficacy when job demands are high show more problem centred coping than people with low self-efficacy. In a way, problem centred coping is more used when job demands and self-efficacy are high. In this sense, these results show empirical evidence about the active pole of the Job Demands-Control Model of Karasek, when ‘control’ is changed by ‘self-efficacy’ beliefs (AU)

Burnout en estudiantes universitarios de España y Portugal y su relación con variables académicas / Burnout in university students and their relationship with academic variables

La investigación actual referida al burnout está ampliando su campo de estudio. De las primeras investigaciones centradas en profesionales de ayuda se ha pasado al estudio del burnout en otros profesionales. Por otro lado, la preocupación de las universidades por ofrecer una enseñanza de calidad supone considerar todas las variables implicadas en el proceso enseñanza-aprendizaje y el bienestar de los estudiantes es un elemento clave en este proceso. En este contexto, el objetivo del presente trabajo se centra en el estudio del burnout en estudiantes universitarios de España y Portugal. Una muestra de 1988 estudiantes universitarios de diferentes titulaciones respondieron al cuestionario Maslach Burnout Inventory – Student Survey (Schaufeli, Salanova, González-Romá y Bakker, 2002). Los resultados muestran la existencia de diferencias significativas en las dimensiones de burnout relacionadas con variables sociodemográficas. Al mismo tiempo el burnout se muestra como predictores del desempeño, las expectativas de éxito y la tendencia al abandono (AU)

Bienestar psicológico en estudiantes universitarios: facilitadores y obstaculizadores del desempeño académico / Psychological well-being among university students: facilitators and obstacles of academic performance

La preocupación de las universidades por ofrecer una enseñan-za de calidad supone considerar todas las variables implicadas en el proceso enseñanza-aprendizaje. En este sentido, es importante la identificación de los obstáculos y facilitadores que los estudiantes encuentran en el cumplimiento de sus tareas y la relación de éstos con el bienestar psicológico y desempeño académico. Se realizó una investigación con 872 de estudiantes de la Universitat Jaume I, procedentes de 18 titulaciones, pertenecientes a los tres centros de esta Universidad. Los resultados obtenidos a través de un cuestionario de autoinforme y técnicas cualitativas (brainstorming y focus groups), muestran una relación positiva entre obstáculos en el estudio, burnout y propensión al abandono. Mientras que los facilitadores en el estudio se relacionan positivamente con el engagement, compromiso, autoeficacia, satisfacción y felicidad relacionada con los estudios. En cuanto al desempeño académico encontramos la existencia de círculos de espirales positi-vas y negativas en las relaciones entre éxito/fracaso pasado, bienestar/malestar psicológico y éxito/fracaso futuro, respectivamente. Por último, se proponen medidas de intervención de cara a reducir obstáculos y optimizar los facilitadores del proceso enseñanza-aprendizaje

The quality of the service in the learning process is an important goal of Universities. In this way, the identification of obstacles and facilitators of the learning process, as well as its relationship with subjective well-being and performance of students is a key topic. Current research was done among 872 University students from Universitat Jaume I (Spain) from 18 different academic specialities of the three University centres. Results from self-report questionnaire and qualitative techniques (brainstorming and focus groups), showed a positive relationship among academic obstacles, burnout and intention to leave. On the other hand, academic facilitators are positively related with engagement, commitment, self-efficacy, satisfaction and happiness. Regarding academic performance, we found gain and loss spirals among past success/failure, subjective (un/)well being, and future success/failure. Finally, we proposed different intervention measures in order to reduce academic obstacles and optimise facilitators among students

Experimental type 2 diabetes induces enzymatic changes in isolated rat enterocytes.

Diabetes in humans and in experimental animals produces changes in the function and structure of the small intestine. The authors determined the activity of intestinal disaccharidases (maltase and sucrase) and of 6-phosphofructo-1-kinase (PFK-1) in enterocytes isolated from the small intestine of male Wistar rats (2.5 to 3 months old) with experimental nonobese type 2 diabetes, induced by streptozotocin (STZ) injection on the day of birth (n0-STZ) or on the 5th day of life (n5-STZ), with different degrees of hyperglycemia and insulinemia (n0-STZ and n5-STZ models). The glycemia (mmol/L) of the diabetic rats (n0-STZ: 8.77 +/- 0.47; n5-STZ: 20.83 +/- 0.63) was higher (P <.01) than that of the nondiabetic (ND) rats (5.99 +/- 0.63); on the contrary, the insulinemia (ng/mL) was significantly lower in both n0-STZ (1.74 +/- 0.53; P <.05) and n5-STZ (1.12 +/- 0.44; P <.01) diabetic rats than in normal rats (3.77 +/- 0.22). The sucrase and maltase activities (U/g protein) in diabetic rats (n0-STZ: 89 +/- 9 and 266 +/- 12; n5-STZ: 142 +/- 23 and 451 +/- 57) were significantly higher than those in the ND group (66 +/- 5 and 228 +/- 22). The PFK-1 activities (mU/mg protein) in the diabetic models (n0-STZ: 14.89 +/- 1.51; n5-STZ: 13.35 +/- 3.12) were significantly lower (P <.05) than in ND rats (20.54 +/- 2.83). The data demonstrated enzymatic alterations in enterocytes isolated from the small intestine of n0-STZ rats that are greater (P <.05) than in the more hyperglycemic and hypoinsulinemic n5-STZ animals. The results also show that nonobese type 2-like diabetes in the rat produces modifications that favor an increase in glucose absorption rates.