Da psicodinâmica à psicopatologia do trabalho no Brasil: (in)definições e possibilidades / De la psicodinámica a la psicopatología del trabajo em Brasil: (in)definiciónes y posibilidades / From psychodynamics to psychopathology of work in Brazil: (in)definitions and possibilities

RESUMO. O presente artigo analisou o estado da arte da psicopatologia do trabalho no Brasil, como objeto de pesquisa e como disciplina, a partir de revisão bibliográfica sistemática integrativa. Foi realizado levantamento em bases de dados virtuais utilizando os descritores 'psicopatologia do trabalho' e 'psicopatologia' (AND) 'trabalho'. Foram incluídos artigos disponibilizados integralmente em português publicados em revistas com revisão cega de pares contendo os descritores no título, resumo, palavras-chave e/ou corpo do texto. O conjunto final dos textos analisados se constituiu de 28 artigos publicados entre 1992 e 2019 majoritariamente em periódicos da psicologia com psicodinâmica do trabalho como referencial teórico e/ou metodológico. Foram ainda identificadas três tendências no uso do termo 'psicopatologia do trabalho' nos artigos: 1) psicopatologia do trabalho como objeto de estudo; 2) como disciplina; e 3) para debater as compreensões das relações entre trabalho e patologias e suas implicações na prática. Enquanto objeto de estudo, as relações entre trabalho e doença mental são negligenciadas. Como disciplina, identificaram-se imprecisões que flexibilizam ou ignoram os limites entre psicopatologia e psicodinâmica do trabalho. Ambas as tendências da literatura podem estar relacionadas com a desconsideração de fatores históricos na determinação da construção dos campos de estudo.

RESUMEN. El presente artículo analizó el estado del arte de la Psicopatología del Trabajo en Brasil, como objeto de investigación y como disciplina, a partir de revisión bibliográfica sistemática integrativa. Se realizó un levantamiento en bases de datos virtuales utilizando los descriptores 'psicopatología del trabajo' y 'psicopatología' (AND) 'trabajo'. Se incluyeron artículos disponibles integralmente en portugués publicados en revistas con revisión ciega de pares conteniendo los descriptores en el título, resumen, palabras clave y/o cuerpo del texto. El conjunto final de textos analizados se constituyó de 28 artículos publicados entre 1992 y 2019 mayoritariamente en periódicos de Psicología con Psicodinámica del Trabajo como referencial teórico y/o metodológico. Se identificaron tres tendencias en el uso del término 'psicopatología del trabajo' en los artículos: 1) psicopatología del trabajo como objeto de estudio; 2) como disciplina; y 3) para debatir las comprensiones de las relaciones entre trabajo y patologías y sus implicaciones en la práctica. En cuanto objeto de estudio, las relaciones entre el trabajo y la enfermedad mental son poco estudiadas. Como disciplina, se identificaron imprecisiones que flexibilizan o ignoran los límites entre Psicopatología y Psicodinámica del Trabajo. Ambas tendencias de la literatura pueden estar relacionadas con la desconsideración de factores históricos en la determinación de la construcción de los campos de estudio.

ABSTRACT. This article analyzed the state of the art of psychopathology of work in Brazil, as an object of study and as a subject, by performing an integrative systematic literature review. A search was conducted in virtual databases using the descriptors 'psychopathology of work' and 'psychopathology' (AND) 'work'. We included articles available in full in Portuguese, published in blind peer-reviewed journals containing the descriptors in the title, abstract, keywords and/or body of the text. The final set of texts consisted of 28 articles published between 1992 and 2019, mostly in psychology journals using psychodynamics of work as theoretical and/or methodological reference. Three trends were also identified in the use of the term 'psychopathology of work' in the articles: 1) psychopathology of work as an object of study; 2) as a subject; and 3) to discuss the understandings of the relationships between work and pathologies and their practical implications. As an object of study, the relationship between work and mental illness is neglected. As a subject, inaccuracies that flexibilize or ignore the limits between psychopathology of work and psychodynamics of work were identified. Both trends in the literature may be related to the lack of reflections that consider the Brazilian context to understand the relations between work and pathology.

Symptoms of Depression, Anxiety, Post-Traumatic Stress Disorder, and Suicidal Ideation Among State, Tribal, Local, and Territorial Public Health Workers During the COVID-19 Pandemic - United States, March-April 2021.

Increases in mental health conditions have been documented among the general population and health care workers since the start of the COVID-19 pandemic (1-3). Public health workers might be at similar risk for negative mental health consequences because of the prolonged demand for responding to the pandemic and for implementing an unprecedented vaccination campaign. The extent of mental health conditions among public health workers during the COVID-19 pandemic, however, is uncertain. A 2014 survey estimated that there were nearly 250,000 state and local public health workers in the United States (4). To evaluate mental health conditions among these workers, a nonprobability-based online survey was conducted during March 29-April 16, 2021, to assess symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal ideation among public health workers in state, tribal, local, and territorial public health departments. Among 26,174 respondents, 52.8% reported symptoms of at least one mental health condition in the preceding 2 weeks, including depression (30.8%), anxiety (30.3%), PTSD (36.8%), or suicidal ideation (8.4%). The highest prevalence of symptoms of a mental health condition was among respondents aged ≤29 years (range = 13.6%-47.4%) and transgender or nonbinary persons (i.e., those who identified as neither male nor female) of all ages (range = 30.4%-65.5%). Public health workers who reported being unable to take time off from work were more likely to report adverse mental health symptoms. Severity of symptoms increased with increasing weekly work hours and percentage of work time dedicated to COVID-19 response activities. Implementing prevention and control practices that eliminate, reduce, and manage factors that cause or contribute to public health workers' poor mental health might improve mental health outcomes during emergencies.

Perceived work ability and work-family conflict in healthcare workers: An observational study in a teaching hospital in Italy.

OBJECTIVE: The aim of the study was to investigate the variables associated with work ability, work-family conflict and the relationship between these variables. METHODS: An observational prospective study was conducted and involved 436 employees of a Teaching Hospital in Rome. Data collection was performed using the following tools: the Work Ability Index (WAI) and the Work-to-family conflict and Family-to-work conflict Scale (WFC-FWC Scale). Data were analyzed through univariate analysis of variance (ANOVA) and multivariate linear regression, using the SPSS software version 25. RESULTS: A direct relationship of the WFC score with two variables (female gender and physicians) and an inverse relationship with other two variables (age and administrative staff) were found. There is a direct relationship between the FWC score and the variable "having sons". The WFC and FWC scores showed a direct relationship between them. The Work Ability presented an almost significant association only with the profession variable, in which administrative staff, followed by physicians, presented a higher WAI score with respect to other professional categories, such as nurses. CONCLUSIONS: Wellbeing intervention for health workers should be directed mainly to women, older workers and those with sons. In addition, more attention should be given to nurses, who showed lower work ability scores.

Health Risk Assessment of Trace Elements in Soil for People Living and Working in a Mining Area.

The present study used soils collected from a small-scale gold mine area to determine the health risks due to trace elements to the at-risk population in the study area. The work involved 74 soil samples from four sampling categories: 29 samples were from the mining pits (MD), 18 samples from the first washing area (WA), 17 samples from the second washing area (WB), and 10 samples from the control area (C). All samples were analyzed for Cr, Cu, As, Pb, Cd, Co, Ni, Zn, and Hg using the Energy Dispersive X-Ray Florescence (ED-XRF) method. Trace element levels were found to vary across the four sampling categories. The concentrations of trace elements recorded from different sampling categories varied in an increasing order of MD > WA > WB > C. Mercury was detected in the highest levels (max. 3.72 ± 0.15) at WB while it was not detected in the samples from C. Samples from MD indicated that Cu (max. 737.66 ± 1.3 mg/kg) was found in the highest levels whereas Hg (mean = 0.007 mg/kg) was the lowest. At WA, Cu (max. = 178.97 ± 2.46 mg/kg) registered the highest average concentration while Hg (mean = 0.05 mg/kg) had the lowest concentration. For WB, Cu (max. = 230.66 ± 3.99 mg/kg) was found in the highest concentration. The hazard index value for all exposure routes was found to be 1.77, making noncarcinogenic effects significant to the adult population. For children, the hazard index value was 9.11, showing a severe noncarcinogenic effect on children living in the study area. For the noncancer effects through the inhalation pathway, the risk posed by Ni, Cu, Zn, and Pb was negligible for both adults and children, while Co posed the highest noncancer risk for children. Cobalt also indicated the highest noncancer risk for children through the dermal pathway, while As indicated the highest noncancer risk to children through ingestion. For the cancer risk, the adults were more at risk compared to children, except for As and Co through the dermal pathway posing the highest threat. Trace element concentrations, hazard quotient, and hazard index values indicated that the area was polluted and that noncarcinogenic and carcinogenic effects on residents and miners were significant. Therefore, there is a need to put in place mining regulations aimed at protecting the at-risk human population in the study area.

Symptoms of Depression, Anxiety, Post-Traumatic Stress Disorder, and Suicidal Ideation Among State, Tribal, Local, and Territorial Public Health Workers During the COVID-19 Pandemic - United States, March-April 2021.

Increases in mental health conditions have been documented among the general population and health care workers since the start of the COVID-19 pandemic (1-3). Public health workers might be at similar risk for negative mental health consequences because of the prolonged demand for responding to the pandemic and for implementing an unprecedented vaccination campaign. The extent of mental health conditions among public health workers during the COVID-19 pandemic, however, is uncertain. A 2014 survey estimated that there were nearly 250,000 state and local public health workers in the United States (4). To evaluate mental health conditions among these workers, a nonprobability-based online survey was conducted during March 29-April 16, 2021, to assess symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal ideation among public health workers in state, tribal, local, and territorial public health departments. Among 26,174 respondents, 53.0% reported symptoms of at least one mental health condition in the preceding 2 weeks, including depression (32.0%), anxiety (30.3%), PTSD (36.8%), or suicidal ideation (8.4%). The highest prevalence of symptoms of a mental health condition was among respondents aged ≤29 years (range = 13.6%-47.4%) and transgender or nonbinary persons (i.e., those who identified as neither male nor female) of all ages (range = 30.4%-65.5%). Public health workers who reported being unable to take time off from work were more likely to report adverse mental health symptoms. Severity of symptoms increased with increasing weekly work hours and percentage of work time dedicated to COVID-19 response activities. Implementing prevention and control practices that eliminate, reduce, and manage factors that cause or contribute to public health workers' poor mental health might improve mental health outcomes during emergencies.

A network modelling approach to assess non-pharmaceutical disease controls in a worker population: An application to SARS-CoV-2.

As part of a concerted pandemic response to protect public health, businesses can enact non-pharmaceutical controls to minimise exposure to pathogens in workplaces and premises open to the public. Amendments to working practices can lead to the amount, duration and/or proximity of interactions being changed, ultimately altering the dynamics of disease spread. These modifications could be specific to the type of business being operated. We use a data-driven approach to parameterise an individual-based network model for transmission of SARS-CoV-2 amongst the working population, stratified into work sectors. The network is comprised of layered contacts to consider the risk of spread in multiple encounter settings (workplaces, households, social and other). We analyse several interventions targeted towards working practices: mandating a fraction of the population to work from home; using temporally asynchronous work patterns; and introducing measures to create 'COVID-secure' workplaces. We also assess the general role of adherence to (or effectiveness of) isolation and test and trace measures and demonstrate the impact of all these interventions across a variety of relevant metrics. The progress of the epidemic can be significantly hindered by instructing a significant proportion of the workforce to work from home. Furthermore, if required to be present at the workplace, asynchronous work patterns can help to reduce infections when compared with scenarios where all workers work on the same days, particularly for longer working weeks. When assessing COVID-secure workplace measures, we found that smaller work teams and a greater reduction in transmission risk reduced the probability of large, prolonged outbreaks. Finally, following isolation guidance and engaging with contact tracing without other measures is an effective tool to curb transmission, but is highly sensitive to adherence levels. In the absence of sufficient adherence to non-pharmaceutical interventions, our results indicate a high likelihood of SARS-CoV-2 spreading widely throughout a worker population. Given the heterogeneity of demographic attributes across worker roles, in addition to the individual nature of controls such as contact tracing, we demonstrate the utility of a network model approach to investigate workplace-targeted intervention strategies and the role of test, trace and isolation in tackling disease spread.

Use of healthcare REsources and associated COsts in controlled versus uncontrolled carcinoid SYndrome in patients with neuroendocrine tumours: the RECOSY study.

PURPOSE: To report healthcare resource use and associated costs in controlled versus uncontrolled carcinoid syndrome (CS) in patients with neuroendocrine tumours. METHODS: A cross-sectional, non-interventional multicentre study was conducted with retrospective data analysis. Resource use was compared between two patient groups: those with controlled CS (> 12 months with no uncontrolled CS episodes) and uncontrolled CS (< 12 months since last uncontrolled episode). Patients were matched for age, sex, and origin and grade of tumour. When no matching patients were available, data from deceased patients were used. Information on healthcare resource use came from review of medical records, patient history and physician reports. Working capacity was assessed using the Work Productivity and Activity Impairment General Health questionnaire. RESULTS: Twenty-six university hospitals in Spain participated, between July 2017 and April 2018. 137 patients were enrolled; 104 were analysed (2 groups of 52). Patients with uncontrolled CS had 10 times more emergency department (ED) visits (mean 1.0 vs 0.10 visits; P = 0.0167), were more likely to have a hospital admission (40.4% vs 19.2%; P = 0.0116) and had longer hospital stays (mean 7.87 vs 2.10 days; P = 0.0178) than those with controlled CS. This corresponded to higher annual hospitalisation costs (mean €5511.59 vs €1457.22; P = 0.028) and ED costs (€161.25 vs €14.85; P = 0.0236). The mean annual total healthcare costs were 60.0% higher in patients with uncontrolled than controlled CS (P = NS). CONCLUSION: This study quantifies higher health resource use, and higher hospitalisation and ED costs in patients with uncontrolled CS. Better control of CS may result 3in lower medical costs.

The combined effect of long working hours and individual risk factors on cardiovascular disease: An interaction analysis.

OBJECTIVES: We examined whether the effect of long working hours on the risk of developing cardiovascular disease (CVD) differs depending on individual risk factors. METHODS: Seven-year follow-up data were extracted from the 2009 to 2016 waves of the Korea Health Panel Survey. Physician's diagnosis or medication for hypertension, diabetes, dyslipidemia, and obesity were included as chronic disease status. Smoking, drinking alcohol, and exercise levels were considered as lifestyle behavior. Hazard ratios were calculated using the Cox regression models to evaluate the risk of CVD related to chronic diseases and unhealthy behavior, based on working hour groups, after adjusting for other covariates. The interactive effects of long working hours with or without chronic diseases and unhealthy behavior on CVD were assessed using the relative excess risk due to interaction and attributable proportion measures. RESULTS: There was a statistically significant interaction between long working hours and chronic diseases within the population, especially among male participants (P-value for interaction <.01 and .03, respectively). There were no significant interactions between unhealthy behavior and long working hours. CONCLUSIONS: Long working hours and chronic disease have a synergistic negative effect on the risk of CVD.

Working conditions and health status of 6,317 front line public health workers across five provinces in China during the COVID-19 epidemic: a cross-sectional study.

BACKGROUND: Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic. METHODS: Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. RESULTS: The prevalence of depression, anxiety, and poor self-rated health was 21.3, 19.0, and 9.8%, respectively, among public health workers (27.1, 20.6, and 15.0% among CDC workers and 17.5, 17.9, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001). CONCLUSIONS: Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19.

A behavioral economic risk aversion experiment in the context of the COVID-19 pandemic.

We investigated what degree of risk of infection with COVID-19 is necessary so that people intend to stay home, even when doing so means losing their salary. We conducted an online survey across Brazil during the initial outbreak, in which 8,345 participants answered a questionnaire designed to identify the maximum tolerated risk (k') necessary for them to disregard social distancing recommendations and guarantee their salaries. Generalized linear mixed models, path analysis structural equation, and conditional interference classification tree were performed to further understand how sociodemographic factors impact k' and to establish a predictive model for the risk behavior of leaving home during the pandemic. We found that, on average, people tolerate 38% risk of infection to leave home and earn a full salary, but this number decreased to 13% when the individual risk perception of becoming ill from severe acute respiratory syndrome coronavirus-2 is considered. Furthermore, participants who have a medium-to-high household income and who are older than 35 years are more likely to be part of the risk-taking group who leave home regardless of the potential COVID-19 infection level; while participants over 45 years old and with good financial health are more likely to be part of the risk-averse group, who stay home at the expense of any salary offered. Our findings add to the political and public debate concerning lockdown strategies by showing that, contrary to supposition, people with low socioeconomic status are not more likely to ignore social distancing recommendations due to personal economic matters.

Telework and telerehabilitation programs for workers with a stroke during the COVID-19 pandemic: A commentary.

BACKGROUND: Due to the coronavirus disease 2019 (COVID-19) pandemic, rehabilitation facilities have become less accessible for patients with a stroke. Lack of early, intensive rehabilitation misses the opportunity for recovery during the critical time window of endogenous plasticity and improvement post-stroke. OBJECTIVES: The purpose of this commentary was to highlighting the benefits of telework and telerehabilitation programs for workers with a stroke during the COVID-19 pandemic. METHODS: Relevant publications regarding the management of individuals with a stroke, telerehabilitation and teleworking in the setting of COVID-19 were reviewed. RESULTS: Previous studies showed that telerehabilitation can effectively provide an alternate method of promoting recovery for patients with a stroke. With the physical distancing precautions in place for mitigating viral spread, teleworking can also provide a method for long term recovery and improvements in quality of life after a stroke. CONCLUSIONS: Overall, this commentary addresses the benefits of physically distant, safe and effective alternatives to support individuals who live with a stroke during COVID-19 pandemic.

Associations of physical activity at work and household income with obesity: a cross-sectional study among rural adults in Korea.

OBJECTIVES: This study was performed to identify the effect of physical activity at work on obesity and to analyze the contribution of socioeconomic factors and health behaviors to this association, which has been relatively little studied. METHODS: From the Korean National Cancer Center Community Cohort, a total of 5,587 adults (2,125 men; 3,462 women) aged more than 30 years living in rural areas were enrolled. Information on socio-demographic factors, health behaviors, and body mass index was gathered using face-to-face interviews and measurements of height and weight. RESULTS: Inverse associations were identified between vigorous-intensity physical activity at work and obesity in both men and women, while no association was found between vigorous-intensity physical activity during leisure time and obesity. High household income was independently associated with a lower risk of obesity among those who had low levels of vigorous-intensity physical activity at work. Vigorous physical activity at work showed an inverse association with obesity in rural areas where heavy manual labor is common. CONCLUSIONS: Our findings indicate the necessity to account for various types of physical activity to improve the assessment and prevention of obesity.

Cambios de la presión arterial en profesionales sanitarios durante su actividad laboral / Changes in blood pressure in healthcare professionals during your work activity

No disponible

The Country That Never Retires: The Gendered Pathways to Retirement in South Korea.

OBJECTIVES: Among all Organization for Economic Cooperation and Development countries, South Korean older adults work until the latest age. We investigate the extent to which work experiences over the life course and family circumstances can be associated with older workers' incentives to remain in the labor force beyond the statutory pension age. We explore gender-specific patterns of labor force exit and labor force re-entry in later life. METHODS: Using panel data of South Korean older workers and retirees from 2006 to 2016, we estimate multilevel discrete-time models with random effects to predict their labor force transition process that unfolds over time. RESULTS: Results show that skilled manual workers are less likely to exit employment and more likely to re-enter the labor force. A longer history of self-employment is related to later retirement. The relationship between career characteristics and the risk of retirement is only significant for men. Late-aged employment transition among women appears to be more related to family conditions. Women who receive financial support from adult offspring are more likely to remain out of the labor force but this relationship is not pronounced among men. DISCUSSION: Policies aimed at extending working lives need to provide various types of social support to older job seekers, especially those who had low-class jobs and those without family networks.

Psychosocial working conditions, pain, mental disorders, and disability pension.

We aimed to investigate associations between psychosocial working conditions and disability pension (DP), and the role of co-existing pain or common mental disorders (CMDs). Survey data collected 1998-2003 on 25,135 Swedish twins born 1935-1958 were linked with national DP register data until 2013. Psychosocial working conditions, pain and CMDs were analyzed by Cox proportional hazards regression models (hazard ratios with 95% confidence intervals). One unit increase in job demands or control was associated with a higher risk for DP due to musculoskeletal disorders. One unit decrease in job demands predicted lower risk of DP due to mental diagnoses. Co-existing pain or CMD played no role for associations of job demands with DP, but pain influenced the associations with DP due to mental diagnoses. To conclude, psychosocial working conditions play different roles for DP depending on the diagnoses.

The effects of COVID-19 stay-at-home order on sleep, health, and working patterns: a survey study of US health care workers.

STUDY OBJECTIVES: By March 2020, COVID-19 forced much of the world to stay at home to reduce the spread of the disease. Whereas some health care workers transitioned to working from home, many continued to report to work in person as essential employees. We sought to explore changes in sleep, health, work, and mood in health care workers during the stay-at-home orders. METHODS: We developed a cross-sectional online survey administered to health care workers. The survey assessed changes in sleep, work, screen time, media exposure, diet, exercise, substance use, and mood. The survey data were collected between March 28, 2020, and April 29, 2020. RESULTS: A total of 834 of 936 individuals completed the entire survey. Respondents were from 41 US states. Mood after the stay-at-home orders worsened, and screen time and substance use increased. Total sleep time shortened in those continuing to work in person (P < .001), whereas it was unchanged in those working from home (P = .73). Those working from home went to bed later, woke up later, and worked fewer hours. Reduced total sleep time and increased screen time before bed were associated with worse mood and screen time. Longer sleep time was associated with better mood. CONCLUSIONS: Health care workers' mood worsened regardless of whether work was in person or remote, although total sleep time was shorter for those working in person. Those working from home may have shifted their sleep time to be more in line with their endogenous circadian phase. Peer or other support services may be indicated to address sleep, mood, and health behaviors among health care workers during these unprecedented times.

Is emotional exhaustion only the result of work experiences? A diary study on daily hassles and uplifts in different life domains.

BACKGROUND AND OBJECTIVES: Emotional exhaustion is considered to be the key symptom of burnout. Although it has been defined that emotional exhaustion rather results from work-related experience than from other life domains, this has rarely been studied empirically. The study aimed to investigate the role of different life domains in predicting emotional exhaustion. More precisely, we examined whether daily uplifts and hassles from different life domains were related to emotional exhaustion beyond work-related uplifts and hassles. DESIGN: A diary study was conducted over the course of 14 consecutive days. METHOD: 141 beginning teachers provided information about their daily hassles and uplifts as well as their daily emotional exhaustion. RESULT: Results of multilevel analyses showed that work-related uplifts were negatively and work-related hassles were positively related to emotional exhaustion. Additionally, private uplifts were associated with a statistically significant decrease and private hassles with an increase in emotional exhaustion beyond work-related events. CONCLUSION: Although the variance in emotional exhaustion that was explained by private events was small, the present study suggests that burnout symptoms might not be completely independent from individuals' daily lives outside work.

Patient-Reported Impact of Axial Spondyloarthritis on Working Life: Results From the European Map of Axial Spondyloarthritis Survey.

OBJECTIVE: To evaluate work-related issues (WRIs) and their determinants in patients with axial spondyloarthritis (SpA) across Europe. METHODS: The European Map of Axial Spondyloarthritis is a cross-sectional online survey (2017-2018) of unselected patients with self-reported axial SpA from 13 European countries. Participants were classified as active or inactive members of the labor force according to the International Labor Organization standards. Those employed reported WRIs due to axial SpA in the past 12 months. Sociodemographic characteristics and patient-reported outcomes were compared between patients with and without WRIs. Stepwise regression analysis was conducted to identify independent determinants of WRIs. RESULTS: The sample comprised 2,846 patients with axial SpA, 1,653 were active members of the labor force, 1,450 were employed, and of those employed, 67.7% reported at least 1 WRI. The most frequently reported WRIs were taking sick leave (56.3%), difficulty fulfilling working hours (44.6%), and missing work for doctor's appointments (34.6%). Of the total sample, 74.1% declared that they had faced or would face difficulties finding a job due to axial SpA. Patients with WRIs were more often female, were less likely to be married or in a relationship, and had a higher educational level, poorer patient-reported outcomes, and a greater prevalence of anxiety and depression. Multivariable regression showed that WRIs were associated with a higher Bath Ankylosing Spondylitis Disease Activity Index score (odds ratio [OR] 1.30 [95% confidence interval (95% CI) 1.16-1.45]) and the 12-item General Health Questionnaire score (OR 1.15 [95% CI 1.09-1.22]), and were negatively associated with inflammatory bowel disease (OR 0.58 [95% CI 0.36-0.91]). CONCLUSION: Approximately two-thirds of employed patients experienced WRIs due to axial SpA. Association between disease activity and psychological distress with WRIs suggests the need to ensure that axial SpA patients receive the required support to cope with their working life.

Effect of an intervention in decreasing of the perception of barriers for bicycle use in the commuting to work / Efeito de uma intervenção na redução da percepção de barreiras para o uso de bicicleta no deslocamento ao trabalho

ABSTRACT This study investigated the effect of an intervention on perceptions of barriers for the bicycle use in commuting to work by industrialists. 876 men (mean age = 35.4 ± 9.5 years) from a metallo-mechanical company participated. The sample was randomized into a control and intervention group (438 participants in each group) considering the use or not of the bicycle when commuting to work. The intervention had 23 meetings of approximately 30 minutes each, spread over six months, based on the Transteoric Model of Behavior Change (TMBC). The perception of barriers to bicycle use was assessed using the "scale to assess the perception of barriers to bicycle use". Descriptive statistics, chi-square, Wilcoxon test, Kruskal-Wallis and Mann-Whitney were applied for analysis, adopting p < 0.05. There was a statistical decline in perception of barriers to bicycle use in the intervention group (Z = -2.218; p = 0.027). When stratified by age group, greater effectiveness of the intervention was observed in reducing in the perception of barriers in individuals aged 30-39 years (Z = -2.637; p = .008). For the other age groups, there were no significant differences. It is concluded that interventions based on TMBC are effective to decrease the perception of barriers for bycicle use in the commuting to work.

RESUMO Esse estudo investigou o efeito de uma intervenção na percepção de barreiras para o uso de bicicleta no deslocamento ao trabalho de industriários. Participaram 876 homens (idade média = 35,4 ± 9,5 anos) de uma empresa metalomecânica. A amostra foi randomizada em grupo controle e intervenção (438 participantes em cada grupo), considerando o uso ou não da bicicleta ao trabalho. A intervenção contou com 23 encontros de 30 minutos cada ao longo de seis meses, baseados no Modelo Transteórico de Mudança de Comportamento (MTMC). A percepção de barreira para uso de bicicleta foi avaliada por meio da "escala de percepção de barreiras para o uso de bicicleta". Para análise foi aplicada estatística descritiva, qui-quadrado, teste de Wilcoxon, Kruskal-Wallis e Mann-Whitney adotando p < 0,05. Houve redução estatística na média da percepção de barreiras para uso de bicicleta no grupo intervenção (Z=-2,218; p=0,027). Quando estratificado por faixa etária, observou-se maior eficácia da intervenção na redução da percepção de barreiras em indivíduos na faixa etária de 30-39 anos (Z=-2,637; p=0,008). Para as demais faixas etárias, não houveram diferenças significativas. Conclui-se que intervenções baseadas no MTMC são eficazes na redução da percepção de barreiras para o uso da bicicleta para o deslocamento ao trabalho.

12-Year longitudinal study linking within-person changes in work and family transitions and workplace injury risk.

INTRODUCTION: Despite the rich tradition of research on predictors of workplace injury, most studies rely on cross-sectional, between-person designs. Furthermore, prior research has often overlooked the possibility that factors outside the work domain can influence the occurrence of actual injuries at work. To address these limitations, the current study examined the effects of work and family demands on the occurrence of workplace injury. Drawing on the intuition of the work-home resources model (W-HR), we investigated how within-person level changes in demands and resources from both domains influence work injuries over a 12-year period. METHOD: We used 12 years of longitudinal data (N = 7,820) to study the long-term within-person changes in work and family domains and to capture the event of low frequency incidence such as workplace injury. Specifically, we conducted multilevel analyses to study the links between within-person change in time and energy resources both in work and family domains and within-person change in the likelihood of experiencing a workplace injury. RESULTS AND CONCLUSION: The findings showed that within-person changes in work hours, spousal work hours, income and number of children, were significantly associated with changes in the likelihood of experiencing a workplace injury. We conclude with a discussion of implications for theory and future research of workplace injuries. Practical application: The research provided useful insights on the intimate association between work and family domains in the context of safety management.