Interactivity of obesity and central obesity on hypertension in Wuwei of Gansu province / 中国基层医药

Objective:To analyze the interaction between obesity and diabetes, obesity and central obesity, central obesity and diabetes on hypertension.Methods:A questionnaire survey on 7 622 residents of Han Chinese ethnicity, aged 35-75 years, of Liangzhou district of Wuwei city were performed using multi-stage random sampling method in September to December 2018. Relative excess risk due to interaction, attributable proportion, synergy index, and 95% CI of the three were used to evaluate the additive interaction. Logistic regression analysis was used to analyze the multiplicative interaction. Results:Among the 7 622 residents, hypertension was detected in 3 212 residents, with a crude prevalence rate of 42.14% and a standardized incidence of 33.81%. There was a significant difference in incidence of hypertension between residents of different sexes, between residents at different ages, between obese residents and normal weight residents, between residents who had central obesity and those who had no central obesity, between residents who smoked and those who did not, between residents of different family economic situations, between residents who had different occupations, and between residents who had diabetes and those who had no diabetes (all P < 0.05). Getting primary, middle, and high school education was a protective factor against hypertension, while obesity, central obesity, diabetes, male gender, age greater than 45 years were the risk factors for hypertension. Multivariate logistic regression analysis showed that there was no additive interaction between obesity and diabetes, obesity and central obesity, central obesity and diabetes on hypertension. There was a multiplicative interaction between obesity and central obesity on hypertension ( P = 0.031, 95% CI: 0.53-0.97) and the interaction was antagonistic, but there were no multiplicative interaction between obesity and diabetes, central obesity and diabetes on hypertension. Conclusion:There was a negative multiplicative interaction between obesity and central obesity on hypertension.

Insights into Conflicts and Harmony in Doctor Patient Relationship through Transactional Analysis

Doctor Patient Relationship (DPR) in India seems to be deteriorating. Remedial measures are incoherent compared to the multitude of factors associated. Transactional Analysis (TA) is a Social Psychology Theory and practice appropriate to analyse changing paradigms of DPR. TA shows that traditional stable DPR model was symbiosis inappropriate for modern era. Current DPR model is game relationship occurring due to failed attempts at symbiosis. Contractual relationship is a stable model of DPR appropriate for modern era and medical fraternity shall work towards bringing a paradigm shift in a coherent manner. TA may be one of the systems that offers models and tools useful for a paradigm shift

Effect of Karnofsky performance status scale and lactate dehydrogenase as well as their interaction on the therapeutic efficacy of diffuse large B-cell lymphoma / 白血病·淋巴瘤

Objective:To explore the factors influencing complete remission in patients with diffuse large B-cell lymphoma (DLBCL), and to explore the effect of the interaction of Karnofsky performance status scale (KPS) scores and the level of lactate dehydrogenases (LDH) on whether patients with DLBCL are completely relieved.Methods:The clinical data of 373 DLBCL patients admitted to Shanxi Province Cancer Hospital from January 2014 to December 2020 were retrospectively analyzed. SPSS 25.0 logistic regression model and Cox proportional risk regression models were used to explore the factors affecting complete remission in patients with DLBCL and to explore whether there was a multiplicative interaction between the factors. For factors with multiplicative interactions, the Matrix package, epiR package, and survival package in R 4.2.0 software were used to analyze whether there was an additive interaction. The relative excess risk of interaction (RERI), attributable proportion due to interaction (AP), and the synergy index (S) were used to evaluate the presence of additive interactions.Results:Elevated β 2 macroglobulin (β 2-MG), KPS scores below 80, and elevated LDH were risk factors for incomplete remission in patients with DLBCL (all P < 0.05). The risk of incomplete remission in patients with elevated β 2-MG, KPS scores below 80 and LDH was 1.971 times ( OR = 1.971, 95% CI 1.161-3.346), 2.056 times ( OR = 2.056, 95% CI 1.057-4.000) and 3.351 times ( OR = 3.351, 95% CI 1.783-6.300) higher than those in patients with normal β 2-MG, KPS scores above 80 and non-elevated LDH, respectively. There was a negative multiplicative interaction between the two risk factors of KPS scores below 80 and elevated LDH ( OR = 0.317, 95% CI 0.126-0.785). The estimated value of RERI, AP and S was -2.07 (95% CI -4.79-0.64),0.50 (95% CI -1.68-0.32),0.50 (95% CI 0.22-1.13), respectively; and there was no additive interaction among them. Conclusions:Elevated β 2-MG, KPS scores below 80, and elevated LDH are risk factors influencing incomplete remission for patients with DLBCL. The combined effect in patients with the combination of elevated LDH and KPS scores below 80 is lower than the single effect of the multiple of the both. There is a negative multiplicative interaction and no additive interaction in DLBCL patients with KPS scores below 80 and elevated LDH level.

Negative Events, Coping and Biological Markers: An Application of Transactional Model of Stress, / Eventos Negativos, Estratégias de Enfrentamento e Marcadores Biológicos: Uma aplicação do Modelo Transacional do Estresse

Abstract Based on the importance of the stress phenomenon, this research sought to evaluate the relationship between stress, coping strategies, negative life events and biological markers, based on the Transactional Stress Model. A general hypothesis of mediation was formulated: coping strategies would mediate the relationship between negative life events and biological markers. The sample consisted of 96 users of a biomedical school laboratory, in which 77.78% were female. Participants answered the Brief COPE questionnaire, as well as a questionnaire on negative life events. Laboratory tests were collected shortly after the application of the questionnaires. Mediations were found between Venting, Red Blood Cells and Hemoglobin. The research aimed to contribute to the knowledge in the field of stress and coping, as well as to serve as a possible empirical study of the Transactional Stress model.

Resumo Dada a importância do fenômeno do estresse, esta pesquisa procurou avaliar a relação entre estresse, estratégias de enfrentamento, eventos negativos na vida e marcadores biológicos baseados no modelo transacional de estresse. A hipótese geral de mediação é que as estratégias de enfrentamento seriam mediadoras à relação entre eventos negativos na vida e os marcadores biológicos. A amostra consistiu de 96 usuários de um laboratório escola em que 77,78% eram mulheres. Participantes responderam ao questionário Brief-COPE, assim como o questionário de eventos negativos na vida. Os testes laboratoriais foram coletados logo após a aplicação dos questionários. As mediações foram encontradas entre auto-distração células vermelhas e hemoglobina. A pesquisa buscou contribuir com o conhecimento na área de estresse e estratégias de enfrentamento, assim como servir como estudo empírico do Modelo Transacional de Estresse.

A Multicentre Study of Nursing Leadership in Andalusian Hospitals from a Gender-based Perspective

ABSTRACT Introduction: Leadership is the ability to guide subordinates in a direction or decision so that they can perform a task or achieve a goal that leaves them feeling empowered and accomplished. Leaders are capable of producing changes and at the same time, they inspire others to do the same. This research analysed gender-based differences and dimensions of nursing leadership styles in 18 hospitals in Andalusia, a region of southern Spain. Methods: The sample population of the study comprised 335 subjects, who were middle managers in 18 public regional hospitals in Andalusia. The instrument used to measure different leadership styles was the Multifactor Leadership Questionnaire (MLQ 5X-Short form), which is composed of 45 items. Results: The study showed that the most predominant leadership style was transactional leadership with a mean value of M = 4.22 (standard deviation [SD] = 0.42) followed by transformational leadership with a mean value of M = 3.97 (SD 0.45). Of the three styles analysed, transactional leadership had the highest statistical median for both male and female subjects. From a gender-based perspective, transformational leadership showed statistically significant differences (p < 0.01) between men and women. This was true for leadership styles as well as for the dimensions that define each style. Conclusion: The most frequent leadership style in middle nursing management in Andalusian hospitals was transactional leadership. In regard to the three leadership styles as well as their dimensions, the female subjects obtained the highest scores. This means that from a gender-based perspective, female nursing managers had better performance levels than their male counterparts in the regional hospital system in Andalusia.

Liderazgo y clima organizacional en trabajadores de establecimientos de salud de una microred de Perú / Leadership and organizational climate in workers of health facilities of a micro-network in Peru

RESUMEN Introducción: El gerente de un establecimiento de salud es el encargado de gestionar y ejecutar las acciones integradas dentro de una institución, por lo que, el tipo de liderazgo que pueda ejercer en sus trabajadores puede influir en el clima organizacional y en el servicio de calidad ofrecido hacia el paciente. Objetivo: Determinar la relación entre el liderazgo y clima organizacional en trabajadores de establecimientos de salud que comprenden una microred de Perú. Método: Estudio descriptivo transversal y correlacional realizado en trabajadores de establecimientos de salud que comprenden una microred de la ciudad de Huaraz, Perú. Se aplicaron dos cuestionarios válidos y confiables al contexto de la población, para recolectar los datos de interés. El análisis de correlación se realizó con el estadígrafo de Spearman (rs) con un nivel de significancia del 5 %. Resultados: Del total de 88 trabajadores, 54,5 % presentaron liderazgo transaccional y 55,7 % transformacional alto y bajo, respectivamente. El nivel de liderazgo de la gerente de la microred fue medio (50 %) y el clima organizacional de los trabajadores fue por mejorar (68,2 %). El coeficiente de Correlación de Spearman (rs) evidenció relación positiva y significativa entre el clima organizacional y el liderazgo transaccional (rs = 0,644; p = 0,000) y transformacional (rs = 0,660; p = 0,000). Conclusiones: La relación entre los tipos de liderazgo de la gerente y el clima organizacional de los trabajadores es positiva y significativa, por lo que, a mayor liderazgo, mejor clima organizacional.

ABSTRACT Introduction: The manager of a health facility is responsible for managing and executing the integrated actions within the institution, so, the type of leadership that can exercise in their workers can influence the organizational climate and quality service offered to the patient. Objective: To determine the relationship between leadership and organizational climate in workers of health facilities that comprise a micro-network in Peru. Method: Cross-sectional and correlational descriptive study carried out in workers of health establishments that comprise a micro-network of the city of Huaraz, Peru. Two valid and reliable questionnaires were applied to the context of the population, to collect the data of interest. The correlation analysis was performed with the Spearman statistician (rs) with a level of significance of 5%. Results: Of the total of 88 workers, 54,5% and 55,7% presented high and low transactional and transformational leadership respectively. The level of leadership of the manager of the micro-network was medium (50,0%) and the organizational climate of the workers was to improve (68,2%). The Spearman correlation coefficient (rs) showed a positive and significant relationship between the organizational climate and the transactional leadership (rs = 0,644, p = 0,000) and transformational leadership (rs = 0,660, p = 0,000). Conclusions: The relationship between the managerial types of the manager and the organizational climate of the workers is positive and significant, so, the greater the leadership, the better the organizational climate.

Contrato psicológico en empleados mexicanos: Creencias de obligaciones relacionales y transaccionales / Psychological contract in Mexican employees: Relational and transactional obligations beliefs

Resumen Se examinan las creencias de una muestra de empleados mexicanos sobre las obligaciones recíprocas en la relación empleado-empleador, con base en los tipos de Contrato Psicológico Relacional y Transaccional. Se realizó un estudio no experimental, correlacional, transversal. Participaron 345 empleados de diversas organizaciones de la Ciudad de México. Se pusieron a prueba modelos PATH sobre la relación de las creencias del empleado sobre las obligaciones empleado-empleador. En el modelo Relacional, se identificaron antecedentes sobre las creencias de Lealtad y Seguridad, el modelo mostró menos variables independientes con un mayor nivel predictivo. En el modelo Transaccional se identificaron más variables independientes relacionadas con un menor nivel predictivo. Se señala la necesidad de proponer modelos predictivos con otras variables, como el compromiso, la justicia y la adherencia organizacional, la satisfacción laboral, el desempeño y la rotación. Esta investigación contribuye a la Teoría del Intercambio Social en las Organizaciones y la dinámica del Contrato Psicológico como un enfoque que puede ayudar en la definición de estrategias, políticas organizacionales y prácticas orientadas a relaciones laborales sanas en México.

Abstract Based on Social Exchange Theory in Organizations, this research examines the beliefs of Mexican employees about reciprocal obligations in the employee-employer relationship, operationalize on the types of Relational and Transactional Psychological Contract. A non-experimental, correlational, cross-sectional study was performed. A total of 345 employees from diferent organizations from Mexico City participated. Correlation analysis, multiple regression analysis and PATH models were conducted. Results of goodness of fit of the measurement model for each tipe of psychological contract are shown to add evidence of validity of the PCI (Psychological Contract Inventory) in Mexican population, as well as acceptable Cronbach Alpha index were founded. Evidence of a reciprocity Relational model was found; this model identifies employer obligation beliefs as antecedents that influenced the employee's Loyalty and Safety beliefs. Evidence of a Transactional model was found; this model identifies antecedents that influenced the beliefs of a Short-Term employment relationship whit a Limited approach. These research marks the opportunity for similar studies in different employee groups and industries. The knowledge and study of the Psychological Contract in Mexico can help organizations to clearly define their internal policies of employment relationships that benefit to both employer and employees. This research proposes the dynamics of the Psychological Contract in the study of employment relationships in Mexico as a powerful approach that provides clarity in the explanation of reciprocity in the workplace.

Experiencia de vida de jóvenes homosexuales y su influencia en la práctica del sexo transaccional / Life experience of homosexual young men and its influence in the practice of transactional sex

Introducción: el sexo transaccional es el acto mediante el cual un individuo accede a satisfacer las demandas sexuales de una persona o grupo de personas a cambio de una remuneración monetaria u otra contraprestación. Objetivo: caracterizar las experiencias que, en la historia de vida de jóvenes homosexuales, han influido en la práctica del sexo transaccional. Métodos: se realizó un estudio descriptivo, de corte transversal, durante los años 2012 y 2013. La muestra la conformaron 25 jóvenes homosexuales pertenecientes al policlínico "Ana Betancourt", a los que se les realizó entrevista abierta y semiestructurada. Resultados: el ámbito familiar constituye, en la totalidad de los entrevistados, un espacio de conflicto y frustración, manifestándose prohibiciones e incomprensiones de los familiares vinculados a la identidad de género y sexo-erótica. Se constató frustración e inestabilidad en el área de pareja; sobrevaloración de la figura materna, vinculada a la necesidad de afecto, y una valoración negativa de la paterna, asociada a la percepción de rechazo por una orientación sexual diferente. La necesidad de afecto era canalizada a través de las relaciones interpersonales y en el marco de la práctica de sexo transaccional. Resultaron motivaciones para esta práctica, poder emigrar a otros lugares donde puedan suplir las carencias detectadas. Conclusiones: las experiencias de vida, vinculadas a la práctica del sexo transaccional, confirman y consolidan las concepciones entorno a la doble moral. Las que más influyen en la práctica de este acto son las vivenciadas en las áreas familiar, de pareja y psicosexual(AU)

Introduction: Transactional sex is the act by which an individual accedes to satisfy the sexual demand from a person or group of persons in exchange for monetary remuneration or compensation. Objective: To characterize the experiences in the life history of homosexual young men that have influenced the practice of transactional sex. Methods: Descriptive, cross-sectional study carried out during the years 2012 and 2013. The sample was made up by 25 homosexual young men from Ana Betancourt Polyclinic, who were conducted on an open and semi-structured interview. Results: The family environment is, in the totality of the interviewees, a space of conflict and frustration, with manifestations of prohibitions and lack of understanding by the relatives associated with gender and sexual-erotic identity. Frustration and instability was perceived in the couple area; over-assessment of the mother's figure, associated to the lack of affection; and a negative evaluation of the father's figure, associated with the perception of despise for a different sexual orientation. The necessity of affection was channeled by interpersonal relationships and by practicing transactional sex. Among the motivations for this proactive were to migrate to places when they can supply the scarcities detected. Conclusions: Life experiences associated with the practice of transactional sex confirm and strengthen the conception regarding double morality. Those influencing this practice the most are the experiences in the family, the couple and psychosexual areas(AU)

Prácticas de liderazgo y su relación con la cultura en un grupo de países latinoamericanos / Leadership practices and its relationship with the culture in a group of latin american countries

El propósito de este estudio fue analizar, a través del MLQ 5X, los perfiles de liderazgo de 167 directivos de cuatro países latinoamericanos (Perú, Venezuela, Ecuador y Colombia), para observar si a pesar de la similitud cultural se presentan diferencias en los patrones de liderazgo. Se compararon estos perfiles con los obtenidos por otros autores en regiones culturalmente distintas, para finalmente confrontar los resultados con los de otra muestra colombiana. Se evidenciaron diferencias significativas en liderazgo, tanto entre países culturalmente distintos, como entre los mismos países latinoamericanos, a pesar de su similitud cultural. Finalmente, la muestra de directivos de este estudio difiere significativamente de la otra muestra colombiana, respecto a algunas variables del MLQ. Se discuten esos hallazgos.

The aim of this study was to analyze, by using the MLQ5X, the leadership profiles of 167 managers from four Latin American countries (Peru, Venezuela, Ecuador and Colombia), to see if there are different patterns of leadership despite cultural similarities. Likewise, these profiles were compared with results obtained by other authors from different regions. Finally, these results were compared with another Colombian sample. Significant differences in leadership were found, both in culturally different countries and in Latin American countries, despite their cultural similarities. Finally, the sample of managers in this study differs significantly from the other Colombian sample, in some variables of the MLQ. These findings are discussed.

Relación entre liderazgo transformacional y transaccional con la conducta de compartir conocimiento en dos empresas de servicios / Relationship between transformational and transactional leadership and the sharing of knowledge in two service organizations / Relação entre liderança transformacional e transacional com a conduta de compartilhar conhecimentos em duas empresas de serviços

El objetivo fue describir la relación entre el liderazgo transformacional-transaccional del líder con la conducta de compartir conocimiento de los colaboradores. Utilizando un diseño descriptivo-correlacional con análisis regresional y un muestreo incidental, se valoraron 150 trabajadores de dos empresas de Bogotá: 14 líderes y 136 colaboradores. Los instrumentos aplicados fueron el Multifactor Leadership Questionarie de Bass & Avolio adaptado por Vega & Zavala (2004) y la escala de Compartir Conocimiento de Castañeda (2010). El análisis estadístico se realizó con el paquete estadístico IBM-SPSS STATISTIC 20,0. Entre los líderes se encontró que el 43% se caracteriza por un liderazgo de baja efectividad (bajo nivel transformacional y transaccional) y el 40%, por un liderazgo de rango completo (alto nivel transformacional y transaccional). En los colaboradores, el compartir conocimiento puntuó entre 4,3 y 5,4/6,0; sobresale compartir experiencias e ideas y, en menor nivel, compartir documentos y conocimientos. Desde la perspectiva de los jefes, el liderazgo transaccional correlacionó significativamente (r=0,63; p=0,01) con compartir conocimiento, pero esta conducta no correlacionó con el liderazgo transformacional (r=0,39; p=0,084). En los colaboradores, el liderazgo transformacional y el transaccional mostraron una relación significativa con compartir conocimiento (r=0,29; p<0,001; r=0,26; p=0,001, respectivamente). Se concluyó que en los líderes, el liderazgo transaccional se relaciona con la conducta de compartir conocimiento, y las recompensas tienen un rol importante. No se confirmó la relación entre liderazgo transformacional y la conducta de compartir conocimiento, pero ésta si se da en los colaboradores. Se sugiere a la cultura organizacional como variable mediadora en la relación entre liderazgo transformacional y compartir conocimiento.

The purpose of this paper was to study the relationship between transformational and transactional leadership and the sharing of knowledge. A descriptive correlational design with regression analysis and a casual sampling method were used. The sample comprised 150 employees from two companies in the city of Bogotá, .D.C., Colombia, of which 14 were leaders and 136 were collaborators. Instruments used were the Multi-factor Leadership Questionnaire developed by Bass and Avolio (2000) and adapted by Vega & Zavala (2004), and the Escala de Compartir Conocimiento [Sharing Knowledge Scale ] developed by Castañeda (2010). Statistical analysis was performed with IBM-SPSS STATISTIC 20.0. Among leaders it was found that 43% of them are characterized by a low effectiveness leadership (low transformational and transactional) and 40% of them show a full range leadership (high transformational and transactional). Among collaborators, sharing of knowledge scored between 4.3 and 5.4 /6.0; sharing experiences and ideas stand out and to a lesser level, sharing documents and knowledge. Among leaders, transactional leadership significantly correlated (r=0.63; p=0.01) with sharing of knowledge but this behavior did not correlate with the transformational style (r=0.39; p=0.084); while among collaborators, transformational and transactional leadership showed a significant relationship with sharing of knowledge (r=0.29; p<0.001; r=0.26; p=0.001, respectively). It was concluded that from the perspective of the leaders, there is a relationship between transactional leadership and the behavior of sharing knowledge, and that rewards play an important role. Among leaders, the relationship between transformational leadership and sharing of knowledge was not confirmed, but it was confirmed in collaborators. Organizational culture is suggested as a mediating variable in the relationship between transformational leadership and the sharing of knowledge.

O objetivo foi descrever a relação entre a liderança transformacional-transacional do líder com a conduta de compartilhar conhecimento dos colaboradores. Utilizando um desenho descritivo-correlacional com análise regressional e uma amostragem incidental, avaliaram-se 150 trabalhadores de duas empresas de Bogotá: 14 líderes e 136 colaboradores. Os instrumentos aplicados foram o Multifactor Leadership Questionarie de Bass & Avolio adaptado por Vega & Zavala (2004) e a escala de Compartilhar Conhecimento de Castañeda (2010). A análise estatística realizou-se com o pacote estatístico IBM-SPSS STATISTIC 20,0. Entre os líderes encontrou-se que 43% se caracteriza por uma liderança de baixa efetividade (baixo nível transformacional e transacional) e 40%, por uma liderança de nível completo (alto nível transformacional e transacional). Nos colaboradores, o compartilhar conhecimento pontuou entre 4,3 e 5,4/6,0; sobressaí compartilhar experiências e ideias e, em menor nível, compartilhar documentos e conhecimentos. Desde a perspectiva dos chefes, a liderança transacional correlacionou significativamente (r=0,63; p=0,01) com compartilhar conhecimento, mas esta conduta não se correlacionou com a liderança transformacional (r=0,39; p=0,084). Nos colaboradores, a liderança transformacional e a transacional mostraram uma relação significativa com compartilhar conhecimento (r=0,29; p<0,001; r=0,26; p=0,001, respectivamente). Conclui-se que nos líderes, a liderança transacional se relaciona com a conduta de compartilhar conhecimento, e as recompensas têm um papel importante. Não confirmou-se a relação entre liderança transformacional e a conduta de compartilhar conhecimento, mas a mesma se dá nos colaboradores. Sugere-se a cultura organizacional como variável mediadora na relação entre liderança transformacional e compartilhar conhecimento.

Un modelo transaccional o contextualizado de autonomía en personas con demencia / A transactional or contextualized model of autonomy in persons with dementia

La demencia es una condición que se caracteriza por la alteración de la memoria y otras funciones cognitivas y de la regulación conductual, de carácter adquirido y que repercute el desempeño y la funcionalidad de la persona. La demencia ha sido declarada una prioridad para la salud pública debido a su creciente frecuencia y es una de las principales causas de discapacidad y dependencia en las personas adultas mayores. La alteración cognitiva presente en la demencia se relaciona con la autonomía de las personas, lo que representa desafíos particulares para la Terapia Ocupacional como disciplina que busca la promoción de participación y de autonomía en las personas. Por medio de este ensayo se realiza una discusión en torno a diferentes paradigmas sobre la autonomía en la demencia, para visualizar el desarrollo de un marco conceptual de dicha relación que expanda su comprensión desde la determinación individual hacia la relación con los demás, el ambiente, la agencia y el transaccionalismo, permitiendo vislumbrar un mayor potencial de intervención de Terapia Ocupacional y de estudio desde la ocupación.

Dementia is a condition that features the impairment of cognition and other cognitive and behavioral functions. Dementia is an acquired condition that impacts performance and functionality and it has been declared a public health priority due to its increasing frequency and because it represents one of the major causes of disability and dependence among older adults. The cognitive impairment that dementia implies has an impact on the person’s capability to be autonomous, which is at the same time an important challenge to address by occupational therapy as a profession and discipline that aims to promote participation and autonomy. This essay offers a discussion about paradigms and notions about autonomy in dementia, in order to develop a conceptual framework that enhances an alternative notion of autonomy in dementia better related to the environment, agency and a transactional perspective of occupation.

"A liberdade é azul", mas está no vermelho: blue", but the color of freedom seems to be in the red / "Three colors

Dinheiro é excitante. Dinheiro é sexo. Dinheiro é liberdade. Comprar é excitante. É erótico. Armadilha. Nem toda soma de dinheiro é capital. O dinheiro torna-se capital no modo de produção capitalista. Assim a mercadoria também torna mercadoria-capital. Entender a mais-valia. O artista vive no azul da liberdade e no vermelho das dívidas. E das dúvidas. Necessidade de esclarecimentos. Estudo. Capital humano. Psicanálise, Ciência, Cabala, Teatro, Amor, Poesia, Humor. Muito humor para suportar as vozes dissonantes. O artista busca diálogo. Diálogo com seu Eu e com o Outro. Erotiza a vida e a vida o erotiza. É livre com ou sem dinheiro. Mas com dinheiro ele é mais livre. "O dinheiro não é tudo. Mas quando você tem muito dinheiro pelo menos ninguém chama: Hei, você aí!", Millôr Fernandes.

Money is exciting. Money is sex. Money is freedom. Buying is exciting. It is erotic. It is a trap. Not all sum of money is capital. Money becomes capital in the capitalism. This way goods also become capitalgoods. Understanding the surplus value. The artist, always in the red, has an account in the black when the topic is freedom. Full of doubts, the artist needs enlightening. Studying. Human capital. Psychoanalysis, Science, Cabala, Theater, Love, Poetry, Humor. A lot of humor to handle the dissonant voices. The artist seeks dialogue. A dialogue between the Self and the Other. He eroticizes life and it is eroticized by it. He is free with or without money. But he has more freedom with money. "Money isn't everything. But when you have a lot of it no one calls you: 'Hey, you there!'", Millôr Fernandes.

Liderazgo y su relación con variables de resultado: un modelo estructural comparativo entre liderazgo transformacional y transaccional en una empresa de entretenimiento en México / Leadership and its Relationship with Outcome Variables: a Structural Model Comparing Transformational and Transactional Leadership in an Entertainment Company in Mexico

El objetivo de la investigación fue determinar la influencia de factores de liderazgo transformacional y transaccional en variables de resultado con personal directivo de nivel medio de una Empresa de Entretenimiento en México, D.F, con el Modelo de de liderazgo transformacional de Bass y Avolio. Se aplicó el "Cuestionario sobre Datos Sociodemográficos y Organizacionales del Trabajador" y la "Adaptación al Multifactor Leadership Questionnaire" (MLQ), a una muestra de n = 100 directivos de nivel medio. Los Modelos de Ecuaciones Estructurales determinaron que en el perfil de liderazgo de los directivos investigados destacan en primer lugar sub-escalas transformacionales como son: Estimulación intelectual, Influencia idealizada (Conducta), Influencia idealizada (Atributo) y Consideración individual. La variable de resultados más importante para ellos es el Esfuerzo extra. Lo anterior implica que los directivos estén interesados en desarrollar la capacidad de resolución de problemas y la actualización de su personal. Se reafirmaron los hallazgos teóricos y empíricos de estudios previos, como son las correlaciones directas significativas entre las variables de liderazgo (liderazgo transformacional, transaccional y variables de resultado), e inversas todas ellas con el no liderazgo. Se obtuvieron niveles de confiabilidad Alpha de Cronbach superiores a .70 en la evaluación de dichas variables, a partir de los instrumentos.

The purpose of this article was to determine the influence of transformational and transactional leadership behavior in the outcome variables of a sample of 100 managers within an entertainment provider organization in Mexico. Structural equation modeling showed that the leadership behavior factors of the participating managers highlighted in first place transformational subscales such as intelectual stimulation, idealized influence (behavior), idealized influence (atribute) and individual consideration. The most important outcome variable for them was extra effort. This result means that managers are interested in developing their followers skillness to resolve problems and update their staff. The theoretical and empirical findings of previous studies of the Model of Bass and Avolio were reaffirmed such as direct and significant correlations between the leadership behaviors and outcome variables and inverse correlations with laissez faire leadership behavior. Alpha Cronbach reliability values were above .70 in such variables.

Ego State Analysis in Stroke Rehabilitation / 中国康复理论与实践

@#Because the rehabilitation process is too long and its effect is non-significant, stroke patients are prone to showing over-reliance on their families, being unconfident in their abilities, and they usually miscommunicate with medical staff, in fact, the reason why they have these problems is that they didn't manifest appropriate ego states, so they couldn't communicate with families and medical staff healthily,which is extremely unfavorable for stroke rehabilitation. So-called ego state is individual mentality and corresponding behavior patterns.This paper used ego state concept in transactional analysis theory to describe the change of stroke patients' ego states, and analyze the communication patterns among patients, medical staffs and families, in order to assist patients to be aware of their own ego states, and present them properly, develop healthy communication, and promote the rehabilitation of the disease in the end.

Injunctions in Chronic Disease Patients and Coping Methods / 中国康复理论与实践

Injunction is a conception of transactional analysis. It is an injunctive message delivered from parent to children. Injunction is important for development of personality. We suppose that a person who received more injunctions may tend to have more psychological problems. If chronic disease patients have some injunctions, they may show some psychological characteristics which are not conductive for rehabilitation. This article analyzed the injunctions in chronic disease patients and some coping methods were also dicussed.

Ego State Analysis in Stroke Rehabilitation / 中国康复理论与实践

Because the rehabilitation process is too long and its effect is non-significant, stroke patients are prone to showing over-reli-ance on their families, being unconfident in their abilities, and they usually miscommunicate with medical staff, in fact, the reason why they have these problems is that they didn't manifest appropriate ego states, so they couldn't communicate with families and medical staff healthi-ly, which is extremely unfavorable for stroke rehabilitation. So-called ego state is individual mentality and corresponding behavior patterns. This paper used ego state concept in transactional analysis theory to describe the change of stroke patients' ego states, and analyze the com-munication patterns among patients, medical staffs and families, in order to assist patients to be aware of their own ego states, and present them properly, develop healthy communication, and promote the rehabilitation of the disease in the end.

The relationship between ego-state and communication skills in medical students / 한국의학교육

PURPOSE: The purpose of this study was to examine the relationship between ego-states and communication skills in medical students. METHODS: A total of 109 medical school students participated in this study, which used the communication skills self-test papers and the Egogram checklist. The data were analyzed by frequency analysis, and Pearson correlation analysis. RESULTS: Ego-state was related to communication skills. In particular, adapted child ego-state was negatively associated with each sphere of communication skills. CONCLUSION: Our results suggested that ego-state types should be considered in developing a communication skills education program for medical students.

Validação fatorial de escala de atitudes frente a estilos de liderança / Factorial validation of scale of attitudes toward leadership styles / Validación factorial de escala de actitudes relativas a estilos de liderazgo

Internacionalmente, os estilos de liderança transformacional e transacional estão entre os mais estudados nos últimos 20 anos. Pressupõe-se que a adoção de um ou outro estilo possa ser predita pelas atitudes do gestor frente a cada estilo. O objetivo deste estudo foi fornecer evidências de validade de uma escala para mensuração de atitudes frente à liderança transformacional e transacional. Os itens foram extraídos de escalas internacionais validadas e passaram pelo processo de tradução-retradução. O questionário foi aplicado a uma amostra de 324 profissionais de organizações públicas e privadas de Brasília. A análise fatorial (PAF com rotação Promax) indicou uma estrutura com dois fatores, teoricamente consistentes com a teoria prévia: Fator 1: Liderança Transformacional (24 itens); Fator 2: Liderança Transacional (8 itens). Conclui-se que as evidências encontradas apontam a validade da escala para medir a atitudefrente aos dois estilos de liderança.

Internacionalmente, los estilos de liderazgo transformacional y transaccional están entre los más estudiados en los últimos 20 anos. Sesupone que sea posible prever la adopción de un estilo u otro por medio de las actitudes del gerente relativas a cada estilo. El objetivode esta investigación fue presentar evidencias de validez de una escala para medir las actitudes relativas al liderazgo transformacionaly transaccional. Los ítems fueran retirados de escalas internacionales validadas y pasaron por el proceso de traducción-retraducción.El cuestionario fue respondido por 324 profesionales de organizaciones públicas y privadas de Brasília. El análisis factorial (PAFcon rotación Promax) indicó una estructura con dos factores teóricamente consistentes con la teoría previa: Factor 1: LiderazgoTransformacional (24 ítems), Factor 2: Liderazgo Transaccional (8 ítems). Se concluye que las evidencias apuntan para la validez de laescala para medir las actitudes relativas a los dos estilos de liderazgo.

Internationally, transformational and transactional are among the leadership styles most frequently studied in the last 20 years. It islikely that the adoption of one style or the other could be predicted by leader’s attitudes toward each style. The aim of this study isto present validity evidences of a scale to measure attitudes toward transformational and transactional leadership styles. Items havebeen taken from internationally validated scales and translated to Portuguese through back-translation process. A sample of 324professionals of public and private organizations of Brasilia has answered the questionnaire. Factorial analysis (PAF with Promax Rotation) indicted a two-factor structure, consistent with previous theory: Factor 1: Transformational Leadership (24 items); Factor2: Transactional Leadership (8 items). The evidences point to the validity of the scale to measure attitudes toward both leadership styles.

Características de liderazgo de los estilos transformacional /transaccional en los profesionales de enfermería de una IPS de Bogotá 2011 / Characteristics of leadership of the transformational/transactional styles in the nursing professionals of an IPS in Bogotá 2011

El liderazgo un fenómeno de estudio y de interés desde diferentes áreas y disciplinas, se define como el proceso de dirigir en las actividades laborales de los miembros de un grupo y se reconoce como componente fundamental que influye en la efectividad general de una organización. La Enfermería como disciplina, es un proceso que promueve y contribuye a la mejora de las condiciones de salud y vida de la población, el logro de objetivos de cuidado propios de la profesión, y el alcance de las metas propuestas en los servicios de salud, por ello favorece el desarrollo social, profesional y organizacional. El objetivo de este estudio fue identificar las características de liderazgo de los estilos Transaccional y Transformacional en los profesionales de Enfermería, a partir de la aplicación del cuestionario MLQ 5x en una IPS de Bogotá en el año 2012, con el fin de contribuir en el mejoramiento de la calidad en la prestación de servicios de la institución. El estudio fue de tipo cuantitativo, descriptivo y transversal. Se aplicó el instrumento MLQ-5X versión corta, basado en la teoría de Bass y Avolio sobre el Liderazgo Transformacional y Transaccional y sus características, a 77 profesionales de enfermería. Como resultado se encontró que los profesionales de Enfermería de la institución identificaron sus características de liderazgo pertenecientes al liderazgo transformacional como son: Influencia Idealizada Conductual en un 65%, Motivación Inspiracional en un 80%, Estimulación Intelectual en un 70%, Consideración Individualizada en un 70%, Esfuerzo Extra en un 80%, Efectividad en un 80% y Satisfacción en un 85%. Se concluyó que en lo concerniente al estudio realizado, se indica que éste permitió identificar las características del liderazgo transformacional y transaccional a través del cuestionario MLQ 5x en la versión líder, con relación a las características del liderazgo transformacional se identificaron las siguientes características de liderazgo Influencia Idealizada Conductual 62%, Motivación Inspiracional 80%, Estimulación Intelectual 70%, Consideración Individualizada 70%, Esfuerzo Extra 80%, Efectividad 80%, Satisfacción 85%. Se encuentra un liderazgo transformacional con tendencia a la categoría alta y un liderazgo transaccional con tendencia a la categoría baja. Por otra parte, respondiendo al objetivo de identificar las características del liderazgo transaccional en los profesionales de Enfermería de la IPS se encontró que los profesionales de Enfermería poco se identifican con estas características teniendo así unos porcentajes como en Recompensa contingente un 58.3%, Excepción Activa 36.2% y excepción pasiva 8.28%. Se identificó que el liderazgo transformacional es el estilo predominante en los profesionales en esta IPS, se encuentra un liderazgo transformacional con tendencia a la categoría alta y un liderazgo transaccional con tendencia a la categoría baja. Es importante incluir en el área de Educación de Enfermería de la institución el tema del liderazgo implementando programas y estrategias que ayuden en el desarrollo de líderes, así como proyectos de educación permanente, exponiéndolo en seminarios, talleres, congresos o simposios, utilizando como base este estudio, donde se establezcan estrategias que fomenten y fortalezcan las características de este Modelo de Liderazgo de Rango Total en el profesional de enfermería.

Leadership, a study and interest phenomenon observed from different areas and disciplines, defined as the process of leading members of a group in their work activities, is recognized as a fundamental component which influences the general effectiveness of an organization. Nursing, as a discipline, is a process that promotes and contributes to the improvement of health and life conditions of the population, achieving health care objectives inherent to the profession, and fulfilling the proposed goals in health services, favoring social, professional and organizational development. This study's objective was to identify the leadership characteristics of the Transactional and Transformational styles in the nursing profession, by applying the MLQ 5x questionnaire at an IPS in Bogota during 2012, in order to contribute in improving the quality of the services rendered by the institution. This was a quantitative, descriptive, and transversal study. The short version of the MLQ-5X instrument based on the Bass and Avolio theory on Transformational and Transactional Leadership and its characteristics was applied to 77 nursing professionals. The result showed that nursing professionals of the institution identified their leadership characteristics pertaining to transformational leadership such as: Idealized Influence Behavior 65%, Inspirational Motivation 80%, Intellectual Stimulation 70%, Individualized Consideration 70%, Extra effort 80%, Effectiveness 80%, and Satisfaction 85%. Regarding the performed study it was concluded that, it allowed the identification of the transformational and transactional leadership characteristics by means of the MLQ 5x questionnaire in leader version. In relation to transformational leadership characteristics the following were identified: Idealized Influenced Behavior 62%, Inspirational Motivation 80%, Intellectual Stimulation 70%, Individualized Consideration 70%, Extra effort 80%, Effectiveness 80% and Satisfaction 85%. As a result there is a transformational leadership with tendency towards a high category and a transactional leadership with tendency towards a low category. On the other hand in response to the objective of identifying transactional leadership characteristics in nursing professionals of the IPS, it was found that nursing professionals are less identified with these characteristics, having percentages such as Contingent Reward 58.3%, Active Exception 36.2% and Passive Exception 8.28%. Regarding the third and last objective, transformational leadership was identified as the predominating style in the professionals of this IPS, a transformational leadership with tendency towards a high category and a transactional leadership with tendency towards a low category were found. It is important to include within the Nursing Education area of the institution the topic of leadership, implementing programs and strategies which help develop leaders, as well as permanent educational projects, by means of seminars, workshops, congresses or symposium, using this study as the base, where strategies are established to promote and strengthen the characteristics of this Total Range Leadership Model in nursing professionals.

Uma experiência de psicoterapia de grupo dentro da Estratégia Saúde da Família / An experience of group psychotherapy in the Brazilian Family Health Program / Una experiencia de psicoterapia de grupo dentro de la Estrategia Salud de la Familia

Este trabalho avaliou um Grupo de Saúde Mental desenvolvido na Estratégia Saúde da Família, baseado na análise transacional associada à terapia cognitivo-comportamental, descrevendo o impacto desta intervenção na melhoria da qualidade de vida da população atendida. Na Unidade Básica de Saúde Cruz das Almas, da Prefeitura de São Paulo, desde janeiro de 2007, realiza-se um grupo de Saúde Mental, com a frequência de uma vez por semana, com duração de uma hora. Neste grupo, os participantes discutem temas de seus interesses e aprendem técnicas de psicoterapia para lidarem com eventos do cotidiano e manejarem suas emoções e comportamentos de forma construtiva. O grupo é aberto aos interessados em participar das sessões de terapia, constituindo-se, em sua maioria, de pacientes acompanhados pelas equipes do Programa Saúde da Família e encaminhados ao Grupo de Saúde Mental. Ao ingressarem ao grupo, os pacientes preenchem o questionário sobre a saúde do(a) paciente, versão brasileira, conhecida pela sigla PHQ-9. Após frequentarem o grupo por, no mínimo, 12 sessões, os participantes preenchem um questionário de autoavaliação, informando sobre sua sensação de melhora em relação à sua saúde, melhora na autoestima e nos relacionamentos pessoais, e a visão mais positiva da vida e das outras pessoas. Dos participantes avaliados, 40 preencheram o questionário PHQ-9. Destes, nove (22,5%) tiveram pontuação de zero a quatro (sem depressão); seis (15%) tiveram pontuação de cinco a nove (depressão leve); dez (25%) tiveram pontuação de 10 a 14 (depressão moderada); sete (17,5%) tiveram pontuação de 15 a 19 (depressão moderada a grave); e oito (20%) tiveram pontuação de 20 ou mais (depressão grave). Dos 65 pacientes que responderam ao questionário de autoavaliação após pelo menos 12 sessões de terapia, 51 (78%) relataram visão mais positiva da vida e dos outros com a terapia; 44 (67%) referiram melhora da autoestima; 52 (80%), melhora nos relacionamentos e 53 (81%), melhora em relação à saúde. A melhora relatada pelos pacientes nas diversas áreas de suas vidas aponta para a importância desse tipo de abordagem dentro da Estratégia Saúde da Família, e para o impacto positivo da Psicoterapia baseada na Análise Transacional associada a técnicas cognitivo-comportamentais no tratamento de pacientes com transtornos mentais na Atenção Primária à Saúde.

This article evaluated an experiment carried out at the Family Health Program with the establishment of a Mental Health Group, based on transactional analysis associated with the cognitive-behavioral therapy, describing the impact of this intervention in improving the quality of life of the population served by the public system. In the Cruz das Almas Health Basic Unit, from São Paulo City Hall, a group of Mental Health has been happening since January, 2007, with the frequency of once a week, during one hour. In it, participants discuss topics of interest and learn psychotherapy techniques to deal with daily events and to manage their emotions and behaviors in a constructive way. The group is open to all those interested in participating in therapy sessions, being constituted, in most cases, by patients followed by the Family Health Program teams and sent to the Mental Health Group. When patients join the group, they fill out a questionnaire known as Patient Health Questionnaire, Brazilian version, known by the acronym PHQ-9. After attending the group for at least 12 sessions, participants complete a self-assessment questionnaire, informing about feeling better on their health, improved self-esteem, and personal relationships, and about having a more positive view of life and of other people. Of the evaluated participants, 40 completed the questionnaire. From these, nine (22.5%) had scores of zero to four (without depression); six (15%) scored five to nine (mild depression); ten (25%) had scores from 10 to 14 (moderate depression); seven (17.5%) had a score of 15 to 19 (moderate to severe depression); and eight (20%) had scores of 20 or more (severe depression). Of the 65 patients who completed the questionnaire for self-evaluation after at least 12 sessions of therapy, 51 (78%) reported a more positive view of life and of other people; 44 (67%) reported improved self-esteem; 52 (80%) related improvement in relationships and 53 (81%) improvement in relation to their health. The improvement reported by patients in different areas of their lives points to the importance of this approach within the Family Health Strategy and the positive impact of psychotherapy based on transactional analysis associated with cognitive-behavioral techniques in treating patients with mental disorders within the Health Primary Attention.

Este artículo evaluó un Grupo de Salud Mental desarrollado en la Estrategia de Salud de la Familia, basado en el análisis transaccional asociada con la terapia cognitivo-conductual, que describe el impacto de esta intervención en la mejora de la calidad de vida de la población atendida. En la Unidad Básica de Salud Cruz das Almas, de la Municipalidad de São Paulo, ha estado funcionando desde enero de 2007 un grupo de Salud Mental, con la frecuencia de una vez por semana, con una duración de una hora. En este grupo, los participantes discuten temas de su interés y aprenden técnicas de psicoterapia para hacer frente a los acontecimientos cotidianos y gestionar sus emociones y conductas de una manera constructiva. El grupo está abierto a todos los interesados en participar en las sesiones de terapia, siendo, en su mayoría, pacientes seguidos por los equipos de la del Programa Salud de la Familia y enviados al Grupo de Salud Mental. Al participar en el grupo, los pacientes completan el cuestionario sobre la salud del paciente, versión brasileña, conocida como el PHQ-9. Después de asistir al grupo por lo menos 12 sesiones, los participantes llenan un cuestionario de auto-evaluación, informando sobre su sensación de mejora en relación con su salud, la mejora de la autoestima y las relaciones personales y sobre su visión más positiva de la vida y de las otras personas. De los participantes evaluados, 40 completaron el cuestionario PHQ-9. De estos, nove (22,5%) tuvieron una puntuación de cero a cuatro (sin depresión); seis (15%) tuvieron una puntuación de cinco a nove (depresión leve); dez (25%) tuvieron una puntuación de 10 a 14 (depresión moderada); siete (17,5%) tuvieron una puntuación de 15 a 19 (depresión moderada a severa); y ocho (20%) tuvieron puntuaciones de 20 o más (depresión severa). De los 65 pacientes que completaron el cuestionario de auto-evaluación después de al menos 12 sesiones de terapia, 51 (78%) reportaron una visión más positiva de la vida y de las otras personas; 44 (67%) reportaron mejora de la autoestima; 52 (80%) reportaron mejora en las relaciones y 53 (81%), mejora en relación con su salud. La mejora reportada por los pacientes en las diferentes áreas de sus vidas muestra la importancia de este enfoque dentro de la Estrategia de Salud de la Familia y para el impacto positivo de la Psicoterapia basada en el Análisis Transaccional asociada con técnicas cognitivo-conductuales en el tratamiento de pacientes con trastornos mentales en la Atención Primaria de Salud.