RESUMEN
The purpose of this scoping review is to employ Arksey and O’Malley’s scoping review methodology to determine leadership and management styles and their influence on health worker’s job satisfaction and productivity in Low-and middle-income countries. A scoping review of literature published in English since May, 2012 was carried out using PubMed, CINAHL, ScienceDirect, ProQuest and Sage. Key search terms strategy was employed using the words “leadership styles”, “management styles”, “health workers”, “productivity” and “job satisfaction” to identify relevant studies. A total of 1487 articles resulted from the application of the search strategy. Nineteen articles met the inclusion criteria of which 18 was quantitative and 1 was qualitative study. The main leadership styles identified were transformational leadership style, transactional leadership style, laissez-faire leadership style and autocratic leadership style. Transformational leadership style was found to have a higher influence on job satisfaction as compared to the other forms leadership styles. Also, transformational leadership styles encouraged about 67% of health workers to provide better healthcare services to their patients. Health facilities in LMICs have employed mainly transformational, transactional, participatory and laissez-faire leadership styles that have varying degree of influence on health workers job satisfaction. Transformational leadership style has proven to positively influence job satisfaction and productivity while laissez-faire leadership demotivate healthcare workers. In order to improve health care services and productivity for client as well as job satisfaction for healthcare workers, transformational leadership trainings will have to be intensified.
RESUMEN
In order to study the detailed morphology of trophoblast cells during human implantation, BeWo cells were cultured as spheroids in suspension culture. These cultures were then processed for light and electron microscopical examination. The present study showed that the BeWo spheroids consist of two cell types which are cytotrophoblast-like and syncytiotrophoblast-like. The cells with larger nuclear diameter made up only about 1 percent of the cell population and appear to be those of syncytiotrophoblast. Therefore the predominant cell type of the BeWo spheroids appeared to be relatively undifferentiated and cytotrophoblast-like. About 10 percent of the BeWo cells in the present study were mitotic, indicating a highly proliferative population. Total cell number increased about 12 times during the culture period from 107 +/- 9 on day 1 to 1211 +/- 145 on day 7 whereas the volume per cell increased about 2 times, from 1300 um3 on day 1 to 2400 um3 on day 7. Therefore overall growth of BeWo spheroids is due to both hyperplasia and hypertrophy. However, it appears that cell proliferation outstrips volumetric growth. These quantitative data show that BeWo cells grow mainly by hyperplasia and provide baseline values for further studies. In addition, the results show that BeWo cell morphology has marked similarities to that reported for human trophoblast, making it a useful model for subsequent in vitro studies.
En un cultivo de suspensión se estudió la morfología de las células durante la implantación del trofoblasto humano, células BeWo. Estos cultivos fueron procesados y examinados a través de microscopía de luz y electrónica. El estudio mostró que los esferoides BeWo constan de dos tipos de células, citotrofoblasto y sincitiotrofoblasto. Las células con mayor diámetro nuclear parecen ser los sincitiotrofoblasto que representaban sólo el 1 por ciento de la población celular. Por tanto, el tipo celular predominante de los esferoides BeWo parecían ser relativamente indiferenciados como citotrofoblasto. Alrededor del 10 por ciento de las células BeWo fueron mitóticas, lo que indica una población altamente proliferativa. El número de células totales aumentó alrededor de 12 veces durante el período de cultivo de 107 +/- 9 días en el día 1 a 1211 +/- 145 en el día 7, mientras que el volumen de la célula creció alrededor de 2 veces, desde 1300 mm3 el día 1 hasta 2400 mm3 el día 7. Por lo tanto, el crecimiento global de esferoides BeWo se debe tanto a la hiperplasia como a la hipertrofia. Sin embargo, parece que la proliferación celular supera al crecimiento volumétrico. Estos datos cuantitativos muestran que las células BeWo crecen principalmente por hiperplasia y proporcionan valores de referencia para estudios posteriores. Además, los resultados muestran que la morfología celular BeWo ha marcado similitudes con los reportado para el trofoblasto humano, por lo que es un modelo útil para posteriores estudios in vitro.