Autopercepción de las personas responsables en los equipos sanitarios de Andalucía. Estudio cuantitativo y cualitativo / Self-perception of health care team leaders in Andalusia. A quantitative and qualitative study

Objetivo. Conocer la percepción y autovaloración de los y las responsables de equipos sanitarios de Andalucía sobre el liderazgo. Material y métodos. Diseño exploratorio descriptivo mixto cuantitativo-cualitativo, llevado a cabo entre 2013 y 2015, usando un cuestionario de elaboración propia y una entrevista semiestructurada. Emplazamiento: Andalucía. Participantes: total de responsables de las unidades de gestión clínica de atención primaria y de las unidades de pediatría, urgencias y medicina interna de las áreas de gestión sanitaria para el estudio cuantitativo. Muestreo intencional de 24 responsables para el estudio cualitativo. Análisis: estudio estadístico descriptivo y análisis bivariante de diferencias de medias. Análisis de contenido de entrevistas incluyendo: codificación, árbol de categorías y triangulación de resultados. Resultados. La dimensión que mejor se autovaloraron fue el apoyo prestado a sus profesionales y la peor, la referente a la autodefinición como «buen/a líder». Esta última giró en torno a 3 dimensiones clave: honestidad y capacidad de ganarse la confianza del equipo, actitud comunicativa y cercana, y reconocimiento y refuerzo de los miembros del equipo. Se describieron estilos dispares de liderazgo. Las principales dificultades que condicionaron el ejercicio de liderazgo se relacionaron con las restricciones derivadas de la crisis económica y con la gestión de los conflictos personales. Conclusiones. Las personas responsables describieron un estilo de liderazgo adaptado a las circunstancias, basado en el apoyo profesional y personal, que apuesta por la comunicación como elemento clave de cohesión y proyecto de equipo. Es necesario seguir estudiando la visión de los líderes, para conocer mejor sus experiencias, necesidades y expectativas (AU)

Objective. To determine the perception and self-assessment on leadership among health care team leaders in Andalusia. Material and methods. Design: Exploratory descriptive study using quantitative and qualitative methodology, developed between 2013 and 2015, using a questionnaire and semi-structured interviews. Place: Andalusia. Participants: All health managers from the Primary Care Management Units and Health Management Areas of the Departments of Paediatrics, Emergency and Internal Medicine, for the quantitative study. A purposive sample of 24 health managers was used for the qualitative study. Methods: Descriptive statistical study and bivariate analysis of comparison of means. Content analysis of the semi-structured interviews: Codification, category tree, and triangulation of results. Results. The best self-assessment dimension relates to support, and the worst to considering oneself as a ‘good leader’. The definition of a ‘good leader’ includes: Honesty, trust, and attitudes of good communication, closeness, appreciation, and reinforcement of the health team members. Different leadership styles were perceived. Main difficulties for leadership are related to the economic crisis and the management of personal conflicts. Conclusions. Health managers describe an adaptive leadership style, based on personal and professional support, and using communication as the main cohesive element for the team project. More studies on leaders’ perspectives are important, in order to better understand their experiences, needs and expectations (AU)

[Self-perception of health care team leaders in Andalusia. A quantitative and qualitative study]. / Autopercepción de las personas responsables en los equipos sanitarios de Andalucía. Estudio cuantitativo y cualitativo.

OBJECTIVE: To determine the perception and self-assessment on leadership among health care team leaders in Andalusia. MATERIAL AND METHODS: Design: Exploratory descriptive study using quantitative and qualitative methodology, developed between 2013 and 2015, using a questionnaire and semi-structured interviews. PLACE: Andalusia. PARTICIPANTS: All health managers from the Primary Care Management Units and Health Management Areas of the Departments of Paediatrics, Emergency and Internal Medicine, for the quantitative study. A purposive sample of 24 health managers was used for the qualitative study. METHODS: Descriptive statistical study and bivariate analysis of comparison of means. Content analysis of the semi-structured interviews: Codification, category tree, and triangulation of results. RESULTS: The best self-assessment dimension relates to support, and the worst to considering oneself as a 'good leader'. The definition of a 'good leader' includes: Honesty, trust, and attitudes of good communication, closeness, appreciation, and reinforcement of the health team members. Different leadership styles were perceived. Main difficulties for leadership are related to the economic crisis and the management of personal conflicts. CONCLUSIONS: Health managers describe an adaptive leadership style, based on personal and professional support, and using communication as the main cohesive element for the team project. More studies on leaders' perspectives are important, in order to better understand their experiences, needs and expectations.

Changes in soil microbial community functionality and structure in a metal-polluted site: The effect of digestate and fly ash applications.

Soil from Trhové Dusníky (Príbram, Czech Republic) is characterized by its high polymetallic accumulations in Pb-Ag-Zn due to mining and smelting activities. In previous studies performed in our research group, we have evaluated the potential use of amendments that would reduce the mobility and availability of metals such as Hg. We have observed that the application of digestate and fly ash in metal-polluted soil has an impact in immobilizing these metals. However, until now we have lacked information about the effect of these amendments on soil microbial functionality and communities. The multi-contaminated soil was used to grow wheat in a pot experiment to evaluate the impact of digestate and fly ash application in soil microbial communities. Soil samples were collected after 30 and 60 days of treatment. The digestate application improved chemical attributes such as the content in total organic carbon (TOC), water soluble carbon (WSOC), total soluble carbon (C), total soluble nitrogen (N), and inorganic N forms (NO3(-)) as consequence of high content in C and N which is contained in digestate. Likewise, microbial activity was greatly enhanced by digestate application, as was physiological diversity. Bacterial and fungal communities were increased, and the microbial biomass was highly enhanced. These effects were evident after 30 and 60 days of treatment. In contrast, fly ash did not have a remarkable effect when compared to digestate, but soil microbial biomass was positively affected as a consequence of macro- and micro-nutrient sources applied by the addition of fly ash. This study indicates that digestate can be used successfully in the remediation of metal-contaminated soil.

Short-term dynamics of culturable bacteria in a soil amended with biotransformed dry olive residue.

Dry olive residue (DOR) transformation by wood decomposing basidiomycetes (e.g. Coriolopsis floccosa) is a possible strategy for eliminating the liabilities related to the use of olive oil industry waste as an organic soil amendment. The effects of organic fertilization with DOR on the culturable soil microbiota are largely unknown. Therefore, the objectives of this study were to measure the short-term effects of DOR and C. floccosa-transformed DOR on the culturable bacterial soil community, while at the same time documenting the bacterial diversity of an agronomic soil in the southeastern Iberian Peninsula. The control soil was compared with the same soil treated with DOR and with C. floccosa-transformed DOR for 0, 30 and 60 days. Impact was measured from total viable cells and CFU counts, as well as the isolation and characterization of 900 strains by fatty acid methyl ester profiles and 16S rRNA partial sequencing. The bacterial diversity was distributed between Actinobacteria, Alphaproteobacteria, Gammaproteobacteria, Betaproteobacteria, Bacilli, Sphingobacteria and Cytophagia. Analysis of the treatments and controls demonstrated that soil amendment with untransformed DOR produced important changes in bacterial density and diversity. However, when C. floccosa-transformed DOR was applied, bacterial proliferation was observed but bacterial diversity was less affected, and the distribution of microorganisms was more similar to the unamended soil.

El clima emocional en los equipos de atención primaria. Una aproximación cualitativa / Emotional climate in Primary Health Care teams. A qualitative approach

Fundamento. Las interacciones sociales en los equipos de trabajo de Atención primaria movilizan importantes aspectos emocionales que afectan el ambiente, rendimiento y satisfacción de profesionales y pacientes. El objetivo del estudio es describir el clima emocional de los equipos de trabajo de Atención primaria, planteando si hay diferencias en la percepción del clima emocional en función de la categoría profesional y de la pertenencia a un grupo con clima emocional positivo o negativo. Métodos. Se ha empleado metodología cualitativa: 2 grupos nominales y 2 grupos focales, con 18 profesionales (personal médico y de enfermería) de Atención primaria de 2 distritos sanitarios andaluces. La información se ha grabado y posteriormente, se ha realizado un análisis de contenido. Resultados. El personal sanitario identificó las siguientes dimensiones explicativas del clima emocional: relaciones profesionales (con un alto peso), proyecto común, reconocimiento profesional, estilo de liderazgo, desgaste y actitudes personales y condiciones de trabajo. Se perciben diferencias entre las opiniones del personal médico y enfermero, asociado a la existencia de un clima emocional negativo. Conclusiones. Se requieren más investigaciones sobre el clima emocional en Atención primaria, de cara a proponer líneas de actuación para mejorar la satisfacción y la calidad de vida de los y las profesionales(AU)

Objective. The social interactions met in the Primary Health Care work teams are driven by important emotional aspects that affect the environment, results and the satisfaction of the professional and the patients. The objective of this work is to describe the emotional climate of Primary Care work teams, looking for the perceptions of different professional category and different work groups (selected by the quality of their emotional climate). Methods. A qualitative methodology was used: 2 nominal groups and 2 focal groups, with 18 physicians and nurses working in the Andalusian Primary Health Care system. The information was recorded and then a content analysis was made. Results. Health care professionals identify the following explanatory dimensions: professional relationship (high scored), shared work project, professional recognition, leadership, burnout and personal attitudes, as well as work conditions. Different opinions were recorded among physicians and nurses, especially when the group had a bad emotional atmosphere. Conclusions. More studies on the emotional climate in Primary Health Care are needed in order to propose strategies to improve satisfaction and quality of work life among professionals(AU)

[Emotional climate in Primary Health Care teams. A qualitative approach]. / El clima emocional en los equipos de atención primaria. Una aproximación cualitativa.

OBJECTIVE: The social interactions met in the Primary Health Care work teams are driven by important emotional aspects that affect the environment, results and the satisfaction of the professional and the patients. The objective of this work is to describe the emotional climate of Primary Care work teams, looking for the perceptions of different professional category and different work groups (selected by the quality of their emotional climate). METHODS: A qualitative methodology was used: 2 nominal groups and 2 focal groups, with 18 physicians and nurses working in the Andalusian Primary Health Care system. The information was recorded and then a content analysis was made. RESULTS: Health care professionals identify the following explanatory dimensions: professional relationship (high scored), shared work project, professional recognition, leadership, burnout and personal attitudes, as well as work conditions. Different opinions were recorded among physicians and nurses, especially when the group had a bad emotional atmosphere. CONCLUSIONS: More studies on the emotional climate in Primary Health Care are needed in order to propose strategies to improve satisfaction and quality of work life among professionals.

Contribution of the saprobic fungi Trametes versicolor and Trichoderma harzianum and the arbuscular mycorrhizal fungi Glomus deserticola and G. claroideum to arsenic tolerance of Eucalyptus globulus.

The presence of high concentrations of arsenic (As) decreased the shoot and root dry weight, chlorophyll and P and Mg content of Eucalyptus globulus colonized with the arbuscular mycorrhizal (AM) fungi Glomus deserticola or G. claroideum, but these parameters were higher than in non-AM plants. As increased the percentage of AM length colonization and succinate dehydrogenase (SDH) activity in the root of E. globulus. Trichoderma harzianum, but not Trametes versicolor, increased the shoot and root dry weight, chlorophyll content, the percentage of AM root length colonization and SDH activity of E. globulus in presence of all As concentrations applied to soil when was inoculated together with G. claroideum. AM fungi increased shoot As and P concentration of E. globulus to higher level than the non-AM inoculated controls. The contribution of the AM and saprobe fungi to the translocation of As from root to shoot of E. globulus is discussed.

Interactions of Trametes versicolor, Coriolopsis rigida and the arbuscular mycorrhizal fungus Glomus deserticola on the copper tolerance of Eucalyptus globulus.

The presence of high levels of Cu in soil decreases the shoot and root dry weights of Eucalyptus globulus. However, higher plant tolerance of Cu has been observed in the presence of the arbuscular mycorrhizal (AM) fungus Glomus deserticola. The hyphal length of G. deserticola was sensitive to low Cu concentrations, and the percentage of AM root colonisation and the metabolic activity of the AM fungus were also decreased by Cu. Therefore, a direct effect of Cu on the development of the AM fungus inside and outside the root cannot be ruled out. E. globulus colonised by G. deserticola had higher metal concentrations in the roots and shoots than do non-mycorrhizal plants; however, the absence of a higher root to shoot metal ratio in the mycorrhizal plants (1.70+/-0.11) indicated that G. deserticola did not play a filtering/sequestering role against Cu. The saprobe fungi Coriolopsis rigida and Trametes versicolor were able to remove Cu ions from the asparagine-glucose growth media. However, plants inoculated with C. rigida and T. versicolor did not accumulate more Cu than non-inoculated controls, and the growth of the plant was not increased in the presence of these fungi. However, C. rigida increased the shoot dry weight, AM root length colonisation, and metabolic mycelial activity of plants colonised with G. deserticola in the presence of Cu; only this saprobe-AM fungus combination increased the tolerance of E. globulus to Cu. Inoculation with G. deserticola and C. rigida increased the E. globulus Cu uptake to levels reached by hyperaccumulative plants.

Improvement of growth of Eucalyptus globulus and soil biological parameters by amendment with sewage sludge and inoculation with arbuscular mycorrhizal and saprobe fungi.

Sewage sludge is widely used as an organic soil amendment to improve soil fertility. We investigated the effects of sewage sludge (SS) application on certain biological parameters of Eucalyptus globulus Labill. The plant was either uninoculated or inoculated with saprobe fungi (Coriolopsis rigida and Trichoderma harzianum) or arbuscular mycorrhizal (AM) fungi (Glomus deserticola and Gigaspora rosea). Sewage sludge was applied to the surface of experimental plots at rates of 0, 2, 4, 6 and 8 g 100 g(-1) of soil. Inoculation with both AM and saprobe fungi in the presence of SS was essential for the promotion of plant growth. The AM, saprobe fungi and SS significantly increased dry shoot weight. The AM fungi induced a significant increase in Fluorescein diacetate (FDA) activity but did not increase beta-glucosidase activity. Addition of SS to AM-inoculated soil did not affect either FDA or alpha-glucosidase activities in plants from soil that was either uninoculated or inoculated with the saprobe fungi. SS increased beta-glucosidase activity when it was applied at 4 g 100 g(-1). SS negatively affected AM colonization as well as the mycelium SDH activity for both mycorrhizal fungi. SS increased Eucalyptus shoot biomass and enhanced its nutrient status. Inoculation of the soil with G. deserticola stimulated significant E. globulus growth and increases in shoot tissue content of N, P, K, Ca, Mg and Fe. Dual inoculation with G. deserticola and either of the saprobe fungi had positive effects on K, Ca, Mg and Fe contents. The application of 8 g 100 g(-1) of SS had no positive effects on plant nutrition. The experimental setup provided a suitable tool for evaluating SS in combination with saprobe and AM fungi as a biological fertiliser for its beneficial effects on E. globulus plant growth.

Saprobe fungi decreased the sensitivity to the toxic effect of dry olive mill residue on arbuscular mycorrhizal plants.

We studied the influence of olive mill dry residue (DOR) treated with saprobe fungi on growth of tomato and alfalfa colonized by Glomus deserticola. The application of 25g kg(-1) of dry DOR to soil decreased the shoot and root dry weight of tomato and alfalfa. Plants were more sensitive to the toxicity of DOR when colonized with the arbuscular mycorrhizal (AM) fungi. The sensitivity of both plants to the toxicity of DOR differed according to whether they were colonized by G. deserticola or by indigenous AM fungi. The phytotoxicity of DOR towards tomato and alfalfa was decreased by incubation the residue before planting with saprobe fungi for 20wk. The beneficial effects of AM fungi on plant growth added with DOR incubated with saprobe fungi depend of the type of the plant and AM fungi. The contribution of AM fungi to the beneficial effect of DOR incubated with saprobe fungi varied according to the type of the plant and AM fungi. G. deserticola increased the shoot and root dry weight of plants when they were grown in the presence of DOR incubated with saprobe fungi for 20wk. The beneficial effect of saprobe fungi on the dry weight and the level of AM mycorrhization of plants seem to be related to the decrease caused by these fungi in the phenol concentration in DOR. However, the toxicity of DOR due to substances other than phenols can not be ignored. The use of certain saprobe and AM fungi allows the possibility of using DOR as an organic fertilizer.

Chemical characterization and effects on Lepidium sativum of the native and bioremediated components of dry olive mill residue.

Dry olive mill residue (DOR) from the olive oil production by two phase centrifugation system was fractionated by a consecutive continuous solid-liquid extraction obtaining the EAF, PF, MF and WF fractions with ethyl acetate, n-propanol, methanol and water, respectively. The chemical, chromatographic and mass spectrometric analyses showed EAF, PF and MF to be mainly composed of simple phenols, phenolic acids, flavonoids and glycosilated phenols (glycosides of phenols, secoiridoids and flavonoids), whereas WF was mainly consisting of polymerin, the metal organic polymeric mixture previously identified in olive oil mill waste waters and composed of carbohydrates, melanin, proteins and metals (K, Na, Ca, Mg and Fe). The identification in DOR of oleoside, 6'-beta-glucopyranosyl-oleoside and 6'-beta-rhamnopyranosyl-oleoside, and of its organic polymeric component, known as polymerin, are reported for the first time in this paper. The inoculation of the previously mentioned fractions with saprobe fungi Coriolopsis rigida, Pycnoporus cynnabarinus or Trametes versicolor indicated these fungi to be able to metabolize both the phenols and glycosilated phenols, but not polymerin. In correspondence, EAF, PF, MF and WF, which proved to be toxic on Lepidium sativum, decreased their toxicity after incubation with the selected fungi, WF showing to be also able to stimulate the growth of the selected seeds. The phytotoxicity appeared mainly correlated to the monomeric phenols and, to a lesser extent, to the glycosilated phenols, whereas polymerin proved to be non toxic. However, the laccase activity was not associated with the decrease of phytotoxicity. The valorization of DOR as a producer of high added value substances of industrial and agricultural interest in native form and after their bioremediation for a final objective of the total DOR recycling is also discussed.

Reusing ethyl acetate and aqueous exhausted fractions of dry olive mill residue by saprobe fungi.

Some saprobe fungi (Phlebia radiata, Trametes versicolor, Coriolopsis rigida, Pycnoporus cinnabarinus, Fomes sclerodermus or Pleurotus pulmonarius) were able to bioconvert the ethyl acetate fraction (DEAF) and the corresponding aqueous exhausted fraction (EAF) of dry olive mill residue (DOR), reducing their phytotoxicity on Lepidium sativum seeds. Large amount of hydroxytyrosol together with other eight monomeric phenols were found in the native DEAF fraction, which represents a good source of antioxidants. P. radiata, T. versicolor and F. sclerodermus caused an effective phytotoxicity reduction of EAF in the concentration range of 25-3 gl(-1). In particular, in the range between 12.5 and 3 gl(-1), the EAF samples inoculated with P. radiata and F. sclerodermus surprisingly stimulated the germinability of L. sativum, suggesting their use as a potential biofertilizer. This is the first report which showed the bioconversion of the above fractions in shorter time with respect to the previous findings concerning DOR. The possible implications of laccase in the decrease of DEAF and EAF phytotoxicity was also discussed.

Bioconversion of olive-mill dry residue by Fusarium lateritium and subsequent impact on its phytotoxicity.

The present study investigated the ability of the non-pathogenic fungus Fusarium lateritium to either degrade or modify aromatic substances in olive-mill dry residue (DOR) and to reduce its phytotoxicity. The 80% reduction of ethylacetate extractable phenols in DOR colonized by the fungus for 20 weeks appeared to be due to polymerization reactions of phenol molecules as suggested by mass-balance ultrafiltration and size-exclusion chromatography experiments. Several lignin-modifying oxidases, including laccase, Mn-peroxidase and Mn-inhibited peroxidase were detected in F. lateritium solid-state cultures. Tests performed with tomato seedlings in soils containing 6% (w/w) sterilized non-inoculated DOR showed that the waste was highly phytotoxic. By contract, F. lateritium growth on DOR for 20 weeks led to a complete removal of the waste toxicity and to a higher shoot dry weight of tomato plants than that obtained in the absence of DOR.

Improvement by soil yeasts of arbuscular mycorrhizal symbiosis of soybean (Glycine max) colonized by Glomus mosseae.

The effects of the soil yeasts Rhodotorula mucilaginosa, Cryptococcus laurentii and Saccharomyces kunashirensis on the arbuscular mycorrhizal (AM) fungus Glomus mosseae (BEG 12) was studied in vitro and in greenhouse trials. The presence of yeasts or their soluble and volatile exudates stimulated the percentage spore germination and hyphal growth of G. mosseae. Percentage root length colonized by G. mosseae and plant dry matter of soybean (Glycine maxL. Merill) were increased only when the soil yeasts were inoculated prior to the AM fungus. Higher beneficial effects on AM colonization and plant dry matter were found when the soil yeasts were inoculated as an aqueous solution rather than as a thin agar slice. Although soluble and volatile exudates of yeasts benefited the AM symbiosis, their modes of action were different.

Contribution of hydrolytic enzymes produced by saprophytic fungi to the decrease in plant toxicity caused by water-soluble substances in olive mill dry residue.

We studied the influence of saprophytic fungi on the toxic effect that the water-soluble substances in dry residues from olive (ADOR) have on the growth of plants. All saprophytic fungi were able to decrease the phytotoxicity of ADOR, although the toxicity of this residue did not decrease in the same way. Penicillium chrysogenum was able to reduce the toxicity of ADOR when this residue was applied at the highest dose of 15%. Fusarium lateritum, F. graminearum and Mucor racemosus were able to reduce the toxicity of ADOR when this residue was applied at the intermediate doses. However, F. oxysporum decreased the phytotoxicity of ADOR only when the residue was applied at the lowest dose of 2.5%. All saprophytic fungi tested produce endoglucanase, endopolymetylgalacturonase and endoxiloglucanase when grown in the presence of ADOR. A close relationship was found between the decrease in the phytotoxicity of ADOR and the amount of hydrolytic enzymes produced by the saprophytic fungi. These results shows that hydrolytic enzymes can be important in the degradation of phytotoxic substances present in olive mill dry residue.

Hydrolytic enzymes and ability of arbuscular mycorrhizal fungi to colonize roots.

The production of hydrolytic enzymes from external mycelia associated with roots and colonized soybean roots (Glycine max L.) inoculated with different arbuscular-mycorrhizal (AM) fungi of the genus GLOMUS:, and the possible relationship between these activities and the capacity of the AM fungi to colonize plant roots was studied. There were differences in root colonization and plant growth between the GLOMUS: strains, and also between two isolates of G. mosseae. Hydrolytic activities in the root and external mycelia associated with roots differed in the AM fungi tested. Correlations were only found between the endoxyloglucanase activity of the external mycelia associated with roots of the AM fungi tested and the percentage root colonization or plant growth. However, hydrolytic activities of roots colonized by the different endophytes correlated with those of external mycelia. The hydrolytic activities were not qualitatively different because the endoxyloglucanase from AM colonized roots and the external mycelia did not show a high degree of polymorphism in the different species of fungus tested. The possible role of the hydrolytic activity of external hyphae of AM fungi was discussed as a factor affecting fungal ability to colonize the root and influence plant growth.

Interaction between Aspergillus niger van Tiegh. and Glomus mosseae. (Nicol. & Gerd.) Gerd. & Trappe.

Percent germination and length of hyphae of germinated Glomus mosseae spores, cultivated on water agar, decreased significantly in the presence of Aspergillus niger; this decrease was independent of any change in pH of the medium. Soluble and volatile compounds produced by A. niger significantly decreased percentage spore germination and the hyphal length of G. mosseae on water agar. The decrease caused by volatile compounds was significantly greater when A. niger was grown on malt extract agar. Shoot dry weights of maize and lettuce plants cultivated in soil in pots, and percentage arbuscular mycorrhizal (AM) root colonization of plants grown either in sand: vermiculite tubes inoculated with G. mosseae spores or in soil in pots with soil inoculum, were unaffected by A. niger when this saprobe was inoculated 2 wk after G. mosseae. Shoot dry weights and percentage AM colonization of plants decreased when the saprobic fungus was inoculated at the same time or 2 wk before G. mosseae. However, the metabolic activity resulting from AM colonization, measured as the percentage of mycelium showing succinate dehydrogenase activity, decreased in all treatments. The population of A. niger decreased when inoculated to the rhizosphere of plants at the same time as, or 2 wk after, G. mosseae, but not when it was inoculated 2 wk before G. mosseae. Our results show that G. mosseae decreases the saprobic fungal population through its effect on the plant, whereas A. niger, by the production of soluble or volatile substances, inhibits G. mosseae in its extramatrical stage.