[Shortage of nurses in Spain: from the global case to particular situation. SESPAS Report 2024]. / Escasez de enfermeras en España: del caso global a la situación particular. Informe SESPAS 2024.

The nursing shortage is a multi-causal phenomenon that affects all countries and currently a global concern. The shortage of nurses jeopardizes the sustainability of health systems and the population health outcomes. Spain has historically had no difficulties in attracting new generations of nurses. The shortage of nurses is caused by the precarious working conditions and lack of professional development that have led to episodes of high international migration and abandonment of the profession. In this paper we focus on the evolution of different indicators of the working conditions of non-specialist nurses, who make up the bulk of the profession. These indicators allow us to analyse the abandonment of the profession, the duration of contracts, their full-time or part-time dedication and the excessive hiring. We have analysed the effect of COVID-19 and the labour reform on these indicators. COVID-19 reduced the abandonment of the profession and is currently at its lowest level, it has also accelerated the need to improve working conditions by increasing the percentage of permanent contracts and reducing the multiplicity of contracts in the same month. The labour reform has helped reduce the percentage of temporary contracts until reaching around 80% of the total contracts, and has reduced the number of nurses in Spain with more than one contract in the same month to below 3000 nurses on a sustained basis.

[Prevalence of burnout syndrome in physicians working in Spain: systematic review and meta-analysis]. / Prevalencia del síndrome de burnout en médicos que trabajan en España: revisión sistemática y metaanálisis.

OBJECTIVE: To analyze the prevalence of burnout syndrome in physicians working in Spain through a systematic review with meta-analysis METHOD: We searched PubMed/MEDLINE, Embase, and PsycINFO (up to June 2023). Observational studies conducted in Spain reporting the prevalence of burnout in physicians were included. From each study, methodological characteristics and results were extracted, and their quality was evaluated. We performed a narrative synthesis with random effects meta-analysis to calculate proportions. RESULTS: Sixty-seven studies with 16,076 participants were included. For the primary outcome, the meta-analysis revealed a global prevalence of burnout in physicians of 24% (95%CI: 19%-29%; 46 studies; 8821 participants; I2=97%). From subgroup analysis, differences were observed depending on the diagnostic criteria used: 18% (95%CI: 13%-23%) for three dimensions of burnout, 29% (95%CI: 24%-34%) for two dimensions and 51% (95%CI: 42%-60%) for one dimension. The heterogeneity between studies could not be fully explained through additional analyses where non-statistically significant differences were found with other variables (e.g., study quality, setting, professional category or medical specialty). CONCLUSIONS: A high prevalence of burnout syndrome was found in physicians working in Spain. These results can contribute to estimating the burden associated with burnout in physicians at a national level and to the design of future studies. Strategies appear to be necessary to prevent and mitigate this situation. PROTOCOL REGISTRATION: Open Science Framework: https://osf.io/b2h4m/.

Exposure to moral stressors and associated outcomes in healthcare workers: prevalence, correlates, and impact on job attrition.

Introduction: Healthcare workers (HCWs) often experience morally challenging situations in their workplaces that may contribute to job turnover and compromised well-being. This study aimed to characterize the nature and frequency of moral stressors experienced by HCWs during the COVID-19 pandemic, examine their influence on psychosocial-spiritual factors, and capture the impact of such factors and related moral stressors on HCWs' self-reported job attrition intentions.Methods: A sample of 1204 Canadian HCWs were included in the analysis through a web-based survey platform whereby work-related factors (e.g. years spent working as HCW, providing care to COVID-19 patients), moral distress (captured by MMD-HP), moral injury (captured by MIOS), mental health symptomatology, and job turnover due to moral distress were assessed.Results: Moral stressors with the highest reported frequency and distress ratings included patient care requirements that exceeded the capacity HCWs felt safe/comfortable managing, reported lack of resource availability, and belief that administration was not addressing issues that compromised patient care. Participants who considered leaving their jobs (44%; N = 517) demonstrated greater moral distress and injury scores. Logistic regression highlighted burnout (AOR = 1.59; p < .001), moral distress (AOR = 1.83; p < .001), and moral injury due to trust violation (AOR = 1.30; p = .022) as significant predictors of the intention to leave one's job.Conclusion: While it is impossible to fully eliminate moral stressors from healthcare, especially during exceptional and critical scenarios like a global pandemic, it is crucial to recognize the detrimental impacts on HCWs. This underscores the urgent need for additional research to identify protective factors that can mitigate the impact of these stressors.

This study explored the nature of moral stressors encountered by health care workers, along with impacts on moral injury and intentions to leave their jobs.Morally distressing encounters were common, with the most prevalent and distressing experiences being organizational or team-based in nature.Findings revealed that severity of moral injury, particularly related to trust violation or betrayal, was a key factor influencing healthcare workers' intentions to leave their jobs.

Síndrome de desgaste profesional en el personal de salud durante la pandemia de COVID-19 / Burnout Syndrome in Health Care Personnel During the COVID-19Pandemic

La Organización Mundial de la Salud (OMS) define el estrés laboral como una reacción que puede manifestarse ante exigencias y presiones laborales que ponen a prueba la capacidad que tiene cada persona para afrontar ciertas situaciones y que se agravan en el personal de salud que atiende pacientes con la COVID-19. Es decir, lo que resulta del desequilibrio entre las presiones y exigencias a las que se enfrenta el individuo, por una parte, y los conocimientos adquiridos por otra parte. El Síndrome de desgaste profesional, conocido también como síndrome de agotamiento emocional o psicológico, o por el anglicismo burnout, es un tipo de estrés laboral que engloba un estado de agotamiento físico, emocional y mental que conlleva a consecuencias individuales y sociales. El objetivo de esta revisión narrativa es identificar los factores de riesgo para el desarrollo del Síndrome de desgaste profesional en el personal de salud relacionado con la atención de pacientes con la COVID-19. Se realizó una búsqueda en la base de datos PubMed, se incluyeron artículos originales, estudios aleatorizados, revisiones sistemáticas y otros textos en español e inglés, publicados durante el periodo 2020-2023. Los principales factores de riesgo identificados en la literatura para el desarrollo de Síndrome de desgaste profesional fueron la juventud, sexo femenino, la soltería, la carga de trabajo y el nivel de satisfacción laboral de los profesionales.

The WHO defines occupational stress as a reaction that may occur when a person is faced with work-related demands and pressures that test the individual's ability to cope with certain situations, and it exacerbates in healthcare personnel who provide care to patients with COVID-19. That is, what results from the imbalance between the pressures and demands that the individual faces, on the one hand, and the knowledge acquired on the other hand. Burnout syndrome is a type of work-related stress that encompasses a state of physical, emotional and mental exhaustion that leads to individual and social consequences. The objective of this systematic review is to identify the risk factors for the development of Burnout Syndrome in health personnel related to the care of patients with COVID-19. A search was carried out in the PubMed database, including original articles, randomized studies, systematic reviews, and textbooks in Spanish and English, published during the period 2020-2023. The main risk factors for the development of Burnout Syndrome identified in the literature were youth, female sex, singleness, workload and the level of job satisfaction of the professionals

Factores psicosociales de riesgo y burnout en policías: un análisis de redes / Psychosocial risks factors and burnout in police officers: a network analysis

El estrés laboral crónico ha sido identificado como uno de los riesgos laborales más importantes que afecta a la salud mental de los agentes de policía. Existen ciertos factores psicosociales que incrementan el estrés laboral en la policía y que, a largo plazo, desencadenan síntomas compatibles con el burnout. En este trabajo se ha utilizado una muestra integrada por 323 policías para valorar la relación que se establece entre los factores psicosociales de riesgo y la probabilidad de experimentar síntomas compatibles con el burnout. Las respuestas de los participantes al MBI-GS y al F-PSICO (versión 4.0) fueron examinadas utilizando análisis de redes. Los resultados muestran que existen redes de factores psicosociales de riesgo más cohesionadas cuando los niveles de cinismo y agotamiento emocional son más elevados. Además, se observa mayor nivel de burnout asociados con una baja autonomía, altas demandas psicológicas, conflictos en el desempeño de rol y un bajo apoyo social percibido. Los resultados son discutidos en términos de su implicación teórica y de su utilidad práctica frente al diseño de entornos de trabajo más saludables, así como frente a la intervención psicológica.(AU)

Chronic work stress has been identified as one of the most important occupational hazards affecting the mental health of police officers. There are certain psychosocial factors that increase job stress in the police and, in the long term, trigger symptoms compatible with burnout. In this work, a sample made up of 323 police officers has been used to assess the relationship established between psychosocial risk factors and the probability of experiencing symptoms compatible with burnout. Participant responses to the MBI-GS and F-PSICO (version 4.0) were examined using network analysis. The results show that there are more cohesive networks of psychosocial risk factors when the levels of cynicism and emotional exhaustion are higher. In addition, a higher level of burnout is observed associated with low autonomy, high psychological demands, conflicts in role performance, and low perceived social support. The results are discussed in terms of their theoretical implication and their practical utility in the design of healthier work environments, as well as in psychological intervention.(AU)

Principais Dificuldades dos Cuidadores Informais da Pessoa com Doença Mental Grave / Main Difficulties of Informal Caregivers of People with Severe Mental Illness / Principales Dificultades de los Cuidadores Informales de la Persona con Enfermedad Mental Grave

Resumo Contexto: O processo de desinstitucionalização da pessoa com doença mental grave, trouxe uma nova realidade ao exigir uma adaptação das famílias, perante a necessidade dos seus membros assumirem o papel de cuidadores informais. Objetivo: Identificar as dificuldades dos cuidadores informais da pessoa com doença mental grave. Metodologia: Realizou-se um estudo descritivo transversal de base quantitativa. Foi constituída uma amostra probabilística aleatória simples de 27 cuidadores informais da pessoa adulta com doença mental grave, acompanhada na consulta externa de psiquiatria dum hospital da região Sul de Portugal. Como instrumento de colheita de dados foi aplicado o Índice de Avaliação das Dificuldades do Cuidador (CADI) e um questionário de caraterização sociodemográfica do cuidador informal. Resultados: Relativamente às características sociodemográficas dos participantes apurou-se que estas estão de acordo com o perfil que caracteriza os cuidadores informais em Portugal. Da aplicação do CADI, resulta que os fatores em que se verificaram mais dificuldades relacionadas com o cuidar foram os fatores relacionados com a falta de apoio familiar, com problemas financeiros, seguindo-se as reações à prestação de cuidados e a falta de apoio profissional. Conclusões: A função de cuidar causa dificuldades ao cuidador, que se vê perante um contexto diferente do habitual e a ter de desempenhar um novo papel. Assim, constatamos que os cuidadores familiares constituem um grupo com necessidades e dificuldades especificas, perante as quais o Enfermeiro Especialista Enfermagem Saúde Mental e Psiquiátrica tem um papel fundamental em termos de intervenção, na capacitação e empoderamento de quem cuida.

Abstract Context: The process of deinstitutionalization of the person with serious mental illness brought a new reality by requiring an adaptation of families, given the need for their members to assume the role of informal caregivers. Objective: To identify the difficulties of informal caregivers of people with severe mental illness. Methodology: A descriptive cross-sectional quantitative study was carried out. A simple random probabilistic sample of 27 informal caregivers of an adult person with severe mental illness was constituted, accompanied in the outpatient psychiatric clinic of a hospital in the south of Portugal. As a data collection instrument, the Caregiver's Difficulties Assessment Index (CADI) and a sociodemographic characterization questionnaire of the informal caregiver, were applied. Results: Regarding the sociodemographic characteristics of the participants, it was found that these are in line with the profile that characterizes informal caregivers in Portugal. From the application of the CADI, it appears that the factors in which there were more difficulties related to care were factors related to the lack of family support, financial problems, followed by reactions to the provision of care and the lack of professional support. Conclusions: The role of caring causes difficulties for the caregiver, who is faced with a different context than usual and having to play a new role. Thus, we found that family caregivers constitute a group with specific needs and difficulties, in view of which the Specialist Nurse Mental Health and Psychiatric Nursing has a fundamental role in terms of intervention, in the training and empowerment of those who care.

Resumen Contexto: El proceso de desinstitucionalización de la persona con enfermedad mental grave trajo una nueva realidad al exigir una adaptación de las familias, ante la necesidad de que sus miembros asuman el rol de cuidadores informales. Objetivo: Identificar las dificultades de los cuidadores informales de personas con enfermedad mental grave. Metodología: Se realizó un estudio cuantitativo descriptivo de corte transversal. Se constituyó una muestra probabilística aleatoria simple de 27 cuidadores informales de una persona adulta con enfermedad mental grave, acompañados en la consulta externa de psiquiatría de un hospital del sur de Portugal. Como instrumento de recolección de datos, se aplicó el Índice de Evaluación de Dificultades del Cuidador (CADI) y un cuestionario de caracterización sociodemográfica del cuidador informal. Resultados: En cuanto a las características sociodemográficas de los participantes, se constató que estas están en consonancia con el perfil que caracteriza a los cuidadores informales en Portugal. De la aplicación del CADI se desprende que los factores en los que hubo más dificultades relacionadas con el cuidado fueron los relacionados con la falta de apoyo familiar, los problemas económicos, seguidos de las reacciones a la prestación del cuidado y la falta de apoyo profesional. Conclusiones: El rol de cuidar genera dificultades para el cuidador, que se enfrenta a un contexto diferente al habitual y al tener que desempeñar un nuevo rol. Así, encontramos que los cuidadores familiares constituyen un grupo con necesidades y dificultades específicas, por lo que la Enfermera Especialista en Salud Mental y Enfermería Psiquiátrica tiene un papel fundamental en términos de intervención, en la formación y empoderamiento de quienes cuidan.

Effectiveness of Resiliency and Recovery Program on Compassion Fatigue among Nursing Officers working in selected Hospitals in India / Efectividad del Programa de Resiliencia y Recuperación sobre la Fatiga por Compasión entre los profesionales de Enfermería que trabajan en Hospitales seleccionados de la India / Eficácia do Programa de Resiliência e Recuperação na Fadiga por Compaixão entre Profissionais de Enfermagem que Trabalham em Hospitais Selecionados na Índia

Objective. The study objective was to evaluate the effectiveness of Resiliency and Recovery Program on Compassion Fatigue level of Nursing Officer from selected hospitals of Pune City (India). Methods. The study used a quasi-experimental approach involving single group pre-test and post-test design. 100 nursing officers, working in selected hospitals of Pune city, who were willing to participate were selected using non probability convenience sampling. The data was collected using The Professional Quality of Life Scale: Compassion Satisfaction and Fatigue (ProQoL) Version 5 of Stamm. The study included pre-test, resiliency and recovery program and post-test. Resiliency and Recovery Program is an intervention aiming to develop five resiliency skills or antibodies including (a) self-regulation, (b) perceptual maturation, (c) intentionality, (d) self-care and (e) connection and support. Results. Statistically significant difference was revealed between the pre-test and post-test score means: Compassion Satisfaction (pre-test = 28.50 to post-test = 31.0; t-18.6671, p<0.001), Burn-out (pre-test = 35.2 to post-test = 31.7; t-15.00, p<0.001), and Secondary Traumatic Stress (pre-test = 37.4 to post-test = 33.07; t-14.8996, p<0.001). Conclusion. Resiliency and Recovery Program had a significant impact on Compassion Fatigue, leading to an increase in Compassion Satisfaction, and a reduction in Burnout and Secondary Traumatic Stress. Inculcating Resiliency skills in nursing officers can help them in reducing compassion fatigue and thus aids in health promotion.

Objetivo. El objetivo del estudio era evaluar la eficacia del Programa de Resiliencia y Recuperación en el nivel de Fatiga por Compasión de los profesionales de enfermería de los hospitales seleccionados de la ciudad de Pune (India). Métodos. El estudio cuasi-experimental con evaluación pre y post-intervención en un solo grupo. Se seleccionaron 100 profesionales de enfermería que trabajaban en hospitales seleccionados de la ciudad de Pune mediante un muestreo no probabilístico por conveniencia. Los datos se recogieron utilizando la Escala de calidad de vida profesional: Compassion Satisfaction and Fatigue ((ProQOL) Version 5 de Stamm. El estudio incluyó una prueba previa, un programa de resiliencia y recuperación y una prueba posterior. El Programa de Resiliencia y Recuperación es una intervención cuyo objetivo es desarrollar cinco habilidades o anticuerpos de resiliencia que incluyen (a) autorregulación, (b) maduración perceptiva, (c) intencionalidad, (d) autocuidado y (e) conexión y apoyo. Resultados. Se observaron diferencias estadísticamente significativas entre las puntuaciones promedio obtenidas antes y después de la intervención en la satisfacción con la compasión (antes = 28.5 a después = 31; t-18.6671, p<0.0001), el agotamiento (antes = 35.2 a después = a 31.7; t-15,00, p<0.001) y el estrés traumático secundario (antes = 37.4 a después 33.1; t-14.8996, p<0.001). Conclusiones. El Programa de Resiliencia y Recuperación tuvo un impacto significativo en la Fatiga por Compasión, lo que condujo a un aumento de la Satisfacción por Compasión y a una reducción del Burnout y del Estrés Traumático Secundario. Inculcar habilidades de resiliencia a los profesionales de enfermería puede ayudarles a reducir la fatiga por compasión y, por tanto, a promover la salud.

Objetivo. O objetivo do estudo foi avaliar a eficácia do Programa de Resiliência e Recuperação no nível de Fadiga por Compaixão em profissionais de enfermagem em hospitais selecionados na cidade de Pune (Índia). Métodos. Foi realizado um estudo quase experimental com avaliação pré e pós-intervenção em grupo único. Foram selecionados 100 profissionais de enfermagem que trabalham em hospitais da cidade de Pune por meio de amostragem não probabilística de conveniência. Os dados foram coletados por meio da versão 5 da Escala de Qualidade de Vida Profissional: Compaixão, Satisfação e Fadiga (ProQoL) de Stamm. O estudo incluiu um pré-teste, um programa de resiliência e recuperação e um pós-teste. O Programa de Resiliência e Recuperação consistiu em uma intervenção cujo objetivo é desenvolver cinco habilidades de resiliência ou anticorpos que incluem (a) autorregulação, (b) maturação perceptual, (c) intencionalidade, (d) autocuidado e (e) conexão e suporte. Resultados. Foram observadas diferenças estatisticamente significativas entre as pontuações médias obtidas antes e depois da intervenção em satisfação por compaixão (antes = 28.5 a depois = 31; t-18.6671, p<0.0001), burnout (antes = 35.2 a depois = a 31.7; t-15.00), p<0.001) e estresse traumático secundário (antes = 37,4 a depois 33.1; t-14.8996, p<0.001). Conclusões. O Programa de Resiliência e Recuperação teve um impacto significativo na Fadiga por Compaixão, levando a um aumento na Satisfação por Compaixão e a uma redução no Burnout e no Estresse Traumático Secundário. Incutir competências de resiliência nos enfermeiros pode ajudá-los a reduzir a fadiga da compaixão e, portanto, promover a saúde.

Calidad de vida profesional de quienes laboran en cuidados paliativos y su relación con el autocuidado, la atención plena y el sentido de vida / Professional quality of life of palliative care staff and its relationship with selfcare, mindfulness and meaning of life

Introducción: La calidad de vida profesional (que incluye satisfacción y fatiga por compasión) y sus factores asociados, han sido poco explorados en cuidados paliativos (CP) en Latinoamérica. Objetivo: Determinar la calidad de vida profesional en CP y su relación con el autocuidado, la capacidad de atención plena y el sentido de vida. Método: Estudio observacional, de corte transversal. Participaron profesionales laborando en CP en Colombia. Se empleó el PROQOL para evaluar satisfacción por compasión (SC), Burnout y trauma secundario (TS), el PSCS para examinar autocuidado, el MAAS para examinar atención plena y la Escala dimensional de sentido de vida (EDSV). Se realizaron análisis descriptivos, correlacionales y de regresión múltiple. Resultados: participaron 108 profesionales. Edad promedio 38 años, 55% médicos, 73% mujeres, 32,4% reportaron elevada afectación del bienestar por la Covid-19. El 85% obtuvieron puntuaciones medias o altas en SC, el 75,9% en Burnout y el 81,5% en TS (con medianas de 42.5, 21 y 12, respectivamente). Hubo una correlación positiva y significativa entre PSCS, MAAS y EDSV con SC, pero negativa y significativa con Burnout y TS. En conjunto, la SC, el MAAS y el autocuidado social tuvieron un efecto predictivo negativo sobre los niveles de Burnout (R2=0,535). Conclusiones: Aunque la mayoría de participantes están satisfechos con su labor, los índices de Burnout y TS fueron elevados durante el período de pandemia. El en conjunto, la satisfacción por compasión, la atención plena y el autocuidado social predijeron niveles menores de Burnout, indicando potenciales vías de apoyo para quienes ejercen CP (AU)

Introduction. Professional quality of life (involving compassion satisfaction and compassion fatigue) and its related factors have been poorly explored in Palliative Care (PC). Objectives. To determine the professional quality of life of PC practitioners in Colombia and its relationship with self-care, mindfulness and meaning of life. Methods. Observational cross-sectional study. Practicing professionals of PC of Colombia were invited. Compassion Satisfaction (CS), Burnout, and Secondary Trauma (ST) were assessed using PROQOL; selfcare was examined using PSCS; MAAS was used to assess Mindfulness capacity, and the Dimensional Scale of sense of life (EDSV) was also employed. Descriptive correlational, and multiple regression analyses were performed. Results. One-hundred and eight participants participated; mean age of 38 years, 73% women, 32,4% indicated high impact on their wellbeing due to Covid-19; 85% of participants showed medium-high scores on CS, 75,9% on Burnout, and 81,5% on ST (median scores of 42.5, 21, and 12, respectively). Scores on PSCS, MAAS and EDSV positively and significantly correlated with CS, and were negatively and significantly related with Burnout and ST. Altogether, SC, MAAS and social selfcare had a negative predictive effect on Burnout levels (R2=0.538). Conclusion. Although most participants were satisfied with their jobs, scores on Burnout, and TS were high during the Pandemic. Together, compassion satisfaction, mindfulness and social selfcare were predictive of lower levels of Burnout, signaling potential lines of intervention for PC practitioners (AU)

Rendimiento Clínico de las Restauraciones Adhesivas con Resina Compuesta en Casos de Pacientes con Desgaste Severo e Incremento de Dimensión Vertical: Revisión de Literatura Sistematizada / Clínical Performance of Adhesive Restorations with Composite Resin in Cases of Patients with Severe Wear and Increased Vertical Dimension: Systematized Literature Review

El desgaste dental severo se describe como la pérdida sustancial de la estructura dental, con exposición de la dentina y pérdida significativa de igual o más de 1/3 de la corona clínica. El uso de materiales compuestos de resina permite al clínico ser más conservador, debido a su aplicación mínimamente invasiva. Además de ello, son relativamente económicas, proporcionan buena estética general, así como un buen rendimiento y facilidad en la reparación. El objetivo de esta revisión de literatura sistematizada es recopilar información disponible en la literatura referente a cuál es el rendimiento clínico de las restauraciones adhesivas con resina compuesta en casos de pacientes con desgaste severo e incremento de la dimensión vertical como objetivo rehabilitador. Se analizaron artículos entre los años 2000 y 2022, seleccionando cuatro bases de datos (Pubmed, Scopus, Scielo y Web of Science). Para identificar los descriptores se utilizó los Medical subject headings (Mesh): Tooth Wear, Composite Restorations, Resin y Oral Rehabilitation. No se aplicó restricciones de idioma, país de origen, autor o lugar de publicación donde se realizó el estudio. Como resultado de la búsqueda se obtuvieron 71 artículos, de los cuales se seleccionaron 5 que cumplieron con los criterios de elegibilidad para ser considerados en la revisión de literatura sistematizada. Se encontró un promedio de tasa de éxito ente el 89,4 % - 100 % en un promedio total de 5.2 años de seguimiento. Se puede concluir, hasta donde se tiene conocimiento en la literatura científica disponible, que el tratamiento de restauraciones adhesivas con resinas compuestas en pacientes con desgaste severo es recomendable, enfocado en un periodo a corto-mediano plazo (3-5 años), siendo una opción de tratamiento económica y mínimamente invasiva.

Severe tooth wear is described as the substantial loss of tooth structure, with dentin exposure and significant loss of equal to or more than 1/3 of the clinical crown. The use of resin composite materials allows the clinician to be more conservative, due to its minimally invasive application. In addition to this, they are relatively inexpensive, provide good general aesthetics, as well as good performance and ease of repair. The objective of this systematic literature review is to collect information available in the literature regarding the clinical performance of adhesive restorations with composite resin in cases of patients with severe wear and increase in the vertical dimension as a rehabilitation objective. Articles between the years 2000 and 2022 were analyzed, selecting four databases (Pubmed, Scopus, Scielo and Web of Science). To identify the descriptors, the Medical subject headings (Mesh) were used: Tooth Wear, Composite Restorations, Resin and Oral Rehabilitation. No language, country of origin, author or place of publication restrictions where the study was conducted were applied. As a result of the search, 71 articles were obtained, of which 5 were selected that met the eligibility criteria to be considered in the systematic literature review. An average success rate between 89.4 % - 100 % was found in a total average of 5.2 years of follow-up. It can be concluded, to the best of our knowledge in the available scientific literature, that the treatment of adhesive restorations with composite resins in patients with severe wear is recommendable, focused on a short-medium term period (3-5 years), being a Inexpensive and minimally invasive treatment option.

Lesiones cervicales no cariosas: una revisión sistemática / Non carious cervical lesions: a systematic review

Introducción: las lesiones cervicales no cariosas (NCCL, por sus siglas en inglés) son un grupo de lesiones que afectan el área cervical del órgano dental causando hipersensibilidad dentinaria y defectos estéticos. Objetivo: analizar la literatura sobre las lesiones cervicales no cariosas, su etiología, consideraciones anatómicas, características morfológicas de la lesión y tratamientos no restaurativos. Material y métodos: se realizó una búsqueda en la base de datos PubMed, utilizando las palabras clave: non-carious cervical lesions OR noncarious cervical lesions OR tooth wear OR tooth erosion OR dental abfraction OR abfraction, recopilando un total de 78 artículos. Resultados: es necesario determinar la etiología antes de seleccionar las estrategias de tratamiento para las lesiones cervicales no cariosas. Conocer los distintos tipos de tejidos que componen al órgano dentario facilita la comprensión de los factores que participan en el desarrollo de las lesiones cervicales no cariosas. Esto permite que el tratamiento se enfoque más en la causa del problema que en los síntomas. Con esto podemos modificar diversos factores de manera interceptiva, los tratamientos de terapia con láser y compuestos tópicos son una estrategia mínimamente invasiva. Conclusiones: la mejor manera de describir a las lesiones cervicales no cariosas sería como una enfermedad multifactorial. Se debe prestar especial atención en los métodos de diagnóstico, identificando cofactores que propicien el avance de la lesión, como son la fricción y la biocorrosión. Esta revisión brinda datos que asocian a los factores oclusales como una de las principales causas de una enfermedad que afecta a más de la mitad de la población adulta (AU)

Introduction: non-carious cervical lesions (NCCL) are a group of lesions that affect the cervical area of the dental organ causing dentin hypersensitivity and cosmetic defects. Objective: to know, through a systematic review, the current state of non-carious cervical lesions. Material and methods: a search was conducted in the PubMed database, using the keywords: non-carious cervical lesions OR noncarious cervical lesions OR tooth wear OR tooth erosion OR dental abfraction OR abfraction, compiling a total of 78 articles. Results: determining etiology is necessary before selecting treatment strategies for non-carious cervical lesions (NCCL). Know the different types of tissues that make up the dentary organ, facilitate the understanding of the factors involved in the development of noncarious al cervical lesions. This allows treatment to focus more on the cause of the problem than on symptoms. With this we can modify various factors in an interceptive way, laser therapy treatments and topical compounds, are a minimally invasive strategy. Conclusions: the best way to describe non-carious al cervical lesions would be as a multifactorial disease to which special attention should be paid to both diagnostic methods, identifying cofactors that promote the progression of injury, such as friction and biocorrosion. This review provides data that associates occlusal factors as one of the main causes of a disease that affects more than half of the adult population (AU)

Prevalencia del síndrome de desgaste en radiólogos españoles / Prevalence of burnout syndrome in Spanish radiologists

Objetivos: Analizar la prevalencia y grado del síndrome de desgaste profesional entre radiólogos en España. Como objetivos secundarios se pretende identificar sus posibles factores desencadenantes y atenuantes para implementar intervenciones preventivas y correctivas, disminuyendo el estrés asociado y aumentando el rendimiento y la satisfacción laboral de los radiólogos. Material y métodos: Estudio transversal y observacional realizado mediante una encuesta en línea, anónima y voluntaria, desarrollada a través de formularios de Google® y dirigida a radiólogos especialistas y en formación. La encuesta se estructura en tres apartados: una valoración cualitativa del grado del síndrome de desgaste profesional a través del Maslach Burnout Inventory Human Services Survey (MBI-HSS), el segundo constituido por una serie de preguntas sociodemográficas y laborales, y el último apartado centrado en las posibles causas de estrés y de mejora en el entorno laboral. Los resultados de la encuesta se analizaron estadísticamente para determinar la asociación entre las variables y el síndrome, así como para determinar posibles factores de riesgo y protectores.Resultados: Tras difundir la encuesta en redes sociales y correo electrónico se recibieron un total de 226 respuestas (175 de especialistas y 51 de residentes). La media de edad fue 41 años (desviación estándar de 11 años, rango de 25 a 68), sin predominancia de género (52% hombres). La prevalencia del síndrome fue del 33%, sin diferencias significativas entre adjuntos y residentes. No se han identificado factores de riesgo que se asocien con el desgaste profesional. Tener docencia en el lugar de trabajo fue el único factor de protección.(AU)

Background and aimsThe primary objective was to analyze the prevalence and degree of professional burnout in radiologists in Spain. Secondary objectives were to identify possible factors that increase or decrease the risk of burnout to enable preventive and corrective measures, decrease the stress associated with this condition, and thereby increase radiologists’ performance and satisfaction at work.Material and methodsThis cross-sectional observational study used a voluntary, anonymous online survey of attending radiologists and residents through Google Forms®. The survey was structured into three sections: a qualitative assessment of the degree of professional burnout with the Maslach Burnout Inventory Human Services Survey (MBI-HSS), a series of sociodemographic and work-related questions, and a final section centered on possible causes of stress and improvements to the working environment.The results of the survey were analyzed statistically to determine which variables were associated with burnout syndrome as well as to identify possible risk factors and protective factors.ResultsAfter disseminating the survey through social networks and email contacts, we received a total of 226 responses (175 from attending radiologists and 51 from residents; 52% men; mean age, 41±11 years; age range, 25-68). The prevalence of the syndrome was 33%, without significant differences between attending radiologists and residents. No risk factors associated with burnout were identified. Teaching in the workplace was the only protective factor.ConclusionsOne-third of the respondents had burnout syndrome. Because the consequences of this syndrome can affect professionals’ personal life and their ability to do their jobs, early detection and intervention should be prioritized.(AU)

Prevalence of burnout syndrome in Spanish radiologists.

BACKGROUND AND AIMS: The primary objective was to analyze the prevalence and degree of professional burnout in radiologists in Spain. Secondary objectives were to identify possible factors that increase or decrease the risk of burnout to enable preventive and corrective measures, decrease the stress associated with this condition, and thereby increase radiologists' performance and satisfaction at work. MATERIAL AND METHODS: This cross-sectional observational study used a voluntary, anonymous online survey of attending radiologists and residents through Google Forms®. The survey was structured into three sections: a qualitative assessment of the degree of professional burnout with the Maslach Burnout Inventory Human Services Survey (MBI-HSS), a series of sociodemographic and work-related questions, and a final section centered on possible causes of stress and improvements to the working environment. The results of the survey were analyzed statistically to determine which variables were associated with burnout syndrome as well as to identify possible risk factors and protective factors. RESULTS: After disseminating the survey through social networks and email contacts, we received a total of 226 responses (175 from attending radiologists and 51 from residents; 52% men; mean age, 41 ± 11 years; age range, 25-68). The prevalence of the syndrome was 33%, without significant differences between attending radiologists and residents. No risk factors associated with burnout were identified. Teaching in the workplace was the only protective factor. CONCLUSIONS: One-third of the respondents had burnout syndrome. Because the consequences of this syndrome can affect professionals' personal life and their ability to do their jobs, early detection and intervention should be prioritized.

Efectividad de una intervención breve en la resiliencia, atención plena y empatía de profesionales de enfermería / Effectiveness of a brief intervention on the resilience, mindfulness and empathy of nursing professionals

Objetivos: Evaluar la eficacia de una intervención guiada basada en la reducción del estrés y compasión, sobre la resiliencia, desgaste por empatía y atención plena de profesionales sanitarios. Metodología: Estudio cuasiexperimental con grupo control e intervención combinada multimodal impartido en 3 sesiones. Grupo control (n = 23), grupo experimental (n = 23). Recogida de datos: se hicieron 4 observaciones y se utilizaron las herramientas Escala Breve de Resiliencia, Inventario Friburgo de Mindfulness, Inventario de Desgaste por Empatía y datos sobre el perfil laboral y vida personal de las profesionales. Para analizar la relación entre variables se utilizó un modelo lineal general, la pruebas de chi cuadrado o de Fisher y análisis de regresión. Resultados: No se encontró un efecto significativo de la intervención evaluada en la puntuación obtenida en atención plena, resiliencia o empatía. El grupo control obtuvo mayor puntuación en atención plena cuando se relacionó con la unidad de trabajo no covid y la ausencia de estresores personales F (1,21)=16,081 p=<0,01, ŋ2=0,434. El perfil empático normal sin riesgo, fue significativamente mayor en unidades no covid frente a las covid en la primera evaluación (70% vs 30%, p=0,002). El perfil de baja resiliencia en técnicos de cuidados auxiliares de enfermería, fue mayor durante la última evaluación (72,2% vs 27,8%, p=0,003), momento que coincidió con un mayor número de pacientes hospitalizados por covid. Conclusiones: Factores personales y laborales (categoría profesional, la unidad de trabajo y presión asistencial) tuvieron más influencia en el bienestar psicológico de los profesionales, que la intervención realizada. (AU)

Objectives: Assess the efficacy of a guided intervention based on stress reduction and compassion, related to resilience and compassion fatigue of healthcare professionals. Methods: Quasi-experimental study with a control and intervention groups, combining a multimodal intervention delivered in 3 sessions. Control group (n = 23), experimental group (n = 23). Data collection: 4 observations were made using the Brief Resilience Scale, Freiburg Mindfulness Inventory, Compassion Fatigue Inventory and data on the professional profile and personal life. In order to analyze the relationship between variables, a general linear model, the chi-square or Fisher test, and regression analysis were used. Results: No significant effect of the evaluated intervention was found on the score obtained in mindfulness, resilience or empathy. The control group obtained a higher score in mindfulness when related to the non-covid work unit and the absence of personal stressors F(1.21)=16.081 p=<0.01, ŋ2=0.434. The normal empathic profile without risk was significantly higher in non-covid units compared to covid units in the first evaluation (70% vs 30%, p=0.002). The profile of low resilience in auxiliary nurses was higher during the last evaluation (72.2% vs 27.8%, p=0.003), a moment in which a greater number of patients were hospitalized with covid. Conclusions: A higher influences on professionals psychological wellbeing was present with personal and job related factors (professional category, work place and healthcare pressure) than the intervention carried out. (AU)

Construcción y validación de un cuestionario para evaluar burnout académico en estudiantes de ciencias de la salud / Construction and validation of a questionnaire to assess academic burnout in health science students / Construção e validação de um questionário para avaliar o burnout acadêmico em estudantes da área da saúde

Objetivo: el burnout (BA) académico puede presentarse en el contexto universitario, se caracteriza por un estado de agotamiento vital que afecta la salud física y mental de los estudiantes, lo que genera una disminución en el rendimiento académico. Este problema aparece con mayor frecuencia en programas universitarios con altas exigencias académicas. El objetivo de este trabajo fue construir y evaluar la estructura factorial de un cuestionario de BA académico en estudiantes que cursaban los programas de medicina, enfermería y psicología. Metodología: los participantes fueron 710 estudiantes de ciencias de la salud (hombres 40.8 % y mujeres 59.2 %), de 16 a 33 años (M = 20.42 años, DT = 3 años). Se evaluó la validez de constructo mediante análisis factorial exploratorio (AFE) y análisis factorial confirmatorio (AFC); además, se calculó la consistencia interna por medio del estadístico alfa de Cronbach. Resultados: el cuestionario burnout académico (CBA-24) quedó conformado por 24 reactivos y una estructura factorial de cuatro dimensiones (agotamiento emocional, cinismo hacia el estudio, cinismo hacia las personas y realización personal). Con la prueba se evaluó el nivel de malestar emocional ante las demandas del entorno académico. Los índices de ajuste alcanzaron valores altos en el modelo propuesto, por lo tanto, el modelo de cuatro factores alcanzó los criterios para considerar que el ajuste es adecuado en todos los índices y mostró una estructura multidimensional. Dichos índices se agruparon de acuerdo con la taxonomía propuesta. Conclusiones: el cuestionario permitió identificar de manera ecológica el constructo de BA ajustado a las demandas de los contextos universitarios.

Objective: Academic burnout (AB) can occur in the university context and is characterized by a state of vital exhaustion that affects the physical and mental health of students, leading to a decrease in academic performance. This problem is more commonly observed in college programs with high academic demands. The aim of this study was to construct and evaluate the factorial structure of a questionnaire for assessing AB in students enrolled in medicine, nursing, and psychology programs. Methodology: The participants consisted of 710 health science students (40.8% male and 59.2% female) aged between 16 and 33 years (M = 20.42 years, SD = 3 years). Construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Additionally, internal consistency was calculated using Cronbach's alpha statistic. Results: The academic burnout questionnaire (ABQ-24) consisted of 24 items and a four-factor factorial structure (emotional exhaustion, cynicism towards studying, cynicism towards people, and personal accomplishment). The questionnaire assessed the level of emotional distress experienced in response to academic demands. The fit indices achieved high values in the proposed structure, indicating that the four-factor model met the criteria for adequate fit across all indices and exhibited a multidimensional structure. These indices were grouped according to the proposed taxonomy. Conclusions: The questionnaire provided an ecologically valid means of identifying the construct of AB, adapted to the demands of university contexts.

Objetivo: o burnoutacadêmico (BA) pode ocorrer no contexto universitário, é caracteri-zado por um estado de esgotamento vital que afeta a saúdefísica e mentaldos alunos, o que gera uma diminuição no desempenho acadêmico. Esse problema aparece com mais frequência em programas universitários com altas demandas acadêmicas. O objetivo deste trabalho foi construir e avaliar a estrutura fatorial de um questionário acadêmico de graduação em estudantes de medicina, enfermagem e psicologia. Metodologia: Os participantes foram 710 estudantes de ciências da saúde (40,8% ho-mens e 59,2 % mulheres), de 16 a 33 anos (M = 20,42 anos, DT = 3 anos). A validade de construto foi avaliada por meio de análise fatorial exploratória (EFA) e análise fatorial confirmatória (AFC); além disso, a consistência interna foi calculada usando a estatística alfa de Cronbach. Resultados: o questionário de burnoutacadêmico (CBA-24) foi composto por 24 itens e uma estrutura fatorial de quatro dimensões (exaustão emocional, cinismo em relação ao estudo, cinismo em relação às pessoas e realização pessoal). Com o teste, avaliou-se o nível de desconforto emocional diante das demandas do ambiente acadêmico. Os índices de ajuste atingiram valores altos no modelo proposto, portanto, o modelo de quatro fatores atendeu aos critérios para considerar que o ajuste é adequado em todos os índices e apresentou uma estrutura multidimensional. Esses índices foram agrupados de acordo com a taxonomia proposta.Conclusões:o questionário permitiu identificar de forma ecológica o construto BA ajustado às demandas dos contextos universitários

Efeito da terapia floral na fadiga por compaixão em residentes de enfermagem: estudo piloto / Flower therapy effect on the quality of professional life in nursing residents: pilot study

Introdução: O residente de enfermagem está exposto a estresses e desgastes que impactam em sua qualidade de vida profissional. Nesse sentido, as práticas integrativas e complementares de saúde podem contribuir para promover o bem-estar físico, mental e espiritual. Objetivo: Verificar o efeito da terapia floral nos componentes da qualidade de vida profissional (fadiga por compaixão - Burnout e Estresse Traumático Secundário - e satisfação por compaixão) em residentes de enfermagem no contexto da pandemia de COVID-19. Metodologia: Estudo piloto quase-experimental do tipo antes e depois, com 16 enfermeiros residentes de hospitais de ensino, que responderam um questionário sociodemográfico e uma escala Professional Quality of Life Scale 4 (ProQOL-4), e utilizaram a fórmula emergencial associada ao Walnut dos Florais de Bach (FiveW) por três semanas com follow up após três semanas. Os dados foram analisados descritivamente e o efeito da intervenção pelo teste t-Student e pelo modelo de efeitos mistos, com nível de significância de 5%. Resultados: A terapia floral auxiliou na redução do escore da subescala Estresse Traumático Secundário do ProQOL-4 (p=0,017), com efeito residual após o follow up. Houve interação do ano da residência e especialidade do programa nas subescalas Satisfação por Compaixão e Burnout; e área de especialização da residência e adoecimento de pessoa próxima por COVID-19 no Estresse Traumático Secundário e Burnout (p<0,05). Conclusão: A fórmula floral FiveW mostrou redução dos escores do Estresse Traumático Secundário, evidenciando que a terapia floral pode contribuir como estratégia complementar para melhora da qualidade de vida profissional.

Introducción: La persona residente de enfermería está expuesta a situaciones estresantes que impactan en su calidad de vida profesional. En ese sentido, las prácticas de salud integradoras y complementarias pueden contribuir a promover el bienestar físico, mental y espiritual. Objetivo: Verificar el efecto de la terapia con esencias florales sobre los componentes de la calidad de vida profesional (fatiga por compasión -burnout y estrés traumático secundario- y satisfacción por compasión) en población residente de enfermería en el contexto de la pandemia por COVID-19. Metodología: Estudio piloto cuasiexperimental antes y después de un solo grupo, con 16 personas enfermeras residentes de hospitales universitarios, que respondieron un cuestionario sociodemográfico y la Escala de Calidad de Vida Profesional 4 (ProQOL-4). Además, utilizaron la fórmula de emergencia asociada al Walnut de los remedios florales de Bach (FiveW), durante tres semanas, con un seguimiento de tres semanas. Los datos fueron analizados descriptivamente y el efecto de la intervención por la prueba t-Student pareada y por el modelo de efectos mixtos, con un nivel de significación del 5 %. Resultados: La terapia floral ayudó a reducir la puntuación de la subescala de Estrés Traumático Secundario del ProQOL-4 (p=0.017) con un efecto residual después del seguimiento. Hubo interacción entre el año de residencia y la especialidad del programa en las subescalas Satisfacción por Compasión y Burnout, así como entre especialidad del programa y enfermedad por COVID-19 de una persona allegada en Estrés Traumático Secundario y Burnout (p<0.05). Conclusión: La fórmula floral FiveW mostró reducción en las puntuaciones de estrés traumático secundario, lo que demuestra que la terapia floral puede contribuir como un manejo complementario para mejorar la calidad de vida profesional.

Introduction: The nursing resident is exposed to stressful situations that impact the quality of their professional life. Integrative and complementary health practices can contribute to promoting physical, mental, and spiritual well-being. Objective: To evaluate the effect of flower essence therapy on the aspects of the professional quality of life (compassion fatigue - burnout and secondary traumatic stress - and compassion satisfaction) of nursing residents in the context of the COVID-19 pandemic. Methods: Quasi-experimental pilot before and after study with 16 resident nurses from teaching hospitals, who answered a sociodemographic questionnaire and the Professional Quality of Life Scale 4 (ProQOL-4). The emergency formula associated with Walnut of the Bach Flower Remedies (FiveW) was used for three weeks with a three-week follow-up. Data were analyzed descriptively. The effect of the intervention was evaluated by the paired Student's t-test and by the mixed effects model, with a significance level of 5%. Results: Floral therapy reduced the score of the Secondary Traumatic Stress subscale of ProQOL-4 (p=0.017) with a residual effect after the follow-up. There was interaction between the year of residency and the program specialty in the Satisfaction for Compassion and Burnout subscales; and also between the program specialty and the COVID-19 infection of a close person in the Secondary Traumatic Stress and Burnout subscales (p<0.05). Conclusion: The FiveW floral formula showed a reduction in Secondary Traumatic Stress scores, evidencing that floral therapy can contribute as a complementary strategy to improve the quality of professional life.

Cargas de trabalho de profissionais técnico-administrativos de uma instituição pública de ensino superior / Workloads of technical-administrative professionals at a public institution of higher education

Resumo: A saúde do trabalhador tem se deparado com novos desafios advindos, por exemplo, da pandemia da covid-19 e da indústria 4.0, o que implica na inevitabilidade de refletir sobre as cargas de trabalho nesse contexto. A dissertação que se segue tem como objetivo analisar as cargas de trabalho presentes no processo laboral dos técnico-administrativos de uma instituição pública de ensino superior no contexto da pandemia da covid-19. Sugere-se também reconhecer as estratégias utilizadas para o enfrentamento dessas cargas no meio laboral. Trata-se de uma pesquisa do tipo exploratória e descritiva, de natureza qualitativa. O estudo se dá na região sul do Brasil. Para esse fim, propõe-se a criação e testagem de um instrumento para identificar as cargas de trabalho que podem causar impactos negativos ou desgaste desses trabalhadores. Os pesquisadores Asa Laurell e Mariano Noriega (1989) orientam o referencial teórico do estudo, a partir do conceito de Cargas de Trabalho, classificadas em físicas, químicas, biológicas, mecânicas, fisiológicas e psíquicas. A coleta de dados se estabelece a partir da aplicação do instrumento criado, um questionário aplicado por meio de entrevista (presencial ou online), com 31 técnico-administrativos que exercem o cargo de secretário(a) nas coordenações de cursos de graduação de uma universidade pública federal. O tratamento dos dados se dá com base na Análise de Conteúdo Temática de Laurence Bardin (2016), com a proposição de duas categorias finais: a primeira sobre o reconhecimento das cargas de trabalho dos técnico-administrativos. Nessa categoria são apresentadas as cargas de trabalho que causam ou podem gerar algum tipo de desgaste nos trabalhadores. O percurso de investigação mostra que as cargas mais reconhecidas pelos trabalhadores pesquisados, a partir de sua percepção do processo de trabalho, são as psíquicas e fisiológicas, com atenção para as condições ergonômicas do trabalho. A segunda categoria, sobre as estratégias individuais e coletivas utilizadas por esses trabalhadores para o enfrentamento das cargas de trabalho, evidencia que os técnico-administrativos utilizam mecanismos individuais e coletivos como medidas protetivas contra os agravos decorrentes do labor, porém esses fatores de proteção requerem aprimoramento. Esses achados corroboram com o que traz a literatura sobre a presença dessas cargas nos ambientes de trabalho, principalmente nas áreas de prestação de serviços e atendimento a pessoas. Uma vez reconhecida a existência das cargas de trabalho, pode-se propor medidas de promoção à saúde e prevenção de doenças dos técnico-administrativos.

Abstract: Worker's health has faced new challenges arising, for example, the covid-19 pandemic and Health 4.0, which implies the inevitability of reflecting on workloads in this context. Therefore, the following dissertation aims to analyze the workloads present in the work process of administrative technicians at a public institution of higher education in the context of the covid-19 pandemic. It is also suggested to recognize the strategies used to face these workloads in the work environment. This is an exploratory and descriptive research, with a qualitative nature. The study takes place in the southern region of Brazil. This academic work proposes the creation and testing of an instrument (questionnaire) to identify the workloads that can cause negative impacts or cause wear on these Workers. Researchers Asa Laurell and Mariano Noriega (1989) guide the theoretical framework of the study, based on the concept of Workloads, classified as physical, chemical, biological, mechanical, physiological and psychological. For the data collection, the questionnaire was applied through interviews (in person or online), with 31 administrative technicians who work as secretary in the coordination of undergraduate courses at a federal public university. Data treatment is based on Laurence Bardin's Thematic Content Analysis (2016), with the proposition of two final categories: the first one is the recognition of administrative technical workers workloads. This category presents the workloads that cause or may generate some type of wear on workers. The investigation shows that the workloads most recognized by the surveyed, based on their perception of the work process, are psychic and physiological, with attention to the ergonomic conditions of work. The second category, about the individual and collective strategies used by these workers to handle with workloads, shows that the administrative technical workers use individual and collective mechanisms as protective measures against the damage resulting from work, but these protection factors require improvement. These findings corroborate with what the literature brings about the presence of these loads in work environments, especially in the areas of service provision and assistance to people. Once the existence of workloads is recognized, measures can be proposed to promote health and prevent diseases for these administrative technical workers.

How does arch form and interproximal contact size affect the 3D displacements and rotations of teeth: a finite element analysis

ABSTRACT Objective: The objective of this study was to determine how arch form and interproximal contact size displace mandibular teeth subjected to an anterior component of force (ACF). Methods: Nine finite element models (FEM) of the mandibular arch were developed using Ansys® v. 16.0 software. They were designed to evaluate the effects of three arch forms (triangular, oval, and square) and three contact sizes (point-to-point, 1 mm diameter, and 2 mm diameter). All nine models were subjected to an ACF of 53.8 N (5486 gm). Three-dimensional tooth rotations and displacements of the mandibular teeth were evaluated, from the right first molar to the left first molar. Results: Arch form had a greater effect on tooth movements than contact size. Triangular arches and point-to-point contacts produced the greatest displacements and rotations of teeth. Oval arches with 2 mm wide interproximal contact points showed the greatest stability. The right first premolar showed the greatest displacements in all of the models. Conclusions: Arch form and contact size affect interproximal tooth stability. Teeth are least stable in narrow arches with point-to-point interproximal contacts, and most stable in wider arches with larger contacts.

RESUMO Objetivo: O objetivo deste estudo foi determinar como o formato da arcada e o tamanho do contato interproximal deslocam os dentes inferiores submetidos a um componente anterior de força (CAF). Métodos: Nove modelos de elementos finitos (MEF) da arcada inferior foram desenvolvidos utilizando o software Ansys® v. 16.0. Eles foram projetados para avaliar os efeitos de três formatos de arcada (triangular, oval e quadrado) e três tamanhos de contato interproximal (ponto a ponto, 1 mm de diâmetro e 2 mm de diâmetro). Todos os nove modelos foram submetidos a um CAF de 53,8 N (5486 gm). Foram avaliados tridimensionalmente as rotações dentárias e os deslocamentos dos dentes inferiores, do primeiro molar direito ao primeiro molar esquerdo. Resultados: A forma da arcada teve um efeito maior no movimento dos dentes do que o tamanho do contato interproximal. Arcadas triangulares e contatos ponto a ponto produziram os maiores deslocamentos e rotações dos dentes. Arcadas ovais com pontos de contato interproximal de 2 mm de largura apresentaram maior estabilidade. O primeiro pré-molar direito apresentou os maiores deslocamentos em todos os modelos. Conclusões: O formato da arcada e o tamanho do contato interproximal afetam a estabilidade dos dentes. Os dentes foram menos estáveis nas arcadas estreitas com contatos interproximais ponto a ponto, e mais estáveis nas arcadas mais largas com contatos maiores.

Estados afectivos emocionales y desgaste profesional durante la atención de pacientes con covid-19 / Emotional affective states and professional burnout during the care of patients with covid-19

Introducción: Los efectos directos de la Covid-19 fueron más allá del espectro de manifestaciones clínicas propias de la enfermedad, también se evidenciaron cambios en los estados afectivos de la persona. Objetivo: Determinar la relación de los estados afectivos emocionales con el desgaste profesional al atender a pacientes afectados por la Covid-19, en el Hospital Materno Infantil, durante el 2020. Métodos: Fue un estudio con enfoque cuantitativo, de tipo observacional, transversal, prospectivo y analítico. Se trabajó con una población censal de 180 trabajadores asistenciales, a quienes se les aplicó un inventario de desgaste profesional y una escala de ansiedad, estrés y depresión (DASS-21), las cuales fueron previamente validadas. En la contrastación de hipótesis se utilizó la prueba X2, con un p < 0,05. Resultados: Se halló relación entre el nivel de ansiedad y el nivel de desgaste laboral del personal de salud (X2 = 18,533; p = 0,000). Hubo relación entre el nivel de estrés y el nivel de desgaste laboral entre dichas variables (X2 = 12,808; p = 0,000). Finalmente, se halló relación entre el nivel de depresión y el desgaste laboral (X2 = 13,618; p = 0,000). Conclusiones: Se evidenció que el 5,6 % (10) presentaron estados afectivos alterados y desgaste laboral.

Introduction: The direct effects of Covid-19 went beyond the spectrum of clinical manifestations of the disease, changes in the affective states of the person were also evidenced. Objective: To determine the relationship between emotional affective states and professional burnout when attending patients affected by Covid-19, in Hospital Materno Infantil, during 2020. Methods: It was a quantitative, observational, cross-sectional, prospective, and analytical study. It worked with a census population of 180 healthcare workers, who were applied an inventory of professional burnout and a scale of anxiety, stress, and depression (DASS-21), which were previously validated.The X2 test was used for hypothesis testing, with a p < 0.05. Results: We found a relationship between the level of anxiety and the level of professional burnout of health personnel (X2 = 18.533; p = 0.000). There was a relationship between the level of stress and the level of professional burnout between these variables (X2 = 12.808; p = 0.000). Finally, we found a relationship between the level of depression and professional burnout (X2 = 13.618; p = 0.000). Conclusions: It was evident that 5.6% (10) presented altered affective states and professional burnout.

Fadiga por compaixão e estratégias de enfrentamento diante da finitude / Compassion fatigue and coping strategies before death / Fatiga por compasión y estrategias de afrontamiento ante la finitud

Resumo A fadiga por compaixão é uma ameaça à saúde mental de profissionais de saúde diante da dificuldade em manejar a empatia. Assim, buscou-se verificar na literatura científica a correlação entre a fadiga por compaixão e a atuação de profissionais em unidades hospitalares que lidam constantemente com a morte, considerando estratégias adotadas para autocuidado. Realizou-se revisão integrativa da literatura, que identificou 11 artigos, nas bases de dados MEDLINE e PubMed, publicados entre 2011 e 2021. Constatou-se que a fadiga por compaixão ocorre com maior frequência em profissionais que lidam direta e recorrentemente com a morte, principalmente quando medidas distanásicas são adotadas. As principais estratégias de adaptação psicológica detectadas foram discussão de casos entre equipes, momentos de lazer e apoio de colegas, espiritualidade e meditação, além de uma liderança construtiva. Ressalta-se a necessidade de maior aprofundamento e novas pesquisas diante da escassez de estudos sobre o tema, principalmente no Brasil.

Abstract Compassion fatigue threatens healthcare professionals' mental health in face of difficulties in managing empathy. This integrative review sought to verify the correlation between compassion fatigue and health professionals' performance in hospital units that frequently deal with death, considering the self-care strategies adopted. Bibliographic search conducted on the MEDLINE and PubMed databases retrieved 11 articles published between 2011 and 2021. Results show that compassion fatigue occurs frequently in professionals who deal directly and recurrently with death, especially when dysthanasia measures are adopted. Case discussion between teams, leisure time and peer support, spirituality and meditation as well as constructive leadership were the main psychological adaptation strategies identified. Further and in-depth research is needed given the scarcity of study on the topic, especially in Brazil.

Resumen La fatiga por compasión es una amenaza para la salud mental de los profesionales de la salud ante la dificultad para gestionar la empatía. Se buscó en la literatura científica la correlación entre la fatiga por compasión y el trabajo de los profesionales en unidades hospitalarias que lidian constantemente con la muerte considerando las estrategias adoptadas para el autocuidado. La revisión integradora de la literatura realizada identificó 11 artículos en las bases de datos MEDLINE y PubMed, publicados entre 2011 y 2021. La fatiga por compasión se presenta más en los profesionales que lidian directa y recurrentemente con la muerte, especialmente durante la adopción de medidas de distanasia. Como principales estrategias de adaptación psicológica destacan la discusión de casos entre equipos, el tiempo libre y apoyo de los compañeros, la espiritualidad y meditación, y el liderazgo constructivo. Son necesarias más investigaciones a fondo dados los escasos estudios, especialmente en Brasil.