Comprehensive evaluation of genetic and acquired thrombophilia markers for an individualized prediction of clinical thrombosis in patients with lymphoma and multiple myeloma.

Patients diagnosed with lymphoma or multiple myeloma are at elevated risk of venous thromboembolism (VTE). Optimum risk stratification and effective thromboprophylaxis can only be achieved through the development of a multiple-specific risk score that successfully captures all aspects of the heterogeneous prothrombotic environment existing in these patients. Our aim was to identify risk factors for thrombosis and suggest an improved tool combining clinical data, thrombo-inflammatory biomarkers and genetic (Thrombo inCode® test) variables for predicting thrombotic risk in patients with lymphoma and multiple myeloma. A prospective longitudinal study was conducted on newly-diagnosed lymphoma and multiple myeloma patients who presented at our institution between February 2020 and January 2021. The study included 47 patients with lymphoma and 16 patients with multiple myeloma. We performed a follow-up of 1 year or until September 2021. The incidence of venous thrombosis and associated risk factors were analysed, including the genetic Thrombo inCode® test. Khorana and ThroLy scores for lymphoma patients and IMPEDE VTE score for myeloma patients were calculated. At a median follow-up of 9.1 months, VTE incidence was 9.5% (6/63), with 4 and 2 patients with lymphoma and myeloma who developed the events, respectively. Univariate analysis showed that the incidence of thrombosis was significantly higher in patients with ECOG ≥ 2 and prior immobility. Median factor VIII levels were significantly higher in patients with thrombosis (with increased values in all of them). Moreover, there was a trend in genetic variant rs5985 (factor XIII) as a protective factor, and a trend to higher thrombotic risk in patients with factor V Leiden, rs2232698 variant (serpinA10), low total protein S activity, elevated D-dimer, aggressive lymphoma and treatment with dexamethasone. The results of our study demonstrate promise for the potential use of widely accessible markers to increase precision in risk prediction for VTE in patients with lymphoma and multiple myeloma, particularly ECOG ≥ 2, immobility and higher factor VIII levels, as well as lymphoma aggressiveness, treatment with dexamethasone and the haemostatic biomarkers D-dimer and total protein S activity. Additionally, genetic variants factor V Leiden, serpinA10 rs2232698 and factor XIII-A Val34Leu warrant further investigation for use in the research setting.

[Spanish version of the Nordic Musculoskeletal Questionnaire: cross-cultural adaptation and validation in nursing aides].

BACKGROUND: The aim of this study is to translate, culturally adapt, and validate a Spanish version of the Nordic Musculoskeletal Questionnaire for a sample of nursing assistant aides. METHODS: The questionnaire was translated and culturally adapted. Next, it was included in a battery of tests that was completed by 526 nursing assistants working in residential care homes in the Principality of Asturias (Spain). To assess its validity, the Exploratory Factor Analysis and the Confirmatory Factor Analysis were used. The internal consistency was estimated with McDonald's Omega coefficient (?), complemented by the test-retest reliability analysis through the intraclass correlation coefficient. The validity of the criteria was established by the correlation between total score on the test and quality of life measures, job insecurity and psychological demand, and social support at work. RESULTS: The Exploratory Factor Analysis and Confirmatory Factor Analysis adjustment indices confirmed it is a unidimensional test. The internal consistency values indicated very high reliability (? = 0.81). Similarly, the intraclass correlation coefficient showed statistically significant values and an excellent correlation coefficient (r = 0.95). The validity of the criteria showed a statistically significant correlation with all the constructs studied, particularly with quality of life. CONCLUSIONS: This Spanish version of the Nordic Musculoskeletal Questionnaire has good psychometric qualities for a population of nursing aides and therefore may be a valid and reliable tool for assessing musculoskeletal disorders.

Versión española del Nordic Musculoskeletal Questionnaire: adaptación transcultural y validación en personal auxiliar de enfermería / Spanish version of the Nordic Musculoskeletal Questionnaire: cross-cultural adaptation and validation in nursing aides

Fundamento. El objetivo de este trabajo es traducir, adaptar culturalmente y validar una versión española del Nordic Musculoskeletal Questionnaire (NMQ) en una muestra de personal auxiliar de enfermería. Metodología. Se realizó la traducción y adaptación cultural del cuestionario y se incluyó dentro de una batería de escalas, cumplimentada por 526 auxiliares de enfermería de centros residenciales para personas mayores del Principado de Asturias. Se analizó la validación de la escala a través de la sucesión del análisis factorial exploratorio (AFE) y el análisis factorial confirmatorio (AFC). La consistencia interna se estimó con el coeficiente ordinal ω de McDonald, complementándose con el análisis de fiabilidad test-retest por medio del coeficiente de correlación intraclase (ICC). La validez de criterio se estimó a través de la correlación de la puntuación total de la prueba con las medidas de calidad de vida, incertidumbre laboral, demanda psicológica y apoyo social en el trabajo. Resultados. Los índices de ajuste de AFE y AFC mostraron que se trata de una prueba unidimensional. Los valores de consistencia interna señalaron una fiabilidad muy alta (ω= 0,81) y el ICC fue excelente (r= 0,95). La validez de criterio mostró una correlación estadísticamente significativa con todos los constructos estudiados, especialmente con la calidad de vida. Conclusiones. La presente versión española del NMQ presenta unas buenas cualidades psicométricas en la población de personal auxiliar de enfermería por lo que podría ser una herramienta válida y fiable en la evaluación de los trastornos musculoesqueléticos. (AU)

Background. The aim of this study is to translate, culturally adapt, and validate a Spanish version of the Nordic Musculoskeletal Questionnaire for a sample of nursing assistant aides. Methods. The questionnaire was translated and culturally adapted. Next, it was included in a battery of tests that was completed by 526 nursing assistants working in residential care homes in the Principality of Asturias (Spain). To assess its validity, the Exploratory Factor Analysis and the Confirmatory Factor Analysis were used. The internal consistency was estimated with McDonald’s Omega coefficient (ω), complemented by the test-retest reliability analysis through the intraclass correlation coefficient. The validity of the criteria was established by the correlation between total score on the test and quality of life measures, job insecurity and psychological demand, and social support at work. Results. The Exploratory Factor Analysis and Confirmatory Factor Analysis adjustment indices confirmed it is a unidimensional test. The internal consistency values indicated very high reliability (ω = 0.81). Similarly, the intraclass correlation coefficient showed statistically significant values and an excellent correlation coefficient (r = 0.95). The validity of the criteria showed a statistically significant correlation with all the constructs studied, particularly with quality of life. Conclusions. This Spanish version of the Nordic Musculoskeletal Questionnaire has good psychometric qualities for a population of nursing aides and therefore may be a valid and reliable tool for assessing musculoskeletal disorders. (AU)

COVID-19 Outcomes in Patients with Hematologic Malignancies in the Era of COVID-19 Vaccination and the Omicron Variant.

A greater understanding of clinical trends in COVID-19 outcomes among patients with hematologic malignancies (HM) over the course of the pandemic, particularly the Omicron era, is needed. This ongoing, observational, and registry-based study with prospective data collection evaluated COVID-19 clinical severity and mortality in 1818 adult HM patients diagnosed with COVID-19 between 27 February 2020 and 1 October 2022, at 31 centers in the Madrid region of Spain. Of these, 1281 (70.5%) and 537 (29.5%) were reported in the pre-Omicron and Omicron periods, respectively. Overall, patients aged ≥70 years (odds ratio 2.16, 95% CI 1.64-2.87), with >1 comorbidity (2.44, 1.85-3.21), or with an underlying HM of chronic lymphocytic leukemia (1.64, 1.19-2.27), had greater odds of severe/critical COVID-19; odds were lower during the Omicron BA.1/BA.2 (0.28, 0.2-0.37) or BA.4/BA.5 (0.13, 0.08-0.19) periods and among patients vaccinated with one or two (0.51, 0.34-0.75) or three or four (0.22, 0.16-0.29) doses. The hospitalization rate (75.3% [963/1279], 35.7% [191/535]), rate of intensive care admission (30.0% [289/963], 14.7% [28/191]), and mortality rate overall (31.9% [409/1281], 9.9% [53/536]) and in hospitalized patients (41.3% [398/963], 22.0% [42/191]) decreased from the pre-Omicron to Omicron period. Age ≥70 years was the only factor associated with higher mortality risk in both the pre-Omicron (hazard ratio 2.57, 95% CI 2.03-3.25) and Omicron (3.19, 95% CI 1.59-6.42) periods. Receipt of prior stem cell transplantation, COVID-19 vaccination(s), and treatment with nirmatrelvir/ritonavir or remdesivir were associated with greater survival rates. In conclusion, COVID-19 mortality in HM patients has decreased considerably in the Omicron period; however, mortality in hospitalized HM patients remains high. Specific studies should be undertaken to test new treatments and preventive interventions in HM patients.

Outcomes after intensive chemotherapy for secondary and myeloid-related changes acute myeloid leukemia patients aged 60 to 75 years old: a retrospective analysis from the PETHEMA registry.

Treatment options for patients with secondary acute myeloid leukemia (sAML) and AML with myeloid-related changes (AMLMRC) aged 60 to 75 years are scarce and unsuitable. A pivotal trial showed that CPX-351 improved complete remission with/without incomplete recovery (CR/CRi) and overall survival (OS) as compared with standard "3+7" regimens. We retrospectively analyze outcomes of 765 patients with sAML and AML-MRC aged 60 to 75 years treated with intensive chemotherapy, reported to the PETHEMA registry before CPX-351 became available. The CR/CRi rate was 48%, median OS was 7.6 months (95% confidence interval [CI]: 6.7-8.5) and event-free survival (EFS) 2.7 months (95% CI: 2-3.3), without differences between intensive chemotherapy regimens and AML type. Multivariate analyses identified age ≥70 years, Eastern Cooperative Oncology Group performance status ≥1 as independent adverse prognostic factors for CR/CRi and OS, while favorable/intermediate cytogenetic risk and NPM1 were favorable prognostic factors. Patients receiving allogeneic stem cell transplant (HSCT), autologous HSCT, and those who completed more consolidation cycles showed improved OS. This large study suggests that classical intensive chemotherapy could lead to similar CR/CRi rates with slightly shorter median OS than CPX-351.

Influence of Job Insecurity on Musculoskeletal Disorders: A Mediation Model with Nursing Aides.

Work-related musculoskeletal disorders are some of the most prevalent diseases in the world. They have a multifactorial aetiology encompassing ergonomic and psychosocial risk factors. The aim of this study is to analyse the way job insecurity and physical workload are linked to musculoskeletal disorders, as well as the mediating role other psychosocial work risks can have on this potential relationship. A parallel mediation path regression analysis was designed using a sample of 457 nursing aides. The influence job insecurity and physical workload has on the onset of musculoskeletal symptoms together with the variables which mediate this relationship were examined. The results prove that both independent variables explain the onset of musculoskeletal symptoms in these professionals. The influence exerted by job insecurity is mediated by the social support received at work and the demands of the job. However, when analysing the physical workload, the social support received at work is not relevant as a mediator in this relationship. Job insecurity and physical workload are significant variables on the occurrence of musculoskeletal symptoms. The data obtained supports the need to focus on physical and psychosocial factors in order to prevent these disorders.

A Chloroplast-Localised Fluorescent Protein Enhances the Photosynthetic Action Spectrum in Green Algae.

Green microalgae are important sources of natural products and are attractive cell factories for manufacturing high-value products such as recombinant proteins. Increasing scales of production must address the bottleneck of providing sufficient light energy for photosynthesis. Enhancing the photosynthetic action spectrum of green algae to improve the utilisation of yellow light would provide additional light energy for photosynthesis. Here, we evaluated the Katushka fluorescent protein, which converts yellow photons to red photons, to drive photosynthesis and growth when expressed in Chlamydomonas reinhardtii chloroplasts. Transplastomic algae expressing a codon-optimised Katushka gene accumulated the active Katushka protein, which was detected by excitation with yellow light. Removal of chlorophyll from cells, which captures red photons, led to increased Katushka fluorescence. In yellow light, emission of red photons by fluorescent Katushka increased oxygen evolution and photosynthetic growth. Utilisation of yellow photons increased photosynthetic growth of transplastomic cells expressing Katushka in light deficient in red photons. These results showed that Katushka was a simple and effective yellow light-capturing device that enhanced the photosynthetic action spectrum of C. reinhardtii.

Severe infections in patients with lymphoproliferative diseases treated with new targeted drugs: A multicentric real-world study.

BACKGROUND: Lymphoid neoplasms treatment has recently been renewed to increase antitumor efficacy and conventional chemotherapies toxicities. Limited data have been published about the infection risk associated with these new drugs, therefore this study analyzes the infectious complications in patients with lymphoproliferative diseases (LPD) treated with monoclonal antibodies (obinutuzumab, ofatumumab, brentuximab, nivolumab, or pembrolizumab), BTK inhibitors (ibrutinib and acalabrutinib), PI3K inhibitors (idelalisib) and BCL2 inhibitors (venetoclax). METHODS: Multicenter retrospective study of 458 LPD patients treated with targeted therapies in real-life setting, in 18 Spanish institutions, from the time of their commercial availability to August 2020. RESULTS: Severe infections incidence was 23% during 17-month median follow-up; cumulative incidence was higher in the first 3-6 months of targeted drug treatment and then decreased. The most frequent etiology was bacterial (54%). Nine (6%) Invasive fungal infections (IFI) were observed, in its majority in chronic lymphocytic leukemia (CLL) patients treated predominantly with ibrutinib. Significant risk factors for severe infection were: severe lymphopenia (p = 0.009, OR 4.7, range 1.3-1.7), combined targeted treatment vs single agent treatment (p = 0.014 OR 2.2 range 1.1-4.2) and previous rituximab (p = 0.03 OR 1.8, range 1.05-3.3). Infection-related mortality was 6%. In 22% of patients with severe infections, definitive discontinuation of the targeted drug was observed. CONCLUSION: A high proportion of patients presented severe infections during follow-up, with non-negligible attributable mortality, but infection incidence is not superior to the one observed during the chemotherapy era. In selected cases with specific risk factors for infection, antimicrobial prophylaxis should be considered.

Risk Factors and Mortality of COVID-19 in Patients With Lymphoma: A Multicenter Study.

Patients with cancer are poorly represented in coronavirus disease 2019 (COVID-19) series, and heterogeneous series concerning hematology patients have been published. This study aimed to analyze the impact of COVID-19 in patients with lymphoma. We present a multicenter retrospective study from 19 centers in Madrid, Spain, evaluating risk factors for mortality in adult patients with COVID-19 and lymphoma. About 177 patients (55.9% male) were included with a median follow-up of 27 days and a median age of 70 years. At the time of COVID-19 diagnosis, 49.7% of patients were on active treatment. The overall mortality rate was 34.5%. Age >70 years, confusion, urea concentration, respiratory rate, blood pressure, and age >65 score ≥2, heart disease, and chronic kidney disease were associated with higher mortality risk (P < 0.05). Active disease significantly increased the risk of death (hazard ratio, 2.43; 95% confidence interval, 1.23-4.77; P = 0.01). However, active treatment did not modify mortality risk and no differences were found between the different therapeutic regimens. The persistence of severe acute respiratory syndrome coronavirus 2-positive polymerase chain reaction after week 6 was significantly associated with mortality (54.5% versus 1.4%; P < 0.001). We confirm an increased mortality compared with the general population. In view of our results, any interruption or delay in the start of treatment should be questioned given that active treatment has not been demonstrated to increase mortality risk and that achieving disease remission could lead to better outcomes.

The Influence of Gender Inequality in the Development of Job Insecurity: Differences Between Women and Men.

Job insecurity is an indicator of precarious work that refers to the fear of losing one's job. It is a relevant source of stress, with negative consequences on people's mental health. The main objective and contribution of this study is to identify how gender inequality and job insecurity are related, responding to the lack of consensus found in scientific literature in this field of study. To do so, a predictive study of job insecurity, broken down by gender, is developed, considering sociodemographic and labor variables as antecedents. The sample included 1,005 employees (420 men and 585 women) aged between 18 and 65, and a linear regression was conducted for each group. Results show that women perceive greater insecurity under precarious working conditions (temporary work, informal work, salary cuts, tenure), whereas in the case of men variables related to their professional careers (job category, education) and household incomes were relevant predictors. It is concluded that job insecurity affects both gender groups, but the conditions in which this perception grows are significantly impacted by gender inequality. These findings will allow for holistic and effective actions to decrease the effects of precarious work.

Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study.

BACKGROUND: Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respiratory viral infections than patients with solid tumors. Data on COVID-19 in patients with hematologic malignancies are limited. Here we characterize disease severity and mortality and evaluate potential prognostic factors for mortality. METHODS: In this population-based registry study, we collected de-identified data on clinical characteristics, treatment and outcomes in adult patients with hematologic malignancies and confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the Madrid region of Spain. Our case series included all patients admitted to 22 regional health service hospitals and 5 private healthcare centers between February 28 and May 25, 2020. The primary study outcome was all-cause mortality. We assessed the association between mortality and potential prognostic factors using Cox regression analyses adjusted for age, sex, comorbidities, hematologic malignancy and recent active cancer therapy. RESULTS: Of 833 patients reported, 697 were included in the analyses. Median age was 72 years (IQR 60-79), 413 (60%) patients were male and 479 (69%) and 218 (31%) had lymphoid and myeloid malignancies, respectively. Clinical severity of COVID-19 was severe/critical in 429 (62%) patients. At data cutoff, 230 (33%) patients had died. Age ≥ 60 years (hazard ratios 3.17-10.1 vs < 50 years), > 2 comorbidities (1.41 vs ≤ 2), acute myeloid leukemia (2.22 vs non-Hodgkin lymphoma) and active antineoplastic treatment with monoclonal antibodies (2·02) were associated with increased mortality; conventional chemotherapy showed borderline significance (1.50 vs no active therapy). Conversely, Ph-negative myeloproliferative neoplasms (0.33) and active treatment with hypomethylating agents (0.47) were associated with lower mortality. Overall, 574 (82%) patients received antiviral therapy. Mortality with severe/critical COVID-19 was higher with no therapy vs any antiviral combination therapy (2.20). CONCLUSIONS: In this series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy. Further studies and long-term follow-up are required to validate these criteria for risk stratification.

Jumping Translocation in a Patient with Acute Leukemia and Fatal Evolution.

Jumping translocations are uncommon cytogenetic abnormalities in which a segment of a donor chromosome, often 1q, is transferred to two or more receptor chromosomes. We describe the case of a 64-year-old man with a history of acute myeloid leukemia associated with myelodysplastic syndrome, who presented with a relapse of the leukemia and, concomitantly, with the appearance of a jumping translocation involving chromosome 1q. The patient had a poor clinical course without the possibility of performing targeted treatment, and he died 5 months after relapse. Jumping translocations are a reflection of chromosomal instability, and they could be related to epigenetic alterations such as pericentromeric chromatin hypomethylation, telomere shortening, or pathogenic variants of the TP53 gene. The existing data suggests a poor clinical outcome, a high risk of disease progression, and an unfavorable prognosis. More molecular studies are required to gain an in-depth understanding of the genetic mechanism underlying these alterations and their clinical significance and to be able to apply an optimal treatment to patients.

Job Insecurity and Mental Health: The Moderating Role of Coping Strategies From a Gender Perspective.

Job insecurity is a growing phenomenon, typical of an employment context characterised by high rates of temporary work and unemployment. Previous research has shown a direct relationship between job insecurity and mental health impairment. The present analysis goes into this relationship in depth, studying the moderating role of coping strategies and predicting that men and women implement different types of strategies. A sample of 1.008 workers is analysed, 588 women and 420 men. The Tobin CSI scale was used to analyse the coping strategies, in addition to JIS-8 to assess job insecurity, the MOS Perceived Social Support Survey and the GHQ-28 test to evaluate mental health. Then, a hierarchical linear regression was designed to study the moderating role of 8 coping strategies of job insecurity and 4 mental health subscales in men and women, separately. Results illustrate that coping strategies play a moderating role in the relationship between job insecurity and mental health. However, the aggravating role of disengagement coping strategies is more relevant than the buffering role of engagement strategies. On the other hand, women implement a greater number of coping strategies, with more positive results for mental health. Also, in the relationship between job insecurity and mental health the most important strategies are the ones related to social interaction inside and outside an organisation, and these are the main ones used by women. It therefore follows that strengthening rich social relationships inside and outside the working environment is a guarantee of well-being.

High prognostic value of measurable residual disease detection by flow cytometry in chronic lymphocytic leukemia patients treated with front-line fludarabine, cyclophosphamide, and rituximab, followed by three years of rituximab maintenance.

It has been postulated that monitoring measurable residual disease (MRD) could be used as a surrogate marker of progression-free survival (PFS) in chronic lymphocytic leukemia (CLL) patients after treatment with immunochemotherapy regimens. In this study, we analyzed the outcome of 84 patients at 3 years of follow-up after first-line treatment with fludarabine, cyclophosphamide and rituximab (FCR) induction followed by 36 months of rituximab maintenance thearpy. MRD was assessed by a quantitative four-color flow cytometry panel with a sensitivity level of 10-4 Eighty out of 84 evaluable patients (95.2%) achieved at least a partial response or better at the end of induction. After clinical evaluation, 74 patients went into rituximab maintenance and the primary endpoint was assessed in the final analysis at 3 years of follow-up. Bone marrow (BM) MRD analysis was performed after the last planned induction course and every 6 months in cases with detectable residual disease during the 36 months of maintenance therapy. Thirty-seven patients (44%) did not have detectable residual disease in the BM prior to maintenance therapy. Interestingly, 29 patients with detectable residual disease in the BM after induction no longer had detectable disease in the BM following maintenance therapy. After a median followup of 6.30 years, the median overall survival (OS) and PFS had not been reached in patients with either undetectable or detectable residual disease in the BM, who had achieved a complete response at the time of starting maintenance therapy. Interestingly, univariate analysis showed that after rituximab maintenance OS was not affected by IGHV status (mutated vs unmutated OS: 85.7% alive at 7.2 years vs 79.6% alive at 7.3 years, respectively). As per protocol, 15 patients (17.8%), who achieved a complete response and undetectable peripheral blood and BM residual disease after four courses of induction, were allowed to stop fludarabine and cyclophosphamide and complete two additional courses of rituximab and continue with maintenance therapy for 18 cycles. Surprisingly, the outcome in this population was similar to that observed in patients who received the full six cycles of the induction regimen. These data show that, compared to historic controls, patients treated with FCR followed by rituximab maintenance have high-quality responses with fewer relapses and improved OS. The tolerability of this regime is favorable. Furthermore, attaining an early undetectable residual disease status could shorten the duration of chemoimmunotherapy, reducing toxicities and preventing long-term side effects. The analysis of BM MRD after fludarabine-based induction could be a powerful predictor of post-maintenance outcomes in patients with CLL undergoing rituximab maintenance and could be a valuable tool to identify patients at high risk of relapse, influencing further treatment strategies. This trial is registered with EudraCT n. 2007-002733-36 and ClinicalTrials.gov Identifier: NCT00545714.

Neurobehavioral Alterations in Zebrafish Due to Long-Term Exposure to Low Doses of Inorganic Arsenic.

Inorganic arsenic (As) is one of the most ubiquitous and toxic substances with widespread health effects on human populations and biodiversity. Although arsenic is a frequent surface water pollutant, there is scant evidence about neurotoxicity in aquatic species in different stages of development. In the present study, we investigated the neurobehavioral effects of chronic exposure to environmentally relevant doses of arsenic. We exposed zebrafish to 50 and 500 ppb during the larval, juvenile, and adult stage (from 4 h to 150 days postfertilization). We then used broad behavioral screening to evaluate motor function, social behavior, learning and memory, and anxiety-like behaviors. Our results show that arsenic exposure to 500 ppb alters motor function from the embryo to the adult stage. Furthermore, during the adult phase, associative learning and the sensorimotor response are affected with both high and low doses of As, respectively. Notably, exposure to 500 ppb of As induces behaviors associated with anxiety, during the juvenile and adult phase but not the larval stage, without changes in whole-body cortisol levels. These results indicate that chronic exposure to arsenic during their lifespan is capable of producing alterations in different behavioral markers in aquatic vertebrates.

Job insecurity and mental health: A meta-analytical review of the consequences of precarious work in clinical disorders / Incertidumbre laboral y salud mental: una revisión meta-analítica de las consecuencias del trabajo precario en trastornos mentales

Faced with the growing instability resulting from the world economic crisis, job insecurity gains relevance in the study of occupational health. In order to analyse the consequences of job insecurity on mental health, a reference document is provided including the empirical research advances in the current framework. This systematic review follows a metaanalytical technique through 56 independent samples with 53,405 participants in total. The analysis offers a significant correlation between subjective job insecurity and mental health. Thus, it has been found that job insecurity is related to the risk or presence of depression, anxiety and emotional exhaustion, as well as to general low satisfaction with life, international comparisons are made, and negative results among workers regardless of the economic situation of the countries are highlighted, too. Moreover, methodological and conceptual contributions have been made in terms of the quality of the metrics applied. Job insecurity appears as a major problem for workers' mental health, generating devastating effects on all kind of professional profiles and economic contexts

Ante la creciente inestabilidad generada por la crisis económica mundial, la incertidumbre laboral vuelve a tomar relevancia en el estudio de la salud en el trabajo. Con el objetivo de analizar las consecuencias de la incertidumbre laboral en la salud mental, se aporta un documento referencial que recoge los avances realizados en la investigación empírica en el contexto actual. Esta revisión sistemática se realiza mediante la técnica meta-analítica a través de 56 muestras independientes con 53,405 participantes en total. El análisis ofrece una correlación significativa entre la incertidumbre laboral subjetiva y la salud mental. Así, se ha encontrado que la incertidumbre laboral guarda relación con el riesgo o presencia de depresión, ansiedad y cansancio emocional, así como con una baja satisfacción general con la vida. Así mismo, se realizan comparaciones internacionales, con resultados igualmente negativos en los trabajadores con independencia de la situación económica de los estados, y también se incorporaron aportaciones metodológicas y conceptuales sobre la calidad de las pruebas de medida utilizadas. De este modo, la incertidumbre laboral queda constatada como una problemática de primer orden para la salud mental de los trabajadores, generando efectos devastadores en todo tipo de perfiles profesionales y contextos económicos

Spanish Validation of the job insecurity scale jis-8: viability of the cognitive and affective model / Validación española de la escala de incertidumbre laboral JIS-8: viabilidad del modelo afectivo y cognitivo

Background: This instrumental study is the Spanish adaptation and validation of the Job Insecurity Scale in its 8-item version (JIS-8). This is one of the reference tests in this field and it also allows the distinction between affect and cognition in quantitative job insecurity to be tested. Method: The JIS-8 was carried out on a Spanish sample with 592 participants (186 men, 406 women; Mean age = 36.68), together with mental health and job satisfaction tests. An exploratory factor analysis and confirmatory factor analysis were carried out, and the relationship between the scale and other variables was examined. Results: The Spanish validation shows good construct validity, internal consistency and a Cronbach a = .88, higher than the value obtained in the validation of the original instrument. The analysis shows the consequences of job insecurity on workers’ mental health, as well as on their job satisfaction. The exploratory factor analysis as well as the confirmatory analysis, in which a one-dimensional and a two-dimensional model were tested, maintain the presence of two factors: the cognitive and the affective dimensions. Conclusions: The results underpin the fact that the test is appropriate for application to people in active employment in the Spanish population (AU)

Antecedentes: a través del presente estudio instrumental se adapta al castellano y se valida la Job Insecurity Scale en su versión de 8 ítems (JIS-8), una de las pruebas de referencia en este campo, que además permite poner a prueba la distinción cognitiva y afectiva en la incertidumbre laboral cuantitativa. Método: el JIS-8 fue administrado a una muestra española de 592 participantes (186 hombres, 406 mujeres; Media de edad = 36,68), junto a pruebas de salud mental y satisfacción laboral. Se realizó un análisis factorial exploratorio y confirmatorio, y se ha estudiado la relación de la escala con otras variables. Resultados: la adaptación española muestra validez de constructo, buena consistencia interna y Cronbach a = .88, superior a la obtenida en la validación del instrumento original. El análisis llevado a cabo prueba las consecuencias de la incertidumbre laboral sobre la salud mental de los trabajadores, así como sobre su satisfacción laboral. Tanto el análisis factorial exploratorio como confirmatorio, donde se pusieron a prueba un modelo unidimensional y otro bidimensional, mantiene la presencia de dos factores: las dimensiones cognitiva y afectiva. Conclusiones: los resultados muestran que la prueba es adecuada para su uso en personas en situación laboral activa en población española (AU)

Spanish validation of the Job Insecurity Scale JIS-8: Viability of the cognitive and affective model.

BACKGROUND: This instrumental study is the Spanish adaptation and validation of the Job Insecurity Scale in its 8-item version (JIS-8). This is one of the reference tests in this field and it also allows the distinction between affect and cognition in quantitative job insecurity to be tested. METHOD: The JIS-8 was carried out on a Spanish sample with 592 participants (186 men, 406 women; Mean age = 36.68), together with mental health and job satisfaction tests. An exploratory factor analysis and confirmatory factor analysis were carried out, and the relationship between the scale and other variables was examined. RESULTS: The Spanish validation shows good construct validity, internal consistency and a Cronbach a = .88, higher than the value obtained in the validation of the original instrument. The analysis shows the consequences of job insecurity on workers’ mental health, as well as on their job satisfaction. The exploratory factor analysis as well as the confirmatory analysis, in which a one-dimensional and a two-dimensional model were tested, maintain the presence of two factors: the cognitive and the affective dimensions. CONCLUSIONS: The results underpin the fact that the test is appropriate for application to people in active employment in the Spanish population.

More Doctors Programme and the strengthening of Primary Health Care in Brazil: reflections from the monitoring and evaluation of the More Doctors Cooperation Project

Universal Health Coverage has been a challenge for the majority of the world’s health systems. Efforts to strengthen systems through universal coverage with the aim of improving living conditions and access to health services are optimized when this is based on quality Primary Health Care (PHC). A national policy has been being developed in Brazil since 2013 aimed at strengthening human resources for PHC. This policy is called the More Doctors Programme and is considered to be an important investment for PHC development in Brazil’s Unified Health System. The purpose of this article is to present the main results of the More Doctors Programme monitoring.