Burnout en el contexto deportivo: análisis teórico-práctico del estado de la cuestión / Burnout in the sporting context: theoretical and practical analysis of the state of the

Con este trabajo pretendemos aproximarnos a la situación actual que, en materia de invstigación y aplicación, podemos encontrar con relación al síndrome de burnout en el contexto deportivo. Para ello hemos analizado los trabajos científicos más recientes, con la finalidad de obtener aquellas tendencias que actualmente está adquiriendo la investigación de este sindrome, siempre desde la perspectiva deportiva que nos ocupa. Para ello, además, hemos buscado las aplicaciones prácticas que dichas investigaciones pueden tener para el psicólogo del deporte que trabaja directamente con deportistas y entrnadores, principalmente. Como se irá desarrollando, a lo largo de la descripción ofrecida, empiezan a exitir pilares sólidos en esta línea de estudio y trabajo aplicado, tanto desde la perspectiva avaluativa, como desde los planteamientos teóricos y prácticos más recientes. Se concluye acerca de las líneas principales de trabajo a las que hábra que atender cuando el psicólogo se erncuentre con deportistas y entrenadores con burnout, bien desde la intervención directa, bien desde planteamientos preventivos(AU)

With this work we try to come closer the current situation that, as for invstigación and application, we can find with relation to the syndrome of burnout in the sports context. For it we have analyzed the most recent scientific works, with the purpose of obtaining those trends that nowadays there is acquiring the investigation of this syndrome, always from the sports perspective quenos occupies. For it, in addition, we have looked for the applications practical that the above mentioned investigations can have for the psychologist of the sport who works directly with sportsmen and entrnadores, principally. Since it will be developing, along the offered description, they begin to exitir solid props in this line of study and applied work, so much from the perspective avaluativa, since from the most recent theoretical and practical expositions. He concludes brings over of the principal lines of work to which hábra to that to attend when the psychologist erncuentre with sportsmen and trainers with burnout, well from the direct intervention, well from preventive expositions (AU)

Modeling the economic burden of diseases imputable to stress at work.

This study evaluated the costs of work-related stress in France. Three illnesses--cardiovascular diseases, depression, musculoskeletal diseases and back pain--that may result from exposure to stress are identified and the proportions of cases attributable to the risk factor are calculated from epidemiological studies. Two methodological hypotheses allow us to provide complementary evaluations of the social cost of occupational stress and raise the ethical questions inherent in the choice of methodology. For the year 2000 our model shows that of a working population of 23.53 million in France some 310,000-393,400 persons (1.3-1.7%) were affected by illnesses attributable to work-related stress, and that 2,300-3,600 persons died as a result of their illness. Work-related stress costs society between Euro 1,167 million and Euro 1,975 million in France, or 14.4-24.2% of the total spending of social security occupational illnesses and work injuries branch.

Stress prevention and management: a challenge for patients and physicians.

Chronic stress is now the commonest contributor to ill health in modern societies. The cost of stress in terms of absenteeism, lost productivity, and health care expense is rapidly increasing. As the problem continues to worsen, there will be an increasing need for interactive systems designed to help people cope with stress. Effective prevention of stress's adverse effects will require the widest possible deployment and implementation of stress reduction strategies.

Assessing the economic impact of stress--the modern day hidden epidemic.

This article examines the economic effects of all forms of stress-work-related stress, home stress, and post-traumatic stress disorder (PTSD)-as health hazards. Such an approach inherently broadens the analysis from a few well-defined, quantitative variables, such as those most commonly studied by economists who traditionally examine job stress alone. It also enables us to draw conclusions regarding the socioeconomic factors and the psychology of stress and helps in understanding the larger question of the economic cost of stress in today's global environment. Stress and its related comorbid diseases are responsible for a large proportion of disability worldwide. The World Health Organization (WHO) Global Burden of Disease Survey estimates that mental disease, including stress-related disorders, will be the second leading cause of disabilities by the year 2020. Although the term "stress" is used in a wide variety of contexts, it has consistently been demonstrated that individuals with stress and related disorders experience impaired physical and mental functioning, more work days lost, increased impairment at work, and a high use of health care services. The disability caused by stress is just as great as the disability caused by workplace accidents or other common medical conditions such as hypertension, diabetes, and arthritis. We present evidence that calls for early recognition of workplace stress and for businesses to allocate more resources to stress management in the workplace.

Role of acid suppressants in intensive care medicine.

Bleeding from stress-induced mucosal lesions continues to be a potential problem in critically ill patients, although its incidence has decreased dramatically over the past decade. Patients considered to be at risk are those with respiratory failure, coagulopathy, severe burns or tetraplegia. The most important cause of stress ulcer bleeding is tissue hypoxia. Provided that appropriate dosage regimens are administered, all agents approved for stress ulcer prophylaxis may reduce the incidence of overt as well as clinically important bleeding. However, the efficacy of stress ulcer prophylaxis does not correlate with the efficacy of gastric acid inhibition. Although numerous studies have demonstrated that an alkaline gastric juice is associated with gastric Gram-negative bacterial overgrowth, controversy remains over whether the pharmacological suppression of gastric acid in critically ill patients facilitates nosocomial pneumonia. The reasons for these divergent results are discussed, as is a possible association between gastric acid suppression and other systemic infections. Finally, several cost-effectiveness analyses performed over recent years have demonstrated that, in properly selected critically ill patients, stress ulcer prophylaxis is cost-effective.

Impact of trauma stress ulcer prophylaxis guidelines on drug cost and frequency of major gastrointestinal bleeding.

Trauma patients are routinely prescribed stress ulcer prophylaxis despite evidence suggesting such therapy be limited to patients with identifiable risk factors for bleeding. With surgeons' consensus, we developed and implemented trauma stress ulcer prophylaxis guidelines, and measured the impact of clinical pharmacists on implementing the guidelines and the effect of the guidelines on drug cost and frequency of major gastrointestinal bleeding. Two groups of 150 consecutive patients admitted with multiple trauma were evaluated before and after guideline implementation and stratified by Injury Severity Score (ISS) to minor (ISS < 9) or moderate to severe (ISS > or = 9) trauma groups. The number of patients prescribed stress ulcer prophylaxis, length and cost of this therapy, and number of patients experiencing major gastrointestinal bleeding (decrease in consecutive hemoglobin > or = 2 g/dl in conjunction with coffee-ground emesis, hematemesis, melena, or hematochezia) were measured. All pharmacist interventions pertaining to stress prophylaxis were collected. Fewer patients were prescribed stress ulcer prophylaxis after guideline implementation (105/150, 70% vs 39/150, 26%, p<0.0001), leading to a decrease in total drug cost of $4558. Use decreased more in patients with minor (40/54, 74% vs 9/59, 15%, p<0.0001) than moderate to severe (65/96, 68% vs 30/91, 33%, p<0.0001) trauma. Neither length of therapy nor agent of choice (> 95% cimetidine) differed between groups. Fifteen (38%) of 38 postguideline prophylaxis orders were determined by the pharmacist not to meet guideline criteria. Recommendations to discontinue therapy were accepted in 9 (60%) of 15 instances. The frequency of major gastrointestinal bleeding remained unchanged between groups (1/150 vs 0/150, p=1.0). Implementation of trauma stress ulcer prophylaxis guidelines limiting therapy to patients with risk factors for bleeding led to a 80% decrease in drug cost and did not affect the frequency of major gastrointestinal bleeding.

Treating work stress: an alternative to workers' compensation.

Work stress is a growing and expensive problem. A model for group psychotherapy for disgruntled workers presenting with psychiatric symptoms was offered through Kaiser Permanente's outpatient psychiatry department. The findings of a 2-year follow-up study conducted on group participants indicate that this type of cognitive-behavioral group psychotherapy can be helpful in increasing employee satisfaction and adjustment at work. This also raises the possibility that early intervention through group psychotherapy may be effective in reducing the incidence of workers' compensation stress claims.

Occupational stress, social support, and the costs of health care.

Relationships among health care costs, social support, and occupational stress are investigated. Health care cost data were collected over two years for 260 working individuals. Multiple regression analyses were used to control for initial health care costs, age, and gender in predicting later costs; independent variables were stress, strain, social support, and their interactions. Main effects and interactions each accounted for significant proportions of the variance in various health care costs.

Occupational stress intervention.

The topic of occupational stress has received considerable research attention during the last decade and has emerged as an important occupational safety and health concern. Worker compensation claims for stress-related illnesses, for example, were the fastest growing type of claim in the 1980s, comprising more that 11% of all such claims. Concern over problems associated with occupational stress and their costs has fostered interest in intervention strategies. While specific work stressors and their resulting physical and mental health consequences have been identified, relatively few successful interventions have been documented in the literature. This article discusses primary, secondary, and tertiary interventions efforts in the area of occupational stress and argues for efforts to increase understanding of the occupational stress intervention process.

[Stress, health and production in swine]. / Stress, Gesundheit und Leistung beim Schwein.

The "porcine stress syndrome" is a well established concept. Effects exerted on part of the meat type pig populations by their increased susceptibility to stress, resulting in meat quality defects, are meant by it. The problem of stress is rather a complex phenomenon. Stress is a part of daily life and can have negative as well as positive effects on performance and health, depending on its intensity and duration. These connections are discussed in the following paragraphs: 1. Definition of stress, and of stress-related reactions and possibilities of their assessment. 2. Stressors and their effects on the performance and health of pigs with regard to genetic dispositions. 3. Conclusions for the avoidance of stress effects in pig production.