Work-related factors and violence among nursing staff in the European NEXT study: a longitudinal cohort study

BACKGROUND: The occurrence of workplace violence is rather frequent within the nursing profession, with well-known consequences on the psychological health of victims. OBJECTIVES: This study is aimed at assessing the relationships between relevant individual, organizational, and psychosocial factors, and the frequency of several types of workplace violence; the direct as well as the interactive impact of violence and psychosocial factors on organizational commitment and perceived health. DESIGN: Questionnaire-based cross-sectional and longitudinal survey designs were employed for the two study objectives, respectively. SETTING: Five hundred and sixty-five healthcare institutions from eight European countries participated in the Nurses' Early Exit Study. PARTICIPANTS: The 34,107 participants were nursing staff holding different qualifications. The response rate was 55.1% in the cross-sectional part and 40.5% in the follow-up phase. At baseline, the respondents were mostly female (89.3%), in the age group 30-44 years (52.9%), registered or specialized nurses (67.0%), working mainly in medico-surgical wards (36.3%), and employed full-time (72.8%). METHODS: In the cross-sectional analysis, the relationship between the predictor variables and frequency of violence was assessed by means of a hierarchical multiple linear regression. In the longitudinal analysis, main direct and interactive effects of violence and psychosocial factors on perceived health and organizational commitment were assessed by means of hierarchical multiple linear regression analyses with interaction terms. RESULTS: Higher levels of adverse work-related factors were significantly associated with higher frequency of the distinguished types of violence. Significant interactions were found between psychosocial factors and violence only in predicting organizational commitment, even if effect sizes were very low. No interactions were observed for perceived health. The prevalence of the distinguished types of violence varied across the participating countries according to the presence of adverse work- and non-work-related factors. CONCLUSIONS: These findings suggest the necessity of interventions both over working conditions conducive to violence and violent behaviours themselves.     

Self-serving confabulation in prose recall

Recent studies suggest that the content of confabulation is mainly positive and self-enhancing. In this group study, we aimed to investigate whether this positive bias is specific to self-referent information. Confabulating amnesic patients, amnesic non-confabulating patients and healthy controls were asked to reproduce a series of short stories. We manipulated the emotional valence of the material by including positive, negative and neutral story plots. We also manipulated the self-reference of the material by including self-referent versus other-referent encoding instructions.

Confabulating patients were as impaired as a group of amnesic patients in the amount of information they recalled, both groups being worse than healthy controls. Importantly, confabulating patients showed a selective bias in the negative self-referent condition, in that they recalled such information in a manner which portrayed a more positive image of themselves. This positive bias was not present in stories that were not encoded in a self-referent manner and it was not significantly correlated to patients’ self-reported mood. We propose that both confabulation and its motivated content result from a deficit in the control and regulation of memory retrieval, which allows motivational factors to acquire a greater role than usual in determining which memories are selected for retrieval. To this extent, the self-enhancing content of confabulation could be explained as a neurogenic exaggeration of normal self-serving memory distortion.     

Integrating physical and social cues when forming face preferences: differences among low and high-anxiety individuals

This study investigated individual differences in the integration of social (i.e., direction of social interest) and physical (i.e., apparent health) cues in a face preference test. While low-anxiety individuals demonstrated preferences for social engagement from healthy-looking faces, but not from unhealthy-looking faces, high-anxiety individuals preferred social engagement from both healthy and unhealthy individuals. Importantly, anxious individuals were not simply less discriminating in their face preferences generally: anxiety levels were positively related to the strength of overall preferences for positive social interest. Collectively, our findings show that perceptions of gaze and expression can be modulated by aspects of facial appearance and that systematic variation among individuals exists in the extent to which this modulation occurs. Furthermore, since previous studies have demonstrated hypersensitive amygdala responses among anxious individuals when viewing faces, our findings suggest that the amygdala may play an important role in determining how different facial cues are integrated in person perception.     

Functional outcome after proximal humeral fractures treated with hemiarthroplasty

Objective

To evaluate functional outcome after hemiarthroplasty for displaced proximal humeral fractures and to review whether prosthesis type, intraoperative technique or previous ipsilateral shoulder surgery could affect the outcome.

Methods

We reviewed the medical records and radiographs of patients who had undergone hemiarthroplasty for proximal humeral fractures between 1992 and 2000. We identified 45 patients, 39 with acute fractures and 6 with fracture-related complications. One surgeon performed 17 surgeries (38%), and the rest were carried out by 11 other orthopedic surgeons. Using the American Shoulder and Elbow Surgeons Evaluation Form and the Western Ontario Rotator Cuff Index, we evaluated patients who had been followed for at least 2 years for residual shoulder pain, range of motion, strength, stability and function. The senior authors reviewed the radiographs.

Results

The mean age of the patients at presentation was 70 (range 46–95) years. The mean active forward elevation was 87°, abduction 63° and external rotation 22°; the mean internal rotation was to the L2 vertebra. Of the patients, 15% reported severe pain, and 25% were unable to sleep on the affected side. Patients with previous surgeries and those with intraoperative cuff tears were found to have more postoperative pain.

Conclusion

We conclude that soft tissue status and operative technique play an important role in late postoperative pain and range of motion. Hemiarthroplasty after failed open reduction and internal fixation is associated with inferior results. We were unable to show a difference in long-term outcome related to the prosthesis type.     

Directly observed therapy for the treatment of hepatitis C virus infection in current and former injection drug users

BACKGROUND AND AIM: There are few studies investigating the treatment of hepatitis C virus (HCV) infection in current and former drug users. With this in mind, we sought to evaluate the antiviral efficacy of interferon alpha-2b (IFN alpha-2b) or pegylated-interferon alpha-2b (PEG-IFN alpha-2b) and ribavirin (RBV) in injection drug users (IDU) enrolled in a directly observed therapy (DOT) program, as measured by sustained virologic response (SVR). METHODS: Viremic HCV-infected IDU, with alanine aminotransferase (ALT) >1.5x upper limit of normal (ULN) were offered 24-48 week (based on HCV genotype) therapy with RBV (800-1200 mg/day, based on weight) along with IFN alpha-2b (3 million IU thrice weekly) replaced by PEG-IFN alpha-2b (1.5 ìg/kg once weekly) as it became available. All injections were directly observed. The primary endpoint was SVR. RESULTS: Overall, 40 patients (33 males) received IFN alpha-2b (12) or PEG-IFN alpha-2b (28), 55% with HCV genotypes 2 or 3. Only 14 discontinued therapy, 5 due to toxicity, 6 due to illicit drug use and 3 did not achieve an early virologic response. In an intent-to-treat analysis, the overall SVR was 55% (22/40), 64% (14/22) in subjects with genotypes 2/3. There was no significant difference in response rates among those with >6 (50%) or 相似文献   

Confabulation: motivated reality monitoring

The study addressed the hypothesis that the content of confabulation is emotionally biased. Confabulating amnesic patients were compared with amnesic non-confabulating patients in a memory recognition experiment that manipulated the valence (pleasant, unpleasant), temporal source (past, present, future) and selection agent (self, other) of the to-be-recognised memories. The results revealed that confabulating patients were more likely than amnesic non-confabulating patients to incorrectly recognise past autobiographical events or thoughts as currently relevant memories, and this was more pronounced for pleasant compared to unpleasant events. These findings suggest that motivational factors, along with defective reality and temporality monitoring, contribute to confabulation.     

Naturally acquired antibodies to polymorphic and conserved epitopes of Plasmodium falciparum merozoite surface protein 3

Many studies on the role of merozoite surface protein 3 (MSP3) in immunity against malaria have focused on a conserved section of MSP3. New evidence suggests that polymorphic sequences within MSP3 are under immune selection. We report a detailed analysis of naturally-acquired antibodies to allele-specific and conserved parts of MSP3 in a Kenyan cohort. Indirect and competition ELISA to heterologous recombinant MSP3 proteins were used for antibody assays, and parasites were genotyped for msp3 alleles. Antibody reactivity to allele-specific and conserved epitopes of MSP3 was heterogeneous between individuals. Overall, the prevalence of allele-specific antibody reactivity was significantly higher (3D7-specific 54%, K1-specific 41%) than that to a recombinant protein representing a conserved portion of C-terminal MSP3 (24%, P < 0.01). The most abundant IgG subclass was IgG3, followed by IgG1. Allele-specific reactivity to the K1-type of MSP3 was associated with a lower risk of clinical malaria episodes during a 6-month follow-up in individuals who were parasitized at the start of the malaria transmission season (Relative risk 0.41 with 95% confidence interval 0.20-0.81, P = 0.011). The potential importance of allele-specific immunity to MSP3 should be considered in addition to immunity to conserved epitopes, in the development of an MSP3 malaria vaccine.     

The effects of age on psychopathology, well-being and repressive coping

The present study was conducted to test the hypothesis that the increased psychological well-being and positivity effect in old age can be related to a high prevalence of repressive coping in healthy older adults. Both older (mean age 73) and younger (mean age 20) adults completed a range of indices measuring psychopathology and repressive coping. Results showed that older adults scored lower than younger adults on almost all indices of psychopathology, and were more likely to be classed as repressive copers than younger adults (41% versus 11%, respectively). Furthermore, when the repressive copers and borderline repressors were removed from both samples, age effects on several, but not all, measures of psychopathology disappeared, indicating that even older non-repressors showed better mental health than young non-repressors. Possible mechanisms of increased positivity, in terms of repressive coping and reductions in intrusive thoughts and rumination in old age, are discussed.