Does smoking cannabis affect work commitment?

Aims This study aimed to examine the associations between cannabis use and work commitment Design We used a 25‐year panel survey initiated in 1985 with follow‐ups in 1987, 1989, 1993, 2003 and 2010. Registered data from a range of public registers were matched with individual responses for the entire period. Setting The panel survey was a nation‐wide study set in Norway. Participants A total of 1997 respondents born between 1965 and 1968 were included in the panel. Measurements Work involvement scale (WIS) was used to assess work commitment. Involvement with cannabis was based on self‐reported smoking of cannabis within the last 12 months and exposure to cannabis through friends. This information was categorized into ‘abstaining’, ‘exposed’, ‘experimented’ and ‘involved’. Control measures included socio‐economic background, mental health (HSCL‐10), education, work satisfaction, unemployment, receipt of social assistance, consumption of alcohol, alcohol‐related problems and use of other illicit drugs. Findings The level of work commitment was associated with involvement with cannabis. In 1993, when the respondents were in their mid‐20s, those who were involved or had experimented with cannabis displayed lower levels of work commitment than those who were abstaining or merely exposed to cannabis through friends (P < 0.05). Work commitment among those who experimented with cannabis converged towards the levels reported by abstainers and the exposed as they grew older, whereas those involved reported decreasing work commitment into adulthood (P < 0.001). Using linear regression models for panel data, an association with continued use of cannabis across the life‐course and a lowering of work commitment was established. Results remained significant even when controlling for a range of other factors known to be related to work commitment, such as socio‐economic background, education, labour market experiences, mental health and family characteristics (P < 0.05). Conclusions In Norway the use of cannabis is associated with a reduction in work commitment among adults.     

Ciliogenesis and autophagy are coordinately regulated by EphA2 in the cornea to maintain proper epithelial architecture

PurposeTo understand the relationship between ciliogenesis and autophagy in the corneal epithelium.MethodssiRNAs for EphA2 or PLD1 were used to inhibit protein expression in vitro. Morpholino-anti-EphA2 was used to knockdown EphA2 in Xenopus skin. An EphA2 knockout mouse was used to conduct loss of function studies. Autophagic vacuoles were visualized by contrast light microscopy. Autophagy flux, was measured by LC3 turnover and p62 protein levels. Immunostaining and confocal microscopy were conducted to visualize cilia in cultured cells and in vivo.ResultsLoss of EphA2 (i) increased corneal epithelial thickness by elevating proliferative potential in wing cells, (ii) reduced the number of ciliated cells, (iii) increased large hollow vacuoles, that could be rescued by BafA1; (iv) inhibited autophagy flux and (v) increased GFP-LC3 puncta in the mouse corneal epithelium. This indicated a role for EphA2 in stratified epithelial assembly via regulation of proliferation as well as a positive role in both ciliogenesis and end-stage autophagy. Inhibition of PLD1, an EphA2 interacting protein that is a critical regulator of end-stage autophagy, reversed the accumulation of vacuoles, and the reduction in the number of ciliated cells due to EphA2 depletion, suggesting EphA2 regulation of both end-stage autophagy and ciliogenesis via PLD1. PLD1 mediated rescue of ciliogenesis by EphA2 depletion was blocked by BafA1, placing autophagy between EphA2 signaling and regulation of ciliogenesis.ConclusionOur findings demonstrate a novel role for EphA2 in regulating both autophagy and ciliogenesis, processes that are essential for proper corneal epithelial homeostasis.     

Understanding the Usage of Content in a Mental Health Intervention for Depression: An Analysis of Log Data

Background

Web-based interventions for the early treatment of depressive symptoms can be considered effective in reducing mental complaints. However, there is a limited understanding of which elements in an intervention contribute to effectiveness. For efficiency and effectiveness of interventions, insight is needed into the use of content and persuasive features.

Objective

The aims of this study were (1) to illustrate how log data can be used to understand the uptake of the content of a Web-based intervention that is based on the acceptance and commitment therapy (ACT) and (2) to discover how log data can be of value for improving the incorporation of content in Web-based interventions.

Methods

Data from 206 participants (out of the 239) who started the first nine lessons of the Web-based intervention, Living to the Full, were used for a secondary analysis of a subset of the log data of the parent study about adherence to the intervention. The log files used in this study were per lesson: login, start mindfulness, download mindfulness, view success story, view feedback message, start multimedia, turn on text-message coach, turn off text-message coach, and view text message. Differences in usage between lessons were explored with repeated measures ANOVAs (analysis of variance). Differences between groups were explored with one-way ANOVAs. To explore the possible predictive value of the login per lesson quartiles on the outcome measures, four linear regressions were used with login quartiles as predictor and with the outcome measures (Center for Epidemiologic Studies—Depression [CES-D] and the Hospital Anxiety and Depression Scale—Anxiety [HADS-A] on post-intervention and follow-up) as dependent variables.

Results

A significant decrease in logins and in the use of content and persuasive features over time was observed. The usage of features varied significantly during the treatment process. The usage of persuasive features increased during the third part of the ACT (commitment to value-based living), which might indicate that at that stage motivational support was relevant. Higher logins over time (9 weeks) corresponded with a higher usage of features (in most cases significant); when predicting depressive symptoms at post-intervention, the linear regression yielded a significant model with login quartile as a significant predictor (explained variance is 2.7%).

Conclusions

A better integration of content and persuasive features in the design of the intervention and a better intra-usability of features within the system are needed to identify which combination of features works best for whom. Pattern recognition can be used to tailor the intervention based on usage patterns from the earlier lessons and to support the uptake of content essential for therapy. An adaptable interface for a modular composition of therapy features supposes a dynamic approach for Web-based treatment; not a predefined path for all, but a flexible way to go through all features that have to be used.     

588名本科护生职业认同及影响因素研究

目的 了解新冠疫情下本科护生职业认同现状及其影响因素。方法 采用一般情况调查表、职业认同量表、护生专业承诺量表对安徽某院校的588名本科护生进行调查。结果 职业认同总分为（58.17±11.27）;护生专业承诺总分为（86.55±20.01）;职业认同与专业承诺呈显著正相关（r=0.790,P<0.05);专业承诺总分、“有无您崇拜的护理前辈或老师”、“如果有机会,您是否会调换专业”两条目得分对职业认同有影响。结论 新冠疫情下本科护生职业认同处于中等水平且受多种因素影响。     

Differential induction of helper and killer T cells from isolated CD4+CD8+ thymocytes in suspension culture

Thymocytes of T cell receptor transgenic mice with nonselecting and RAG-2^−/− backgrounds were developmentally arrested at the CD4⁺CD8⁺ stage before positive selection. These thymocytes underwent lineage commitment upon transient stimulation with a combination of ionomycin, a calcium ionophore, and phorbol 12-myristate 13-acetate (PMA), a protein kinase C activator, in suspension culture. The effective drug doses were limited within narrow ranges and much lower than those which induce proliferation of mature T cells. The doses corresponded to those which inhibit glucocorticoid-induced apoptosis in these thymocytes. CD4 lineage commitment required longer duration, higher intensity of the stimulation, or both, than CD8 lineage commitment. Functional helper T cells (Th1 and Th2) were induced from the CD4 lineage-committed cells upon secondary stimulation with a combination of ionomycin and PMA followed by lymphokine treatment. Cytotoxic T cells were induced from the CD8 lineage-committed cells upon incubation with concanavalin A and irradiated splenic dendritic cells, but not with the combination of ionomycin and PMA. These results indicate that positive selection is mimicked by the pharmacological stimulation in the absence of other cell types, but that final maturation of CD8 T cells may require a different signal.     

Importancia del compromiso del personal sanitario para la satisfacción de los pacientes en Atención Primaria

Conocer en qué medida el compromiso organizativo de los profesionales sanitarios de Atención Primaria es importante para la satisfacción de los pacientes. Estudio observacional, de corte transversal, cuantitativo, retrospectivo, y no controlado. Cuarenta centros de Atención Primaria pertenecientes al área de salud de Gran Canaria. Atención primaria. Seiscientos diecisiete profesionales sanitarios (46% médicos y 54% enfermeros) y 1.537 usuarios de los centros de Atención Primaria (35,39% hombres y 64,60% mujeres). Muestreo no probabilístico por conveniencia. Para evaluar el compromiso organizativo se usó un cuestionario autoadministrado a profesionales sanitarios de centros de Atención Primaria. La satisfacción de los pacientes se obtuvo mediante encuesta telefónica y las variables de control a partir de fuentes secundarias. Los datos se analizaron mediante regresión lineal múltiple. Para profundizar en los resultados se usaron también entrevistas semiestructuradas. El entorno socioeconómico de los centros de salud no influye en la satisfacción de los pacientes. El compromiso organizativo de los trabajadores influye positivamente en la satisfacción de los usuarios de los centros de salud. También se encontró que los profesionales más comprometidos tienen menos disponibilidad en sus agendas para citas a corto plazo. Las entrevistas sugieren que se debe a que dedican más tiempo a sus pacientes, lo cual hace que estén más satisfechos. El compromiso organizativo afectivo de los profesionales sanitarios es una actitud que permite mejorar la satisfacción de los pacientes, por ello, los gestores sanitarios deberían emplear prácticas dirigidas a fortalecer dicha actitud.Palabras clave: Satisfacción del paciente, Compromiso organizativo, Calidad asistencial, Atención primaria, Gestión de personal