Stress reactions following acute situations involving moral challenges among health care professionals

Many health care professionals have to make morally difficult decisions during acute, stressful situations. The aim was to explore the applicability of an existing qualitatively developed model of individual reactions among professional first responders following such situations using a quantitative approach. According to the model, the interaction of antecedent individual and contextual characteristics affect the immediate emotional reactions to acute, stressful events involving a moral dilemma. Continuous coping efforts and the quality of social support will also affect the long‐term positive and negative reactions to the event. The participants (n = 204, about 50% response rate) represented three Swedish health care professions stationed at a university hospital and a regional hospital: Physicians (n = 50), nurses (n = 94) and “others” (n =60, mainly social welfare officers and assistant nurses). Except for the personality dimension emotional stability which was measured using an established instrument, all measurement scales were operationalizations of codes and categories from the qualitative study (ten scales altogether). Four multiple regression analyses were performed with long‐term positive and negative reactions in everyday acute and morally extremely taxing situations respectively as dependent variables. The outcome showed that long‐term positive reactions covaried with much use of the coping strategies Emotional distancing and Constructive emotional confrontation and a perception of a well‐functioning Formal social support. Regarding long‐term negative reactions, higher age and little use of Emotional distancing accounted for much of the variance. Immediate emotional reactions also contributed significantly. Conclusion: the results largely supported the model concepts and their assumed relationships.     

A meta‐analysis of the differential relations of traditional and cyber‐victimization with internalizing problems

This meta‐analysis examined the associations between cyber‐victimization and internalizing problems controlling for the occurrence of traditional victimization. Twenty independent samples with a total of 90,877 participants were included. Results confirmed the significant intercorrelation between traditional and cyber‐victimization (r = .43). They both have medium‐to‐large bivariate correlations with internalizing problems. Traditional victimization (sr = .22) and cyber‐victimization (sr = .12) were also uniquely related to internalizing problems. The difference in the relations between each type of victimization and internalizing problems was small (differential d = .06) and not statistically significant (p = .053). Moderation of these effect sizes by sample characteristics (e.g., age and proportion of girls) and study features (e.g., whether a definition of bullying was provided to participants and the time frame used as reference) was investigated. Results are discussed within the extant literature on cyber‐aggression and cyber‐victimization and future directions are proposed.

     

A Comparison of Homeless Male Veterans in Metropolitan and Micropolitan Areas in Nebraska: A Methodological Caveat

This study explored differences between homeless male veterans in metropolitan and micropolitan cities in Nebraska on sociodemographic, housing, clinical, and psychosocial characteristics as well as health service use. A convenience sample of 151 homeless male veterans (112 metropolitan, 39 micropolitan) were recruited from Veterans Affairs facilities and area shelters in Omaha, Lincoln, Grand Island, and Hastings in Nebraska. Research staff conducted structured interviews with homeless veterans. Results showed that compared to homeless veterans in metropolitans, those in micropolitans were more likely to be White, unmarried, living in transitional settings, and were far more transient but reported greater social support and housing satisfaction. Veterans in micropolitans also reported more medical problems, diagnoses of anxiety and personality disorders, and unexpectedly, were more likely to report using various health services and less travel time for services. Together, these findings suggest access to homeless and health services for veterans in micropolitan areas may be facilitated through Veterans Affairs facilities and community providers that work in close proximity to one another. Many homeless veterans in these areas are transient, making them a difficult population to study and serve. Innovative ways to provide outreach to homeless veterans in micropolitan and more rural areas are needed.     

Not so Sweet Revenge: Unanticipated Consequences of High-Intensity Sweeteners

While no single factor accounts for the significant increases in overweight and obesity that have emerged during the past several decades, evidence now suggests that sugars, in general, and sugar-sweetened beverages, in particular, may be especially problematic. One response to this concern has been an explosion in the availability and use of noncaloric sweeteners as replacements for sugar. While consumers have been led to believe that such substitutes are healthy, long-term epidemiological data in a number of cohorts have documented increased risk for negative outcomes like type 2 diabetes, heart disease, and stroke among users of artificial sweeteners. Experimental data from animals has provided several plausible mechanisms that could explain this counterintuitive relationship. In particular, my research has demonstrated that artificial sweeteners appear to interfere with basic learned, predictive relations between sweet tastes and post-ingestive consequences such as the delivery of energy. By interfering with these relations, artificial sweeteners inhibit anticipatory responses that normally serve to maintain physiological homeostasis, and over the long term, this interference could result in negative health effects like those seen in the human cohort studies. These data suggest that reducing the consumption of all sweeteners is advisable to promote better health.     

Quels sont les prédicteurs des comportements associés au respect des règles d’hygiène en soins infirmiers en cours de formation ?

We present a study whose aim is to analyse the predictability of behaviors associated with breaches of hygiene rules based on the constructs of the theory of planned behavior and implementation of intention. One hundred and fifty nursing students replied to a questionnaire following their theoretical training and then after returning from practical placement during which some were observed in a professional situation. The results highlighted the fact that self-reported behavior was associated with behavior observed in context with regard to the observance of rules governing hand hygiene and the decontamination of surfaces. Self-reported behavior is explained successively by behavioral control, intention and implementation of intention when the latter relates to behavioral reflexivity. These results are discussed from the point of view of nurse training practices.     

A comparison of individuals with unanswered callings to those with no calling at all

The purpose of this research was to compare the life-, job-, and health-related experiences of those who perceive an unanswered occupational calling to those who (1) are living a calling and (2) perceive no calling at all. Surveys containing measures of callings, work engagement, job involvement, career commitment, life and job satisfaction, turnover intentions, physical health and emotional well-being were administered to 378 American academics. As expected, academics with an answered occupational calling tended to report better job attitudes and domain-specific satisfaction and less withdrawal intentions than those who reported an unanswered occupational calling or no calling at all. Furthermore, those who did not have a calling to a particular vocation reported better life-, job-, and health-related outcomes than those experiencing an unanswered calling. Surprisingly, only those academics experiencing an unmet calling reported significantly poorer physical and psychological health as compared to the other two calling groups. These results are consistent with the self-determination theory, which predicts that those who are able to satisfy their basic psychological needs reap benefits in terms of psychological growth, optimal functioning, and wellbeing. The study contributes to the literature on callings by showing that having a calling is a benefit only if it is met, but can be a detriment when it is not as compared to having no calling at all.     

Emotional intelligence and health‐related quality of life in institutionalised Spanish older adults

This study explores the relationship between emotional intelligence (EI) and health‐related quality of life (HRQoL) in a sample of Spanish older adults who are institutionalised in long‐term care (LTC) facilities. One hundred fifteen institutionalised individuals (47.82% women; 88.3 ± 7.9 years) from southern Spain completed a set of questionnaires that included measures of EI, health and personality. Data were analysed via hierarchical regression. After controlling for personality and sociodemographic variables, the EI dimensions, emotional comprehension and emotional facilitation, accounted for part of the variance in several HRQoL facets. These dimensions could have an important role in the HRQoL of residents in LTC. Moreover, the use of a performance measure addresses the limitations of previous studies that have relied on self‐report measures. These aspects underscore the importance of the results of this study.     

A Comparison of Taped-Problem Interventions to Increase Math Fact Fluency: Does the Length of Time Delay Affect Student Learning Rates?

An alternating treatments design with a control condition was used to evaluate and compare the effects of two taped-problem interventions on addition fact fluency. Both taped-problem interventions were identical with the exception of the time delay between the auditory cue of the problem and the answer. One condition used a 2-s delay and the other condition used no delay. Results showed that both taped-problem conditions showed growth in student digits correct per minute scores and that the no-delay condition was slightly more efficient as the taped-problem no-delay procedure took approximately 33% less time. Discussion focuses on using comparative intervention designs to detect nuances in procedures to improve our understanding of math fact interventions that result in the highest learning rates.     

The Comorbidity of Conduct Problems and Depression in Childhood and Adolescence

An extensive body of research documents the high prevalence of comorbidity among child and adolescent disorders in general and between conduct problems and depression in particular. These problems co-occur at significantly higher rates than would be expected by chance and their comorbidity may have significant implications for nosology, treatment, and prognosis. Four main hypotheses have been put forth to account for these high rates of comorbidity. First, comorbidity may be a result of shortcomings associated with referral or informant biases. Second, comorbidity may be an artifact of overlapping definitional criteria. Third, one disorder may cause the other disorder by influencing the developmental trajectory and placing an individual at increased risk for further difficulties. Finally, comorbidity between two disorders may be explained by shared underlying causal or risk factors. The purpose of this review is to explore these possibilities, concentrating primarily on the common risk factors of parent psychopathology, emotion regulation, and cognitive biases that may underlie the co-occurrence of these two disorders. Based on our review, we propose a model for the development of comorbidity between these two disorders.