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.     

When family and research clash: The role of autobiographical emotion in the production of stories of the Italian civil war, 1943–1945

This paper engages the emotional side of Second World War storytelling practices and research. Specifically, it explores how a politics of trust and togetherness animates communities of remembrance concerning the anti-Fascist Resistance experience in northern Italy. I reflect on my encounter with memories of wartime violence through the lens of autobiographical emotion. In a region torn asunder by conflicting stories of loss and violence during the anti-Nazi resistance and civil war, I possess a dual identity of researcher and Partisan's grandchild. This carries a powerful emotional bond of ethical obligations that cannot be ignored in the research process. Drawing on affect theory, I contextualize my oral history fieldwork experience in relation to that emotional bond.     

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.     

The Holland Code of Members of the National Organization for Human Services: A Preliminary Study of Human Services Professionals

This study determined the Holland code of members of the National Organization for Human Services. The authors used the O*NET Interest Profiler–Short Form to find that a sample of 355 human services professionals had a Holland code of Social Artistic, with Investigative, Enterprising, and Conventional codes significantly lower than Artisitc. Demographic differences were not found based on gender, whether participants identified human services as their primary field, or whether they had formal education in human services. Slight differences based on age were noted. Results will be used to advocate for inclusion of “human services professional” in the Standard Occupational Classification system.     

From “4Rs and 2Ss” to “Amaka Amasanyufu” (Happy Families): Adapting a U.S.-based Evidence-Based Intervention to the Uganda Context

In Uganda, one in five children presents mental health challenges, including disruptive behavior disorders (DBDs). DBDs can persist through adulthood and result in negative outcomes. Effective interventions for DBDs have been developed and tested in high-poverty communities in developed countries. Yet, most African countries, such as Uganda, lack such interventions. This paper describes the adaptation process of an evidence-based intervention of U.S. origin to optimize fit to context with intervention fidelity, as part of a randomized trial conducted with youth that exhibit behavioral challenges and their caregivers in 30 schools in Uganda. The process involved: initial meetings with headteachers and teachers to introduce the study and the main concepts of the intervention; initial manual review focusing on 4Rs and 2Ss content by the Uganda team; engagement of community stakeholders for additional feedback on content and cultural relevance; final revision of the manual; and collection of children’s drawings for the illustration of the manual. This paper describes both similarities and differences between the original and adapted intervention content and methods of delivery. The findings also highlight the importance of involving community stakeholders in the adaptation process.     

Comparative analysis of the risk-handling procedures for gene technology applications in medical and plant science

In this paper we analyse how the risks associated with research on transgenic plants are regulated in Sweden. The paper outlines the way in which pilot projects in the plant sciences are overseen in Sweden, and discusses the international and national background to the current regulatory system. The historical, and hitherto unexplored, reasons for the evolution of current administrative and legislative procedures in plant science are of particular interest. Specifically, we discuss similarities and differences in the regulation of medicine and plant science, and we examine the tendency towards dichotomizing risk — focusing on social/ethical risks in medicine and biological risks in plant science. The context of this article is the Synpraxia research project, an inter-disciplinary program combining expertise in sciences and the humanities.