Determinants of Physicians’ Job Satisfaction: A national multi-centre study from the Sultanate of Oman

Objectives: Physician satisfaction with their job can lead to a better quality of care, fewer chances of making errors, and better patient outcomes. The purpose of the study was to examine physician satisfaction; and to assess job satisfaction across several factors, such as quality of care, ease of practice, relationship with leadership, and inter-professional collaboration. Method: A descriptive cross-sectional design was used. Data were collected between July 2019 and January 2020. Participants provided demographic information and completed surveys related to physician satisfaction (13-item Likert type items on a scale from 1 to 5), and inter-professional collaboration (15-item, 4-point Likert scale, ranging from 1 for “strongly disagree” to 4 for “strongly agree”). Multiple linear regressions were used to determine the relationship between overall job satisfaction and demographic features and inter-professional collaboration. Results: Out of 396 physicians who were contacted, 354 responded (response rate = 89.4%). The median age was 40 years, and there were 208 male and 124 female physicians. The vast majority (238/354 = 62%) were expatriates. Seventy percent had a post-graduate degree. The vast majority (308 = 87%) worked in government hospitals. Results showed that 15 (5%) of the physicians were not satisfied with their job (<3.00), 179 (40%) expressed a moderate level of satisfaction (3.00 – 3.75), and 129 (55%) were highly satisfied (>3.76). There was no difference in mean job satisfaction score among different groups of study participants, except for gender, and the working grade (p < 0.05). The overall job satisfaction rates were higher for the quality of care (M = 3.93, SD = 0.61), and for ease of practice (M = 3.89, SD = 0.55) and lower for the relationship with leadership (M = 3.67, SD = 0.86). Having a clinical postgraduate degree together with a PhD, a senior level of responsibility and good inter-professional relationship were associated with higher job satisfaction rates (p = 0.003 and 0.007, respectively). Conclusion: Overall, the job satisfaction rate was high. There was no difference among different groups of study participants, except for the working grade. Having a clinical postgraduate degree, a senior level of responsibility, and good inter-professional relationship were associated with higher job satisfaction rates. The overall job satisfaction rates were higher for the quality of care, and for ease of practice, and lower for relationship with the leadership. Relationship with the leadership is a modifiable factor and efforts at enhancing the physician-leadership relationship may lead to even higher satisfaction rates. Keywords: Interprofessional relations; Job Satisfaction; Leadership; Oman; Physician; Quality of health car

Direct and Moderating Effects of Work Environment and Structural Empowerment on Job Stress and Job Satisfaction Among Nurses in the Sultanate of Oman

Objective: This paper seeks to explore the relationships between nurses’ work environment, job stress, and job satisfaction, as well as the moderating effects of work environment and empowerment on the job stress–job satisfaction relationship. Methods: A descriptive correlational design was utilized. The study encompassed a convenience sample of 1,796 hospital nurses from the 11 governorates in Oman. A self-report questionnaire that included a set of instruments was used to collect data. Results: The results showed that nurses who perceived higher levels of job stress reported lower levels of satisfaction and empowerment, and perceived their work environment as less favorable and supportive. The findings only confirmed the direct effects of work environment and empowerment on satisfaction; there was no support for indirect or moderating effects. The hierarchical regression model showed that 46.5% of the variation in the level of job satisfaction was explained by the study variables. Conclusion: The results of this study demonstrate the importance of implementing strategies that empower staff, provide a supportive and positive work environment, and tackle job stress to enhance levels of job satisfaction. Keywords: Work Environment; Empowerment; Job Stress; Job Satisfaction; Nurses; Oman

Catalysts for long-life closed-cycle CO2 lasers

Long-life, closed-cycle operation of pulsed CO2 lasers requires catalytic CO-O2 recombination both to remove O2, which is formed by discharge-induced CO2 decomposition, and to regenerate CO2. Platinum metal on a tin (IV) oxide substrate (Pt/SnO2) has been found to be an effective catalyst for such recombination in the desired temperature range of 25 to 100 C. This paper presents a description of ongoing research at NASA-LaRC on Pt/SnO2 catalyzed CO-O2 recombination. Included are studies with rare-isotope gases since rare-isotope CO2 is desirable as a laser gas for enhanced atmospheric transmission. Results presented include: (1) achievement of 98% to 100% conversion of a stoichiometric mixture of CO and O2 to CO2 for 318 hours (greater than 1 x 10 to the 6th power seconds), continuous, at a catalyst temperature of 60 C, and (2) development of a technique verified in a 30-hour test, to prevent isotopic scrambling when CO-18 and O-18(2) are reacted in the presence of a common-isotope Pt/Sn O-16(2) catalyst

The Anti-social Behaviour, Crime and Policing Act 2014: implications for sex workers and their clients

© 2015 Taylor & Francis. The Anti-social Behaviour, Crime and Policing Act 2014 introduced new powers to deal with behaviour deemed to be ‘anti-social’. In this paper we consider how the new law could be used against sex workers and their clients and the impact this may have. Although the new powers were not intentionally designed to respond to prostitution, we suggest that they will be utilised to tackle it. We argue that the law will be used inconsistently in a way which will go directly against policy which seeks to ‘tackle demand’ and take a less punitive approach to dealing with sex workers. Despite a policy shift to see sex workers more as victims and less as offenders, we draw on existing evidence to demonstrate that the new anti-social behaviour order law will be utilised to exclude street sex workers from public spaces. We claim that a degree of ‘policy re-fraction’ will occur when the new laws are implemented by practitioners

The war on street 'terror': why tackle anti-social behaviour?

This article examines the rationales of Dutch politicians for tackling the perceived pressing problem of 'anti-social behaviour' (ASB) and the question did they copy the British approach? The first part will describe in short the concept of policy transfer and the recent British fight against ASB. The focus will be on the introduction of the Anti-social Behaviour Order. The second part is an empirical study into the Dutch retreat from 'condoning' ASB, consisting of interviews with Dutch politicians focusing on their ideas for tackling ASB. Those are compared with the British's rationales. This kind of comparative elite ethnography is not common in criminology, but this article aims at providing evidence of its benefits. By answering the research question an insight into the origins of policy in the sphere of criminal justice can be obtained

Sporormiella as a tool for detecting the presence of large herbivores in the Neotropics

The reliability of using the abundance of Sporormiella spores as a proxy for the presence and abundance of megaherbivores was tested in southern Brazil. Mud-water interface samples from nine lakes, in which cattle-use was categorized as high, medium, or low, were assayed for Sporormiella representation. The sampling design allowed an analysis of both the influence of the number of animals using the shoreline and the distance of the sampling site from the nearest shoreline. Sporormiella was found to be a reliable proxy for the presence of large livestock. The concentration and abundance of spores declined from the edge of the lake toward the center, with the strongest response being in sites with high livestock use. Consistent with prior studies in temperate regions, we find that Sporormiella spores are a useful proxy to study the extinction of Pleistocene megafauna or the arrival of European livestock in Neotropical landscapes

Distinguishing Asthma Phenotypes Using Machine Learning Approaches.

Asthma is not a single disease, but an umbrella term for a number of distinct diseases, each of which are caused by a distinct underlying pathophysiological mechanism. These discrete disease entities are often labelled as asthma endotypes. The discovery of different asthma subtypes has moved from subjective approaches in which putative phenotypes are assigned by experts to data-driven ones which incorporate machine learning. This review focuses on the methodological developments of one such machine learning technique-latent class analysis-and how it has contributed to distinguishing asthma and wheezing subtypes in childhood. It also gives a clinical perspective, presenting the findings of studies from the past 5 years that used this approach. The identification of true asthma endotypes may be a crucial step towards understanding their distinct pathophysiological mechanisms, which could ultimately lead to more precise prevention strategies, identification of novel therapeutic targets and the development of effective personalized therapies

Complete mitochondrial DNA sequences provide new insights into the Polynesian motif and the peopling of Madagascar

More than a decade of mitochondrial DNA (mtDNA) studies have given the 'Polynesian motif' renowned status as a marker for tracing the late-Holocene expansion of Austronesian speaking populations. Despite considerable research on the Polynesian motif in Oceania, there has been little equivalent work on the western edge of its expansion - leaving major issues unresolved regarding the motif's evolutionary history. This has also led to considerable uncertainty regarding the settlement of Madagascar. In this study, we assess mtDNA variation in 266 individuals from three Malagasy ethnic groups: the Mikea, Vezo, and Merina. Complete mtDNA genome sequencing reveals a new variant of the Polynesian motif in Madagascar; two coding region mutations define a Malagasy-specific sub-branch. This newly defined 'Malagasy motif' occurs at high frequency in all three ethnic groups (13-50%), and its phylogenetic position, geographic distribution, and estimated age all support a recent origin, but without conclusively identifying a specific source region. Nevertheless, the haplotype's limited diversity, similar to those of other mtDNA haplogroups found in our Malagasy groups, best supports a small number of initial settlers arriving to Madagascar through the same migratory process. Finally, the discovery of this lineage provides a set of new polymorphic positions to help localize the Austronesian ancestors of the Malagasy, as well as uncover the origin and evolution of the Polynesian motif itself

The association of spirometric small airways obstruction with respiratory symptoms, cardiometabolic diseases, and quality of life: Results from the Burden of Obstructive Lung Disease (BOLD) study

Background: Spirometric small airways obstruction (SAO) is common in the general population. Whether spirometric SAO is associated with respiratory symptoms, cardiometabolic diseases, and quality of life (QoL) is unknown. Methods: Using data from the Burden of Obstructive Lung Disease study (N = 21,594), we defined spirometric SAO as the mean forced expiratory flow rate between 25 and 75% of the FVC (FEF25-75) less than the lower limit of normal (LLN) or the forced expiratory volume in 3 s to FVC ratio (FEV3/FVC) less than the LLN. We analysed data on respiratory symptoms, cardiometabolic diseases, and QoL collected using standardised questionnaires. We assessed the associations with spirometric SAO using multivariable regression models, and pooled site estimates using random effects meta-analysis. We conducted identical analyses for isolated spirometric SAO (i.e. with FEV1/FVC ≥ LLN). Results: Almost a fifth of the participants had spirometric SAO (19% for FEF25-75; 17% for FEV3/FVC). Using FEF25-75, spirometric SAO was associated with dyspnoea (OR = 2.16, 95% CI 1.77–2.70), chronic cough (OR = 2.56, 95% CI 2.08–3.15), chronic phlegm (OR = 2.29, 95% CI 1.77–4.05), wheeze (OR = 2.87, 95% CI 2.50–3.40) and cardiovascular disease (OR = 1.30, 95% CI 1.11–1.52), but not hypertension or diabetes. Spirometric SAO was associated with worse physical and mental QoL. These associations were similar for FEV3/FVC. Isolated spirometric SAO (10% for FEF25-75; 6% for FEV3/FVC), was also associated with respiratory symptoms and cardiovascular disease. Conclusion: Spirometric SAO is associated with respiratory symptoms, cardiovascular disease, and QoL. Consideration should be given to the measurement of FEF25-75 and FEV3/FVC, in addition to traditional spirometry parameters

When enough should be enough: Improving the use of current agricultural lands could meet production demands and spare natural habitats in Brazil

Providing food and other products to a growing human population while safeguarding natural ecosystems and the provision of their services is a significant scientific, social and political challenge. With food demand likely to double over the next four decades, anthropization is already driving climate change and is the principal force behind species extinction, among other environmental impacts. The sustainable intensification of production on current agricultural lands has been suggested as a key solution to the competition for land between agriculture and natural ecosystems. However, few investigations have shown the extent to which these lands can meet projected demands while considering biophysical constraints. Here we investigate the improved use of existing agricultural lands and present insights into avoiding future competition for land. We focus on Brazil, a country projected to experience the largest increase in agricultural production over the next four decades and the richest nation in terrestrial carbon and biodiversity. Using various models and climatic datasets, we produced the first estimate of the carrying capacity of Brazil's 115 million hectares of cultivated pasturelands. We then investigated if the improved use of cultivated pasturelands would free enough land for the expansion of meat, crops, wood and biofuel, respecting biophysical constraints (i.e., terrain, climate) and including climate change impacts. We found that the current productivity of Brazilian cultivated pasturelands is 32–34% of its potential and that increasing productivity to 49–52% of the potential would suffice to meet demands for meat, crops, wood products and biofuels until at least 2040, without further conversion of natural ecosystems. As a result up to 14.3 Gt CO2 Eq could be mitigated. The fact that the country poised to undergo the largest expansion of agricultural production over the coming decades can do so without further conversion of natural habitats provokes the question whether the same can be true in other regional contexts and, ultimately, at the global scale