Helping others not always helps ourselves: the relationship between victim incivility and emergency workers’ burnout through work-to-family conflict.

Purpose – This study aims to analyse whether and when victim incivility may be related to work-to-family conflict and then burnout among emergency workers. Design/methodology/approach – A total of 304 Italian emergency workers from five firehouses and six emergency rooms completed questionnaires, examining: victim incivility, work-to-family conflict, social support seeking and burnout symptoms. Descriptive analyses, confirmatory factor analyses and structural equation models were conducted. Findings – Victim incivility was positively associated with burnout symptoms, both directly and indirectly, as mediated by work-to-family conflict. Additionally, social support seeking exacerbated (rather than mitigated) the impact of work-to-family conflict on burnout symptoms. Practical implications – Organisations can greatly benefit from implementing family-friendly practices and providing their workers with training programmes on how to deal with difficult victims. Originality/value – This study contributes to the existing literature on workplace incivility and work–life interface by supporting for the first time the notion that victim incivility can spill over into emergency workers’ family domain and by clarifying how and when victim incivility is related to burnout symptoms

Prison Personnel: Burnout, Stress Reactions, and Intent to Quit

The ultimate aim of the present research was to examine well-being of prison Correctional Officers (COs), in particular we have analyzed predictors of burnout and psychosomatic symptoms, and variables affecting job dissatisfaction and intent to quit. 108 self-report questionnaires examining occupational stressors, burnout, psychosomatic symptoms, job dissatisfaction, and intent to quit were collected in an Italian public prison. First of all, the findings revealed that participants showed neither significant burnout nor psychosomatic complaints; this result may be partially explained by the specific-police “macho” culture, the fear of appearing weak which causes the need to show emotions different from the real ones. Furthermore, burnout is mainly affected by the quality of interactions, in terms of stressful contacts, with inmates whereas psychosomatic symptoms by stressful relationships with colleagues and superiors. Finally, the intent to quit the current job, which was found to be rather low, was affected by burnout, in particular by emotional exhaustion. Overall considered, our results suggest some applicative implications, and especially the importance to provide useful strategies, at both organizational and individual level, which may support COs in coping with occupational stressors. In particular, counseling may be effective in preventing emotional distress and in reducing sickness absence caused by the contact with problematic inmates. DOI: 10.5901/mjss.2015.v6n3s1p61

A journey through roses and thorns: becoming a physician by learning from patients with life-threatening illnesses. A qualitative study with international medical students

The medical students' well-being may be threatened by various stressors associated with providing care to different kinds of patients. This study aims to explore students' clinical experiences with patients who suffer from life-threatening illnesses, focusing on potential risk and protective factors. Audio-recorded and face-to-face interviews were conducted and transcribed verbatim. The "Interpretive Description" approach was used to analyse data. Overall, ten medical students with a mean age of 28 years old were interviewed. Well-being promoting factors were the following: therapeutic relationships, work-life balance, social support and communication, perception of improvement in knowledge and availability of advanced directives. Whilst factors that may reduce well-being included death exposure, managing emotions, communication difficulties, internal conflicts and disagreements, lack of knowledge and subjective concerns. These findings shed light on facets that are inherent parts of clinical experience with patients suffering from a life-threatening illness and that may turn in risk or protective factors for the medical students. Understanding the students' subjective experiences may aid in the improvement of the current educational programs, as well as in the development of tailored supportive and preventative interventions to promote well-being and professional competencies among this kind of students

The impact of mindfulness on psychosomatic complaints among firefighters: The mediator role of vicarious traumatisation

Firefighters are at risk to develop post-traumatic and psychosomatic symptoms. But in order to face negative health effects they have psychological resources at their disposal, such as mindfulness. This study aims to test the a model by which intrusion predicts general dysphoria in response to mindfulness. Self-report measures were administered to Italian firefighters. Structural equation modelling shown that mindfulness did not directly influence general dysphoria: mediation analyses revealed its meaningful indirect effect via intrusion. The results suggest that mindfulness can lead to reduced symptoms of general dysphoria through low levels of intrusive thoughts

Self-healing CD30- T-clonal proliferation of the tongue: report of an extremely rare case

The etiology of traumatic ulcerative granulomas with stromal eosinophilia (TUGSE) is not clear, traumatic irritation having advocated as the most likely cause. TUGSEs are typically self-limiting slow-healing lesions of the oral mucosa with unclear pathogenesis, commonly manifesting as a rapidly developing, long-lasting ulcer

Proactive personality and training motivation among older workers

Purpose – This paper aims at examining the relationship between proactive personality and training motivation among older workers (aged over 55 years) in a context characterized by the growing ageing of the global population. First, the authors hypothesized that proactive personality predicts the motivation to learn among older workers and that this relationship is mediated by goal orientation. In particular, the authors hypothesized that learning goal orientation may mediate the relationship between proactive personality and learning motivation. Design/methodology/approach – The employees of an Italian bank completed an online questionnaire. AMOS 17 was used to carry out confirmatory factor analysis, and the SPSS macro was used to test the meditational model. Findings – The results confirmed both the hypotheses, demonstrating the influence of proactive personality on training motivation of older workers, as mediated by goal orientation and, in particular, by learning goal orientation. Practical implications – From an applicative point of view, this study may have implications for organizations that aim to increase the employability of older people by encouraging them to undertake more training. In particular, interventions aimed at increasing learning goal orientation could contribute in strengthening proactive personality that, in turn, may affect levels of training motivation. Originality/value – Even if proactive personality has already been found as a predictor of learning motivation, to the best of the authors’ knowledge, the present study demonstrates that the relationship between proactive personality and training motivation is mediated by goal orientation among older workers

Emotional dissonance and exhaustion among healthcare professionals: the role of the perceived quality of care

Objectives The aim of this exploratory study was to analyze the association between emotional dissonance and emotional exhaustion among healthcare professionals, and the mediating role of the perceived quality of care in this relationship. Material and Methods Self-report questionnaires were administered to 724 healthcare workers. The measurement model was tested and the mediation hypothesis was verified through hierarchical multiple regression analyses. Bootstrapping was used to construct confidence intervals to evaluate the mediation effects. Results Emotional dissonance was significantly related to emotional exhaustion, and the perceived quality of care was negatively related to emotional exhaustion. The perceived quality of care had a partial mediating effect on the relationship between emotional dissonance and emotional exhaustion. Emotional dissonance had a significant effect on emotional exhaustion, and the perceived quality of care was a mediating factor in this relationship among healthcare professionals. Conclusions The management of the perceived quality of care may be helpful in the prevention of burnout and distress in the workplace. Int J Occup Med Environ Health. 2019;32(6):841–5

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription