982 research outputs found

    Associations between job demands, job resources and patient-related burnout among physicians: results from a multicentre observational study

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    OBJECTIVES: To investigate associations of job demands and resources with patient-related burnout among physicians. DESIGN: Multicentre observational study. SETTING: Fifty medical departments at 14 (academic and non-academic) hospitals in the Netherlands. PARTICIPANTS: Four hundred sixty-five physicians (71.6% response rate), comprising 385 (82.8%) medical specialists and 80 (17.2%) residents. MAIN OUTCOME MEASURES: Job demands (workload and bureaucratic demands), job resources (participation in decision making, development opportunities, leader's inspiration, relationships with colleagues and patients)-measured with the validated Questionnaire of Experience and Evaluation of Work and Physician Worklife Survey-and patient-related burnout, measured using the validated Copenhagen Burnout Inventory. RESULTS: Patient-related burnout was positively associated with workload (b=0.36; 95% CI, 0.25 to 0.48; p<0.001) and negatively associated with development opportunities (b=-0.18; 95% CI, -0.27 to -0.08; p<0.001) and relationships with patients (b=-0.12; 95% CI, -0.22 to -0.03; p=0.01). Relationships with patients moderated the association between bureaucratic demands and patient-related burnout (b=-0.15; 95% CI, -0.27 to -0.04; p=0.01). CONCLUSIONS: Physicians with high workloads and few development opportunities reported higher levels of patient-related burnout. Those with positive patient relationships were less likely to experience patient-related burnout, even in the presence of excessive bureaucracy. Therefore, positive physician-patient relationships may be supported to reduce the likelihood of physicians' patient-related burnout. However, the specific support needed to effectively reduce patient-related burnout may vary per healthcare context and thus requires intensified research across healthcare systems and settings

    Listening to limericks: a pupillometry investigation of perceivers’ expectancy

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    What features of a poem make it captivating, and which cognitive mechanisms are sensitive to these features? We addressed these questions experimentally by measuring pupillary responses of 40 participants who listened to a series of Limericks. The Limericks ended with either a semantic, syntactic, rhyme or metric violation. Compared to a control condition without violations, only the rhyme violation condition induced a reliable pupillary response. An anomaly-rating study on the same stimuli showed that all violations were reliably detectable relative to the control condition, but the anomaly induced by rhyme violations was perceived as most severe. Together, our data suggest that rhyme violations in Limericks may induce an emotional response beyond mere anomaly detection

    Combinatorics of Open Covers VI: Selectors for Sequences of Dense Sets

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    We consider the following two selection principles for topological spaces: [Principle 1:] { For each sequence of dense subsets, there is a sequence of points from the space, the n-th point coming from the n-th dense set, such that this set of points is dense in the space; [Principle 2:]{ For each sequence of dense subsets, there is a sequence of finite sets, the n-th a subset of the n-th dense set, such that the union of these finite sets is dense in the space. We show that for separable metric space X one of these principles holds for the space C_p(X) of realvalued continuous functions equipped with the pointwise convergence topology if, and only if, a corresponding principle holds for a special family of open covers of X. An example is given to show that these equivalences do not hold in general for Tychonoff spaces. It is further shown that these two principles give characterizations for two popular cardinal numbers, and that these two principles are intimately related to an infinite game that was studied by Berner and Juhasz

    Solubility and Nucleation of Methyl Stearate as a Function of Crystallization Environment

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    Crystallization studies of methyl stearate from supersaturated dodecane, kerosene, and toluene solutions reveal strong evidence that solvent choice influences solubility and nucleation behavior. Solute solubility is less than ideal with toluene, kerosene, and dodecane, respectively, exhibiting the closest behavior to ideality, the latter consistent with the highest solvation. Polythermal crystallization studies using the Kashchiev–Borissova–Hammond–Roberts (KBHR) model [Kashchiev et al. J. Phys. Chem. B 2010, 114, 5441; Kashchiev et al. J. Cryst. Growth 2010, 312, 698; Camacho et al. CrystEngComm 2014, 16, 974] reveal a progressive nucleation (PN) mechanism with crystallite interfacial tension (γeff) values between 0.94 and 1.55 mJ/m2, between 1.21 and 1.91 mJ/m2, and between 1.18 and 1.88 mJ/m2 for dodecane, kerosene, and toluene, respectively. Nucleation rates at the critical undercooling lie between 4.56 × 1016 and 1.79 × 1017 nuclei/mL·s, with the highest rates associated with crystallization from kerosene solutions. Iso-supersaturation nucleation rates are the highest for dodecane ranging from 2.39 × 1017 to 3.63 × 1018 nuclei/mL·s. Nucleation in toluene appears to be hindered by its relatively higher interfacial tension, which is associated with nucleation rates about an order of magnitude less than those obtained for dodecane

    The Surgical Hazardous Attitudes Reflection Profile (SHARP) Instrument - A Prototype Study

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    OBJECTIVE: There is growing recognition that surgeons’ non-technical skills are crucial in guaranteeing optimal quality and safety of patient care. However, insight in relevant attitudes underlying these behavioral skills is lacking. Hazardous attitudes potentially cause risky behavior, which can result in medical errors and adverse events. A questionnaire offering surgeons insight in their attitudinal profile is still missing and would be instrumental in risk reduction. Therefore, the aim of this study is to develop a prototype of a reliable and valid instrument to measure hazardous attitudes among surgeons. DESIGN: To measure hazardous attitudes, a prototype of the Surgical Hazardous Attitudes Reflection Profile (SHARP) tool was designed using a mixed methods approach, consisting of (1) 2 focus group discussions, (2) a modified Delphi analysis, and (3) a survey followed by (4) statistical analysis of the psychometric properties. Statistical analysis included exploratory factor analysis with varimax rotation, calculation of internal consistency reliability coefficients, and interscale correlations. SETTING: Fourteen hospitals across the Netherlands were recruited to guarantee demographic variety and the inclusion of academic, tertiary, and general hospitals. PARTICIPANTS: Nineteen experts participated in the 2 focus groups, and 19 in the modified Delphi study. In total, 302 surgeons (54.1%) completed the SHARP. RESULTS: In total, 302 surgeons (54.1%) completed the SHARP. Exploratory factor analysis resulted in 6 subscales measuring attitude towards (1) authority (α = 0.78), (2) self-performance (α = 0.69), (3) performance feedback (α = 0.61), (4) own fitness to perform (α = 0.54), (5) uncertainty (α = 0.51), and (6) planned procedures (α = 0.48). CONCLUSIONS: This study resulted in a prototype instrument identifying 6 potential hazardous attitudes in surgeons. Attitudes towards “authority” and “self-performance” can now be validly and reliably measured. Further research is required to optimize the prototype version of the instrument and could usefully explore the plausible relations between hazardous attitudes and clinical outcomes
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