An Exploratory Analysis of Stress, Burnout, and Depression in the IECMH Workforce

A growing trend in the psychological literature has consistently found a strong association between stress, burnout, and depression, especially in populations who are exposed to a high amount of occupational stress. And, while the relationship between stress and burnout has been distinct and strong, the same cannot be said for burnout and depression. Historically, burnout and depression have shared such a strong conceptual relationship that the literature disagreed as to whether they were truly separate mechanisms. However, while the two constructs do present behavioral similarities the underlying mechanisms which direct their presentation are subtly different. Depression is defined as a diagnosable mood disorder, which is implicated from a number of biopsychosocial factors regardless of occupation characteristics, while burnout is defined as an occupational syndrome which presents in response to prolonged exposure stress within one’s vocation specifically. Understanding the relationship between stress, burnout, and depression is relevant for all professionals, but may be especially important to study in sectors interacting with vulnerable populations known to be at risk for burnout. The Infant and Early Childhood Mental Health (IECMH) workforce includes professionals who engage and serve children and families, many of whom have experienced trauma and/or have high psychosocial risk. This workforce may be particularly vulnerable to burnout in the context of the COVID-19 pandemic. Specifically, mental health symptoms (including depression) and stress rates have increased for many since the start of the pandemic. The current study aimed to explore perceived stress, burnout, and depression in a population of IECMH professionals, and to test whether depression symptoms act as a risk factor in the context of stress and burnout. The sample consists of 141 clinicians who work in the IECMH field (e.g., child welfare, home visiting, childcare), and who completed self-report measures of current stress, current burnout, and current depression in the summer of 2020. Bivariate correlation indicated significant and large relationships between both perceived stress and burnout (r = .70, p \u3c .001), and depression and burnout (r = .59, p \u3c .001). Given the high collinearity between our predictor (stress) and proposed moderator (depression, r = .80, p \u3c .001), testing for the moderating effect of depression on the link between stress and burnout was unjustified. These results led us to wonder if other factors might better serve as protective factors in the context of stress and burnout and thus we examined the moderating effect of self-compassion on buffering against the relationship between stress and burnout. To explore the possibility of self-compassion weakening this relationship between perceived stress and burnout, simple moderation analyses were conducted in SPSS using Hayes’ PROCESS 4.0 Macro. The overall model results were significant (F(3, 99) = 65.08, R2 = .66, p \u3c .001) and the interaction term was also significant (R2 change = .04, p = .001). Specifically, the relationship between stress (x) and burnout (y) remained significant across all levels of self-compassion, but the strength of the relationship between x and y was strongest when self-compassion was low and weakest when self-compassion was high

Improving Nurse Manager Job Satisfaction: An Urban Academic Quality Improvement Project

Background: It is important that the nurse managers are able to contribute to organizational vision, mission, and goals by influencing others, sharing the vision, and implementing it (Boyce, 2018). They are pivotal to the successful accomplishments of the hospital mission. The issue of recruiting, developing and retaining nurse managers is one that challenges many health care institutions, hospitals, hospitals, and health systems. The literature regarding this concern was reviewed and the paucity of useful science in this regard led to question of how to improve the job satisfaction and job retention of nurse managers at urban academic medical centers. Objective: The purpose of this project was to examine the effectiveness of educational interventions for nurse manager role development, job satisfaction and intent to remain in the role. Methods: This quality improvement project utilized a quasi-experimental pre-posttest design, incorporating the AONL Nurse Competency tool, the Turnover Intention Tool, and the Minnesota Satisfaction (Short Form) tool. The sample size consisted of 16 nurse managers from various nursing areas at an urban academic hospital. Demographics, competency self-assessments, as well as job satisfaction and the intent to remain in the role were measured and reviewed. The interventions were presented in four educational sessions. Results: The managers had a mean age of 53.3 years, 73.3% were female and Black. Sixty percent were Masters’ prepared. On average, had 27.9 years in the profession. There was no difference in most of the measured variables except about job satisfaction and retention. There was a one- point drop in thinking about leaving the organization, the job, and the profession. Conclusion/Implications: While statistical significance was not found, the nurse managers’ responses were clinically significant; they expressed greater positive responses to the financial components of the interventions. Based upon the responses, this is but a first step in engaging the managers at a deeper level to positively influence their intent to stay

CLU: A new algorithm for EST clustering

BACKGROUND: The continuous flow of EST data remains one of the richest sources for discoveries in modern biology. The first step in EST data mining is usually associated with EST clustering, the process of grouping of original fragments according to their annotation, similarity to known genomic DNA or each other. Clustered EST data, accumulated in databases such as UniGene, STACK and TIGR Gene Indices have proven to be crucial in research areas from gene discovery to regulation of gene expression. RESULTS: We have developed a new nucleotide sequence matching algorithm and its implementation for clustering EST sequences. The program is based on the original CLU match detection algorithm, which has improved performance over the widely used d2_cluster. The CLU algorithm automatically ignores low-complexity regions like poly-tracts and short tandem repeats. CONCLUSION: CLU represents a new generation of EST clustering algorithm with improved performance over current approaches. An early implementation can be applied in small and medium-size projects. The CLU program is available on an open source basis free of charge. It can be downloaded fro

No neurocognitive advantage for immediate antiretroviral treatment in adults with greater than 500 CD4+ T-cell counts

OBJECTIVE: To compare the effect of immediate versus deferred antiretroviral treatment (ART) on neuropsychological test performance in treatment-naive HIV-positive adults with >500 CD4+ cells/μL. DESIGN: Randomized trial. METHODS: The START parent study randomized participants to commence immediate versus deferred ART until CD4+ <350 cells/μL. The START Neurology substudy used 8 neuropsychological tests, at baseline, months 4, 8, 12 and annually, to compare groups for changes in test performance. Test results were internally standardized to z-scores. The primary outcome was the average of the eight test z-scores (QNPZ-8). Mean changes in QNPZ-8 from baseline were compared by intent-to-treat using longitudinal mixed models. Changes from baseline to specific time points were compared using ANCOVA models. RESULTS: 592 participants had a median age of 34 years; median baseline CD4+ count of 629 cells/μL; the mean follow-up was 3.4 years. ART was used for 94% and 32% of accrued person-years in the immediate and deferred groups, respectively. There was no difference between the immediate and deferred ART groups in QNPZ-8 change through follow-up [-0.018 (95% CI: -0.062 to 0.027, p = 0.44)], or at any visit. However, QNPZ-8 scores increased in both arms during the first year, by 0.22 and 0.24, respectively (p < 0.001 for increase from baseline). CONCLUSIONS: We observed substantial improvement in neurocognitive test performance during the first year in both study arms, underlining the importance of using a control group in studies assessing neurocognitive performance over time. Immediate ART neither benefitted nor harmed neurocognitive performance in individuals with CD4+ cell counts above 500 cells/μL

Off-trial evaluation of bisphosphonates in patients with metastatic breast cancer

BACKGROUND: Bisphosphonate therapy has been readily accepted as standard of care for individuals with bone metastases from breast cancer. In this study we determined whether the proportion of patients experiencing a skeletal related event (SRE) in a clinical practice population was similar to that observed in phase III randomized controlled studies. METHODS: A retrospective chart review was conducted of 110 patients receiving intravenous bisphosphonates for advanced breast cancer. The proportion of patients experiencing at least one SRE after 12 months of therapy was determined. SRE included vertebral or non-vertebral fracture, cord compression, surgery and/or radiotherapy to bone. RESULTS: The proportion of patients who had an SRE was 30% (28 individuals) and the median time to first event was greater than 350 days. Non-vertebral events and radiotherapy were the most frequent type of SRE, while cord compression and hypercalcaemia were rare (1%). Most patients in the study had bone-only disease (58.2%) and most had multiple bone lesions. In the first 12 months the mean duration of exposure to intravenous bisphosphonates was 261 days and most patients remained on treatment until just before death (median 27 days). CONCLUSION: This study suggests that the rate of clinically relevant SREs is substantially lower than the event rate observed in phase III clinical trials. We attribute this lower rate to observational bias. In the clinical trial setting it is possible that over-detection of skeletal events occurs due to the utilisation of regular skeletal survey or radionucleotide bone scan, whereas these procedures are not routine in clinical practice. Phase IV observational studies need to be conducted to determine the true benefits of bisphosphonate therapy in order to implement rationale use of bisphosphonates

Mining Biological Pathways Using WikiPathways Web Services

WikiPathways is a platform for creating, updating, and sharing biological pathways [1]. Pathways can be edited and downloaded using the wiki-style website. Here we present a SOAP web service that provides programmatic access to WikiPathways that is complementary to the website. We describe the functionality that this web service offers and discuss several use cases in detail. Exposing WikiPathways through a web service opens up new ways of utilizing pathway information and assisting the community curation process

Preparation and Characterization of the Extracellular Domain of Human Sid-1

In C. elegans, the cell surface protein Sid-1 imports extracellular dsRNA into the cytosol of most non-neuronal cells, enabling systemic spread of RNA interference (RNAi) throughout the worm. Sid-1 homologs are found in many other animals, although for most a function for the protein has not yet been established. Sid-1 proteins are composed of an N-terminal extracellular domain (ECD) followed by 9–12 predicted transmembrane regions. We developed a baculovirus system to express and purify the ECD of the human Sid-1 protein SidT1. Recombinant SidT1 ECD is glycosylated and spontaneously assembles into a stable and discrete tetrameric structure. Electron microscopy (EM) and small angle x-ray scattering (SAXS) studies reveal that the SidT1 ECD tetramer is a compact, puck-shaped globular particle, which we hypothesize may control access of dsRNA to the transmembrane pore. These characterizations provide inroads towards understanding the mechanism of this unique RNA transport system from structural prospective

A Virulent Wolbachia Infection Decreases the Viability of the Dengue Vector Aedes aegypti during Periods of Embryonic Quiescence

A new approach for dengue control has been proposed that relies on life-shortening strains of the obligate intracellular bacterium Wolbachia pipientis to modify mosquito population age structure and reduce pathogen transmission. Previously we reported the stable transinfection of the major dengue vector Aedes aegypti with a life-shortening Wolbachia strain (wMelPop-CLA) from the vinegar fly Drosophila melanogaster. Here, we report a further characterization of the phenotypic effects of this virulent Wolbachia infection on several life-history traits of Ae. aegypti. Minor costs of wMelPop-CLA infection for pre-imaginal survivorship, development and adult size were found. However, we discovered that the wMelPop-CLA infection dramatically decreased the viability of desiccated Ae. aegypti eggs over time. Similarly, the reproductive fitness of wMelPop-CLA infected Ae. aegypti females declined with age. These results reveal a general pattern associated with wMelPop-CLA induced pathogenesis in this mosquito species, where host fitness costs increase during aging of both immature and adult life-history stages. In addition to influencing the invasion dynamics of this particular Wolbachia strain, we suggest that the negative impact of wMelPop-CLA on embryonic quiescence may have applied utility as a tool to reduce mosquito population size in regions with pronounced dry seasons or in regions that experience cool winters

Aberrant lipid metabolism disrupts calcium homeostasis causing liver endoplasmic reticulum stress in obesity.

The endoplasmic reticulum (ER) is the main site of protein and lipid synthesis, membrane biogenesis, xenobiotic detoxification and cellular calcium storage, and perturbation of ER homeostasis leads to stress and the activation of the unfolded protein response. Chronic activation of ER stress has been shown to have an important role in the development of insulin resistance and diabetes in obesity. However, the mechanisms that lead to chronic ER stress in a metabolic context in general, and in obesity in particular, are not understood. Here we comparatively examined the proteomic and lipidomic landscape of hepatic ER purified from lean and obese mice to explore the mechanisms of chronic ER stress in obesity. We found suppression of protein but stimulation of lipid synthesis in the obese ER without significant alterations in chaperone content. Alterations in ER fatty acid and lipid composition result in the inhibition of sarco/endoplasmic reticulum calcium ATPase (SERCA) activity and ER stress. Correcting the obesity-induced alteration of ER phospholipid composition or hepatic Serca overexpression in vivo both reduced chronic ER stress and improved glucose homeostasis. Hence, we established that abnormal lipid and calcium metabolism are important contributors to hepatic ER stress in obesity