Obstacles to compassion-giving among nursing and midwifery managers: an international study

Aim: To explore nursing and midwifery managers’ views regarding obstacles to compassion-giving across country cultures. Background: The benefit of compassionate leadership is being advocated, but despite the fact that health care is invariably conducted within culturally diverse workplaces, the interconnection of culture, compassion and leadership is rarely addressed. Furthermore, evidence on how cultural factors hinder the expression of compassion among nursing and midwifery managers is lacking. Methods: Cross-sectional, exploratory, international online survey involving 1 217 participants from 17 countries. Managers’ responses on open-ended questions related to barriers for providing compassion were entered and thematically analysed through NVivo. Results: Three key themes related to compassion-giving obstacles emerged across countries: 1. related to the managers’ personal characteristics and experiences; 2. system-related; and 3. staff-related. Conclusions: Obstacles to compassion-giving among managers vary across countries. An understanding of the variations across countries and cultures of what impedes compassion to flourish in health care is important. Implications for nursing practice and policy: Nursing mangers should wisely use their power by adopting leadership styles that promote culturally competent and compassionate workplaces with respect for human rights. Policymakers should identify training and mentoring needs to enable the development of managers’ practical wisdom. Appropriate national and international policies should facilitate the establishment of standards and guidelines for compassionate leadership, in the face of distorted organizational cultures and system-related obstacles to compassion-giving

Hearing, feeling or seeing a beat recruits a supramodal network in the auditory dorsal pathway

Hearing a beat recruits a wide neural network that involves the auditory cortex and motor planning regions. Perceiving a beat can potentially be achieved via vision or even touch, but it is currently not clear whether a same neural network underlies beat processing. Here we used functional magnetic resonance imaging (fMRI) to test to what extent the neural network involved in beat processing is supramodal, i.e. is the same in the different sensory modalities. Brain activity changes in twenty-seven healthy volunteers were monitored while they were attending to the same rhythmic sequences (with and without a beat) in audition, vision and the vibrotactile modality. We found a common neural network for beat detection in the three modalities that involved parts of the auditory dorsal pathway. Within this network, only the putamen and the supplementary motor area (SMA) showed specificity to the beat, while the brain activity in the putamen covariated with the beat detection speed. These results highlighted the implication of the auditory dorsal stream in beat detection, confirmed the important role played by the putamen in beat detection and indicated that the neural network for beat detection is mostly supramodal. This constitutes a new example of convergence of the same functional attributes into one centralized representation in the brain

Deficient top-down cognitive control and auditory processing in tinnitus: evidences from auditory and visual spatial stroop tasks.

Tinnitus is the perception of sound in the absence of external stimulus. Currently, the pathophysiology of tinnitus is not understood, but recent studies indicate that alterations in the brain involve non-auditory areas, including the prefrontal cortex (Leaver et al., 2011). Here, we hypothesize that these brain alterations would selectively affect top-down cognitive control mechanisms that play a role in the regulation of sensations, emotions and attention resources. Simple reaction speed, processing speed and the efficiency of the executive control were evaluated in tinnitus participants (TP, n=17) and control subjects (CS) matched for age, gender, educational level and hearing acuity. We used a spatial Stroop paradigm in both the auditory and visual modalities. Subjects were presented with the words “left” and “right” either through the left or the right earphone (in hearing) or in the left or right part of a screen (in vision). Subjects had to focus either on the meaning of the words or their location and to press as quickly as possible on a response-button. Results showed slowed down response times in all auditory conditions (i.e. reaction speed, processing speed and interference) in TP as compared to CS, while only the interference conditions appeared altered in TP in vision. This indicates that tinnitus is associated with modality-specific deficits along the auditory processing system as well as a selective impairment of the cognitive control that is involved in both modalities. We postulate that cognitive control mechanisms would play a key-role in tinnitus development and in the associated attention deficits