(Un)Broken: Lateral violence among hospital nurses, user violence, burnout, and general health: A structural equation modeling analysis

Introduction Workplace violence is a social problem yet to be solved. Although it is present in virtually all work environments, its prevalence in healthcare settings stands out, being perceived as something inherent to the job. Most studies in this context have focused on user violence against professionals. However, it has been observed that violence among colleagues in these types of jobs is a risk factor for the health of workers and has rarely been studied as a whole. Among the main consequences of exposure to violence reported in the literature, burnout syndrome, depression, anxiety, or somatic problems have been among the most studied. On the one hand, some authors claim that being exposed to workplace violence can increase the associated physical and psychological pathology and lead to a picture congruent with burnout. On the other hand, it has been hypothesized that violence is associated with burnout, which can trigger physical and psychological symptoms. Taking into account this background, the aim of this study is to explore workplace violence in health personnel, symptomatology, and burnout syndrome through mediation models that allow us to know the interrelationships between the variables.MethodsA cross-sectional design with a double descriptive-associative strategy was used. The sample was composed of 950 nursing professionals from public hospitals. The scales of physical and non-physical violence from users to professionals HABS-U, personal, social, and occupational violence among co-workers using the Health Aggressive Behavior Scale – Co-workers and Superiors (HABS-CS) scale, the burnout scale Maslach Burnout Inventory – General Survey (MBI-GS) which evaluates professional exhaustion, efficacy and cynicism, and the factors referring to depression, anxiety, somatization, and dysfunction of the GHQ-28 scale were applied. In order to calculate the models, workplace violence was used as a predictor of symptomatology, using the burnout variables as mediators. Regression coefficients with and without mediation model, direct and standardized estimates were obtained. For statistical power, Bootstrap analysis was used to calculate direct mediation effects.ResultsAfter controlling the mediation effects of burnout and cynicism, physical and non-physical user violence toward healthcare personnel were significant predictors of the GHQ-28 scores. These same results were obtained when assessing the relationship between social, occupational, and personal violence among co-workers and GHQ-28 scores.ConclusionOur results contribute to increase the evidence about the effects of violence on the health of professionals and to advance in the characterization of the possible consequent psychological damage. Regardless of the type of violence experienced, exposure to violence can lead to anxious, depressive or somatization symptoms, among others. Violence is also a predictor of burnout syndrome, which in turn accentuates the rest of the consequences studied. Despite the limitations of the proposed model, these results serve to highlight the complexity of the situation experienced by healthcare professionals. Moreover, it serves as a basis for proposing intervention/prevention programs to raise awareness and protect professionals from these risks. To this end, self-care tools should be proposed with which professionals take care of their own health through the management of violent situations and/or the improvement of occupational health

Tough Love Lessons: Lateral Violence among Hospital Nurses

Background: Workplace violence is a growing social problem among many professions, but it particularly affects the health sector. Studies have mainly focused on evaluating user violence toward health professionals, with less attention being paid to other sources of conflict, such as co-workers themselves. There are different manifestations of this violence in what has been called a context of tolerated or normalized violence among co-workers. However, its effects are far from being tolerable, as they have an impact on general health and job satisfaction and contribute to burnout among professionals. Based on this idea, and following the line of the previous literature, nursing staff are a population at high risk of exposure to workplace violence. For this reason, the present study aims to evaluate exposure to lateral violence or violence among co-workers in nursing staff in public health services and the relationship of this exposure with some of the most studied consequences. (2) Methods: A cross-sectional associative study was carried out in which scales of workplace violence (HABS-CS), burnout (MBI-GS), job satisfaction (OJS), and general health (GHQ-28) were applied to a sample of 950 nursing staff from 13 public hospitals located in the southeast of Spain. (3) Results: The results show that nursing staff have a high exposure to violence from their co-workers, which is more common in male nurses. Greater exposure is observed in professionals with between 6 and 10 years of experience in the profession, and it is not characteristic of our sample to receive greater violence when they have less experience or are younger. A positive correlation is observed with high levels of burnout and a negative correlation with general health and job satisfaction. (4) Conclusions: The results of this work contribute to increasing the scientific evidence of the consequences of a type of workplace violence frequent among nursing staff and to which less attention has been paid in relative terms to other types of prevalent violence. Organizations should be aware of the importance of this type of workplace violence, its frequency and impact, and implement appropriate prevention policies that include the promotion of a culture that does not reward violence or minimize reporting. A change of mentality in the academic environment is also recommended in order to promote a more adequate training of nursing staff in this field

Measurement of the cross section for the production of a WW boson in association with b−b^- jets in pppp collisions at s=7\sqrt{s}=7 TeV with the ATLAS detector

A measurement is presented of the cross section for the production of a W boson with one or two jets, of which at least one must be a b-jet, in pp collisions at sqrt(s)=7 TeV. Production via top decay is not included in the signal definition. The measurement is based on 35 pb^-1 of data collected with the ATLAS detector at the LHC. The W+b-jet cross section is defined for jets reconstructed with the anti-kt clustering algorithm with transverse momentum above 25 GeV and rapidity within +/-2.1. The b-jets are identified by reconstructing secondary vertices. The fiducial cross section is measured both for the electron and muon decay channel of the W boson and is found to be 10.2 +/- 1.9 (stat) +/- 2.6 (syst) pb for one lepton flavour. The results are compared with next-to-leading order QCD calculations, which predict a cross section smaller than, though consistent with, the measured value.Peer Reviewe

Search for New Physics in the Dijet Mass Distribution using 1 fb−1^{-1} of pppp Collision Data at s=\sqrt{s}=7 TeV collected by the ATLAS Detector

Invariant mass distributions of jet pairs (dijets) produced in LHC proton-proton collisions at a centre-of-mass energy sqrt(s)=7 TeV have been studied using a data set corresponding to an integrated luminosity of 1.0 fb^-1 recorded in 2011 by ATLAS. Dijet masses up to ~4 TeV are observed in the data, and no evidence of resonance production over background is found. Limits are set at 95% CL for several new physics hypotheses: excited quarks are excluded for masses below 2.99 TeV, axigluons are excluded for masses below 3.32 TeV, and colour octet scalar resonances are excluded for masses below 1.92 TeV.Peer Reviewe

Measurement of the top quark pair production cross section in pppp collisions at s=7\sqrt{s}=7 TeV in dilepton final states with ATLAS

A measurement of the production cross section of top quark pairs (ttbar) in proton-proton collisions at a center-of-mass energy of 7 TeV recorded with the ATLAS detector at the Large Hadron Collider is reported. Candidate events are selected in the dilepton topology with large missing transverse energy and at least two jets. Using a data sample corresponding to an integrated luminosity of 35 pb^-1, a ttbar production cross section of 171 +/- 20(stat.) +/- 14(syst.) +8-6(lum.) pb is measured for an assumed top quark mass of 172.5 GeV. A second measurement requiring at least one jet identified as coming from a b quark yields a comparable result, demonstrating that the dilepton final states are consistent with being accompanied by b-quark jets. These measurements are in good agreement with Standard Model predictions.Peer Reviewe

Performance of Missing Transverse Momentum Reconstruction in Proton-Proton Collisions at 7 TeV with ATLAS

The measurement of missing transverse momentum in the ATLAS detector, described in this paper, makes use of the full event reconstruction and a calibration based on reconstructed physics objects. The performance of the missing transverse momentum reconstruction is evaluated using data collected in pp collisions at a centre-of-mass energy of 7 TeV in 2010. Minimum bias events and events with jets of hadrons are used from data samples corresponding to an integrated luminosity of about 0.3 inverse nb and 600 inverse nb, together with events containing a Z boson decaying to two leptons (electrons or muons) or a W boson decaying to a lepton (electron or muon) and a neutrino, from a data sample corresponding to an integrated luminosity of about 36 inverse pb. An estimate of the systematic uncertainty on the missing transverse momentum scale is presented.Peer Reviewe

INDIGO-DataCloud: A data and computing platform to facilitate seamless access to e-infrastructures

This paper describes the achievements of the H2020 project INDIGO-DataCloud. The project has provided e-infrastructures with tools, applications and cloud framework enhancements to manage the demanding requirements of scientific communities, either locally or through enhanced interfaces. The middleware developed allows to federate hybrid resources, to easily write, port and run scientific applications to the cloud. In particular, we have extended existing PaaS (Platform as a Service) solutions, allowing public and private e-infrastructures, including those provided by EGI, EUDAT, and Helix Nebula, to integrate their existing services and make them available through AAI services compliant with GEANT interfederation policies, thus guaranteeing transparency and trust in the provisioning of such services. Our middleware facilitates the execution of applications using containers on Cloud and Grid based infrastructures, as well as on HPC clusters. Our developments are freely downloadable as open source components, and are already being integrated into many scientific applications

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease