Investigating the association between patient verbal aggression and emotional exhaustion among Italian health care professionals during the COVID-19 pandemic

Aims: To analyze whether patient verbal aggression would be related to emotional exhaustion and whether this relationship would be mediated by work–family conflict and moderated by dehumanization and resilience. Background: Although patient verbal aggression has been identified as one of the most experienced forms of aggression, its effects on Italian health care providers during the pandemic are still poorly known. Methods: A total of 197 Italian health care professionals completed paper-and-pencil questionnaires. Descriptive statistics and moderated mediation analyses were performed. Results: Patient verbal aggression was positively related to health care professionals' emotional exhaustion, both directly and indirectly, as mediated by work–family conflict. Health care providers were more likely to become emotionally exhausted when they had low resilience and, simultaneously, tended to ascribe patients non-uniquely human traits. Conclusions: Patient verbal aggression may spill over onto health care professionals' family lives. Dehumanization represents an ineffective coping strategy that exacerbates the effects of aggression on work–family conflict, whereas resilience represents a protective resource against emotional exhaustion. Implications for nursing management: Hospital organisations could benefit from providing their staff with stress management interventions, aggression management, psychological support and psychological resilience training programmes. These programmes should incorporate coping skills on establishing work–home boundaries and balancing empathy with cognitive problem-solving abilities

Unlocking the gender diversity-group performance link: the moderating role of relative cultural distance

PurposeThis study aims to shed light on the relationship between gender diversity and group performance by considering the moderating role of relative cultural distance. Drawing from the categorization-elaboration model (CEM), the authors hypothesize that gender-diverse collaborative learning groups perform better when a low level of relative cultural distance in country-level individualism-collectivism or power distance exists among group members.Design/methodology/approachTo test this hypothesis, the authors conducted a study on 539 undergraduate students organized into 94 groups. The assessment of group performance was based on scores given by external raters.FindingsThe authors found that relative cultural distance significantly moderated the gender diversity-group performance relationship such that gender diversity was positively related to group performance when the collaborative learning group included members who similarly valued individualism-collectivism or power distance (i.e. relative cultural distance was low) and was negatively related to group performance when the collaborative learning group comprised members who differently valued individualism-collectivism or power distance (i.e. relative cultural distance was high).Originality/valueThis study contributes to understanding when gender diversity is positively associated with group performance by expanding the range of previously examined diversity dimensions to include relative cultural distance in country-level individualism-collectivism and power distance

Obscuring Active Galactic Nuclei with Nuclear Starburst Disks

We assess the potential of nuclear starburst disks to obscure the Seyfert-like AGN that dominate the hard X-ray background at z~1. Over 1200 starburst disk models, based on the theory developed by Thompson et al., are calculated for five input parameters: the black hole mass, the radial size of the starburst disk, the dust-to-gas ratio, the efficiency of angular momentum transport in the disk, and the gas fraction at the outer disk radius. We find that a large dust-to-gas ratio, a relatively small starburst disk, a significant gas mass fraction, and efficient angular momentum transport are all important to produce a starburst disk that can potentially obscure an AGN. The typical maximum star-formation rate in the disks is ~10 solar masses per year. Assuming no mass-loss due to outflows, the starburst disks feed gas onto the black hole at rates sufficient to produce hard X-ray luminosities of 10^{43}-10^{44} erg s^{-1}. The starburst disks themselves should be detectable at mid-infrared and radio wavelengths; at z=0.8, the predicted fluxes are ~1 mJy at 24microns and ~10-30 microJy at 1.4GHz. Thus, we predict a large fraction of radio/X-ray matches in future deep radio surveys. The starburst disks should be easily distinguished from AGN in future 100microns surveys by Herschel with expected fluxes of ~5 mJy. Any AGN-obscuring starbursts will be associated with hot dust, independent of AGN heating, resulting in observable signatures for separating galactic and nuclear star-formation. Finally, because of the competition between gas and star-formation, nuclear starbursts will be associated with lower-luminosity AGN. Thus, this phenomenon is a natural explanation for the observed decrease in the fraction of obscured AGN with luminosity.Comment: 13 pages, 12 figures, 3 in color; accepted by Ap

The resolved fraction of the Cosmic X-ray Background

We present the X-ray source number counts in two energy bands (0.5-2 and 2-10 keV) from a very large source sample: we combine data of six different surveys, both shallow wide field and deep pencil beam, performed with three different satellites (ROSAT, Chandra and XMM-Newton). The sample covers with good statistics the largest possible flux range so far: [2.4*10^-17 - 10^-11] cgs in the soft band and [2.1*10^-16 - 8*10^{-12}]cgs in the hard band. Integrating the flux distributions over this range and taking into account the (small) contribution of the brightest sources we derive the flux density generated by discrete sources in both bands. After a critical review of the literature values of the total Cosmic X--Ray Background (CXB) we conclude that, with the present data, the 94.3%, and 88.8% of the soft and hard CXB can be ascribed to discrete source emission. If we extrapolate the analytical form of the Log N--Log S distribution beyond the flux limit of our catalog in the soft band we find that the flux from discrete sources at ~3*10^-18 cgs is consistent with the entire CXB, whereas in the hard band it accounts for only 93% of the total CXB at most, hinting for a faint and obscured population to arise at even fainter fluxes.Comment: Accepted for publication in Ap

Managers' compassionate goals, innovation, and firm performance: an examination of mediating processes, and boundary conditions in small- and medium-sized enterprises

This study aims to examine the relationships of managers' compassionate goals with innovation and performance in small- and medium-sized enterprises (SMEs). By integrating social exchange theory with social information processing theory, we hypothesize a serial mediation model in which organizational cooperation and firm innovation sequentially mediate a positive relationship between managers' compassionate goals and firm performance. However, we predict that this positive indirect effect would occur only when managers have low self-image goals and there is a high innovation-supportive work environment. Based on survey data from a sample of 116 SMEs in France, our results provide support for our predictions. This study contributes to the literature by disclosing the mechanisms and boundary conditions of the relationship of managers' compassionate goals with SMEs' innovation and performance. Theoretical and managerial implications of this study are discussed

Rubbing effects on the structural and optical properties of poly(3­hexylthiophene) films

International audienc

The First INTEGRAL AGN Catalog

We present the first INTEGRAL AGN catalog, based on observations performed from launch of the mission in October 2002 until January 2004. The catalog includes 42 AGN, of which 10 are Seyfert 1, 17 are Seyfert 2, and 9 are intermediate Seyfert 1.5. The fraction of blazars is rather small with 5 detected objects, and only one galaxy cluster and no star-burst galaxies have been detected so far. A complete subset consists of 32 AGN with a significance limit of 7 sigma in the INTEGRAL/ISGRI 20-40 keV data. Although the sample is not flux limited, the distribution of sources shows a ratio of obscured to unobscured AGN of 1.5 - 2.0, consistent with luminosity dependent unified models for AGN. Only four Compton-thick AGN are found in the sample. Based on the INTEGRAL data presented here, the Seyfert 2 spectra are slightly harder (Gamma = 1.95 +- 0.01) than Seyfert 1.5 (Gamma = 2.10 +- 0.02) and Seyfert 1 (Gamma = 2.11 +- 0.05).Comment: 17 pages, 12 figures, accepted for publication in Ap

Attitude towards Intranasal Vaccines and Psychological Determinants: Effects on the General Population in Northern Italy

Little is known about the use of intranasal vaccines, but some studies have shown that this innovative way of administration is preferred over needle injection as it is considered both less painful and intrusive to the body, equally effective, and associated with fewer side effects. This study aimed to investigate specific psychological determinants (intolerance of uncertainty, persecutory ideation, perceived control, vaccine hesitancy) of attitude toward nasal vaccine delivery. A convenience sample including 700 Italian participants took part in this cross-sectional study and completed an online questionnaire. A structural equation model with a latent variable was performed to study the relationship between psychological variables, vaccine hesitancy, and attitude toward nasal vaccine delivery. The results indicate that both a hesitant attitude toward vaccination (beta = 0.20, p = 0.000) and low perceived control (beta = -0.20, p = 0.005) may directly increase preference for nasal administration; furthermore, high levels of persecutory ideation may indirectly influence the propensity for intranasal vaccine. These findings suggest that pharmaceutical companies could implement nasal vaccines and provide detailed information on these vaccines through informational campaigns. Hesitant individuals with low levels of perceived control could more easily comply with these types of vaccines

Measuring Moral Distress Among Critical Care Clinicians : Validation and Psychometric Properties of the Italian Moral Distress Scale-Revised

OBJECTIVES: Moral distress is a common experience among critical care professionals, leading to frustration, withdrawal from patient care, and job abandonment. Most of the studies on moral distress have used the Moral Distress Scale or its revised version (Moral Distress Scale-Revised). However, these scales have never been validated through factor analysis. This article aims to explore the factorial structure of the Moral Distress Scale-Revised and develop a valid and reliable scale through factor analysis. DESIGN: Validation study using a survey design. SETTING: Eight medical-surgical ICUs in the north of Italy. SUBJECTS: A total of 184 clinicians (64 physicians, 94 nurses, and 14 residents). INTERVENTIONS: The Moral Distress Scale-Revised was translated into Italian and administered along with a measure of depression (Beck Depression Inventory-Second Edition) to establish convergent validity. Exploratory factor analysis was conducted to explore the Moral Distress Scale-Revised factorial structure. Items with low (less than or equal to 0.350) or multiple saturations were removed. The resulting model was tested through confirmatory factor analysis. MEASUREMENTS AND MAIN RESULTS: The Italian Moral Distress Scale-Revised is composed of 14 items referring to four factors: futile care, poor teamwork, deceptive communication, and ethical misconduct. This model accounts for 59% of the total variance and presents a good fit with the data (root mean square error of approximation = 0.06; comparative fit index = 0.95; Tucker-Lewis index = 0.94; weighted root mean square residual = 0.65). The Italian Moral Distress Scale-Revised evinces good reliability (\u3b1 = 0.81) and moderately correlates with Beck Depression Inventory-Second Edition (r = 0.293; p < 0.001). No significant differences were found in the moral distress total score between physicians and nurses. However, nurses scored higher on futile care than physicians (t = 2.051; p = 0.042), whereas physicians scored higher on deceptive communication than nurses (t = 3.617; p < 0.001). Moral distress was higher for those clinicians considering to give up their position (t = 2.778; p = 0.006). CONCLUSIONS: The Italian Moral Distress Scale-Revised is a valid and reliable instrument to assess moral distress among critical care clinicians and develop tailored interventions addressing its different components. Further research could test the generalizability of its factorial structure in other cultures