The importance and feasibility of hospital interventions to prevent and manage patient aggression and violence against physicians in China:a Delphi study

Background: Aggression and violence by patient (and their relatives/friends) is widely acknowledged as a serious occupational hazard, with physicians being particularly susceptible to witnessing and experiencing such incidents within hospitals. Research has shown that the negative consequences of such aggression and violence are not only felt at the individual level, but also at the team and organizational levels. Understanding how to prevent and manage this behavior towards physicians in hospitals is urgent and not fully researched. While there are many potentially effective interventions, it is unclear which ones would be valuable and feasible for Chinese hospitals. Because patient aggression and violence may occur more frequently in Chinese hospitals than in other countries, this suggests that cultural differences play a role and that tailored interventions may be needed. Method: We conducted a Delphi study to reach a consensus on the importance and feasibility of hospital interventions to prevent and manage patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. Seventeen experts in China were invited to complete online questionnaires over three rounds. Results: After three rounds, consensus was achieved concerning 44 interventions, five other interventions were rejected, and no consensus was reached on another two. These interventions were clustered into eight categories: environment design, access and entrance, staffing and working practices, leadership and culture, training and education, support, during/after-the-event actions, and hospital policy. Each category is considered important in preventing and managing patient (and their relatives/friends) aggression and violence towards physicians in Chinese hospitals. This study also investigated the feasibility of the suggested interventions and found that 36 of the 44 interventions were considered not only relevant, but also feasible for implementation in Chinese hospitals. Conclusions: This study provides an overview of interventions that can be implemented in Chinese hospitals to prevent and manage patient (and their relatives/friends) aggression and violence before, during, and after a violent incident occurs.</p

The importance and feasibility of hospital interventions to prevent and manage patient aggression and violence against physicians in China:a Delphi study

Background: Aggression and violence by patient (and their relatives/friends) is widely acknowledged as a serious occupational hazard, with physicians being particularly susceptible to witnessing and experiencing such incidents within hospitals. Research has shown that the negative consequences of such aggression and violence are not only felt at the individual level, but also at the team and organizational levels. Understanding how to prevent and manage this behavior towards physicians in hospitals is urgent and not fully researched. While there are many potentially effective interventions, it is unclear which ones would be valuable and feasible for Chinese hospitals. Because patient aggression and violence may occur more frequently in Chinese hospitals than in other countries, this suggests that cultural differences play a role and that tailored interventions may be needed. Method: We conducted a Delphi study to reach a consensus on the importance and feasibility of hospital interventions to prevent and manage patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. Seventeen experts in China were invited to complete online questionnaires over three rounds. Results: After three rounds, consensus was achieved concerning 44 interventions, five other interventions were rejected, and no consensus was reached on another two. These interventions were clustered into eight categories: environment design, access and entrance, staffing and working practices, leadership and culture, training and education, support, during/after-the-event actions, and hospital policy. Each category is considered important in preventing and managing patient (and their relatives/friends) aggression and violence towards physicians in Chinese hospitals. This study also investigated the feasibility of the suggested interventions and found that 36 of the 44 interventions were considered not only relevant, but also feasible for implementation in Chinese hospitals. Conclusions: This study provides an overview of interventions that can be implemented in Chinese hospitals to prevent and manage patient (and their relatives/friends) aggression and violence before, during, and after a violent incident occurs.</p

Prevalence, risk factors, consequences, and prevention and management of patient aggression and violence against physicians in hospitals:A systematic review

Most reviews have examined workplace violence rather heterogeneously without explicit regard to a professional group or particular source of violence (from colleagues/leaders vs. from patients and their relatives/friends). This study reviews the literature regarding the prevalence, risk factors, consequences, and prevention and management of aggression and violence by patients (and their relatives/friends) against physicians in hospitals. A total of 104 studies were included by searching five databases. The prevalence of aggression and violence was higher in developing countries and against younger physicians. The risk factors for the occurrence of aggression and violence were present at multiple levels (i.e., patients, patient-physician interactions, hospitals, and society). However, knowledge on how risk factors at different levels interact is absent. Although research on risk factors acknowledged multiple levels, research on consequences was mainly focused on the individual level (i.e., work functioning, psychological well-being and health) with less attention to the team and organizational level. While some prevention models took into account the risk factors of aggression and violence in different contexts, there is still limited knowledge on how to establish a well-aligned and comprehensive intervention strategy that considers risk factors and consequences at different levels.</p

Real-Time Substructure Tests and Numerical Simulation of Mechanical Characteristics of Natural Rubber-Laminated Bearings

Natural rubber lamination is a kind of seismic isolation of bearings often used in civil engineering. The advantage of laminated bearings is large vertical stiffness and small lateral stiffness. In seismic regions, structural periods would be extended and the effect of seismic forces can be lowered using bearings. In previous tests, the static cyclic loading method was mainly used that failed to take account of the loading rate. The real-time substructure testing is proposed to simulate true seismic loads. This testing and test setup were first introduced, and the effect of the loading rate was studied. Then the effects of vertical pressure and peak acceleration of ground motion were studied. At last the test results were simulated by the finite element method, and an accurate method to calculate seismic responses of bridges with laminated bearings was proposed.Ламинирование природным каучуком – один из видов сейсмической изоляции опор, часто используемый в гражданском строительстве. Ламинированные опоры характеризуются высокой вертикальной жесткостью и низкой поперечной жесткостью. В сейсмических регионах сроки строительства увеличиваются, а влияние сейсмических сил может быть уменьшено за счет применения подобных опор. До сих пор основой для испытаний служил статический метод циклического нагружения, не позволявший учитывать его скорость. Предложен метод испытания в реальных условиях эксплуатации, моделирующий истинные сейсмические нагрузки. Внедрены метод испытаний и испытательная установка, изучено влияние скорости нагружения, вертикального давления и пикового ускорения движения грунта. Выполнено моделирование результатов испытания с помощью метода конечных элементов. Предложен точный метод расчета сейсмических характеристик мостов с опорами, ламинированными природным каучуком

How organizational cognitive neuroscience can deepen understanding of managerial decision-making:a review of the recent literature and future directions

There is growing interest in exploring the potential links between human biology and management and organization studies, which is bringing greater attention to bear on the place of mental processes in explaining human behaviour and effectiveness. The authors define this new field as organizational cognitive neuroscience (OCN), which is in the exploratory phase of its emergence and diffusion. It is clear that there are methodological debates and issues associated with OCN research, and the aim of this paper is to illuminate these concerns, and provide a roadmap for rigorous and relevant future work in the area. To this end, the current reach of OCN is investigated by the systematic review methodology, revealing three clusters of activity, covering the fields of economics, marketing and organizational behaviour. Among these clusters, organizational behaviour seems to be an outlier, owing to its far greater variety of empirical work, which the authors argue is largely a result of the plurality of research methods that have taken root within this field. Nevertheless, all three clusters contribute to a greater understanding of the biological mechanisms that mediate choice and decision-making. The paper concludes that OCN research has already provided important insights regarding the boundaries surrounding human freedom to act in various domains and, in turn, self-determination to influence the workplace. However, there is much to be done, and emerging research of significant interest is highlighted

Quantum theory of two-photon interference

In this paper, we study two-photon interference with the approach of photon quantum theory, with specific attention to the two-photon interference experiment carried out by Milena D'Angelo et al. (Phys. Rev. Lett 87:013602, 2001). We find the theoretical result is accordance with experiment data.Comment: arXiv admin note: substanital text overlap with arXiv:1011.3593, and with arXiv:quant-ph/0408001, arXiv:quant-ph/0103035 by other author

Cyclophosphamide induces NR2B phosphorylation-dependent facilitation on spinal reflex potentiation

Chang CH, Peng HY, Wu HC, Lai CY, Hsieh MC, Lin TB. Cyclophosphamide induces NR2B phosphorylation-dependent facilitation on spinal reflex potentiation. Am J Physiol Renal Physiol 300: F692-F699, 2011. First published November 24, 2010; doi:10.1152/ajprenal.00531.2010.-It is well-established that cyclophosphamide (CYP) can sensitize the pelvic afferent nerve arising from the urinary bladder and therefore induce suprapubic pain. To test the possibility that CYP might mediate the development of visceral hypereflexia/hyperalgesia by facilitating spinal activity-dependent neural plasticity, we compared the pelvic-urethra reflex activity and spinal N-methyl-D-aspartate receptor NR2B subunit (NR2B) phosphorylation in rats treated with vehicle solution and CYP. Compared with vehicle solution, when accompanied by upregulation of phosphorylated NR2B expression in the lumbosacral (L6-S2) dorsal horn, CYP increased the evoked spikes in spinal reflex potentiation induced by repetitive stimulation (1 stimulation/1 s). Moreover, intraperitoneal pretreatments with N(G)-nitro-L-arginine methyl ester and roscovitine, nitric oxide synthase and cyclin-dependent protein kinase 5 (Cdk5) antagonists, respectively, overwrote CYP-enhanced reflex potentiation and NR2B phosphorylation. When compared with the untreated group, the treatment with small-interfering RNA of NR2B, which decreased the expression of NR2B expression, abolished CYP-dependent reflex facilitation and spinal NR2B phosphorylation. These results suggested that CYP might facilitate spinal reflex potentiation mediated by N-methyl-D-aspartate receptors and participate in the development of visceral hypereflexia/hyperalgesia through nitric oxide-and Cdk5-dependent NR2B phosphorylation at the lumbosacral dorsal horn

EphrinB2 induces pelvic-urethra reflex potentiation via Src kinase-dependent tyrosine phosphorylation of NR2B

Wu HC, Chang CH, Peng HY, Chen GD, Lai CY, Hsieh MC, Lin TB. EphrinB2 induces pelvic-urethra reflex potentiation via Src kinase-dependent tyrosine phosphorylation of NR2B. Am J Physiol Renal Physiol 300: F403-F411, 2011. First published December 8, 2010; doi:10.1152/ajprenal.00520.2010.-Recently, the role of EphB receptor (EphBR) tyrosine kinase and their ephrinB ligands in pain-related neural plasticity at the spinal cord level have been identified. To test whether Src-family tyrosine kinase-dependent glutamatergic N-methyl-D-aspartate receptor NR2B subunit phosphorylation underlies lumbosacral spinal EphBR activation to mediate pelvic-urethra reflex potentiation, we recorded external urethra sphincter electromyogram reflex activity and analyzed protein expression in the lumbosacral (L(6)-S(2)) dorsal horn in response to intrathecal ephrinB2 injections. When compared with vehicle solution, exogenous ephrinB2 (5 mu g/rat it)-induced reflex potentiation, in associated with phosphorylation of EphB1/2, Src-family kinase, NR2B Y1336 and Y1472 tyrosine residues. Both intrathecal EphB1 and EphB2 immunoglobulin fusion protein (both 10 mu g/rat it) prevented ephrinB2-dependent reflex potentiation, as well as protein phosphorylation. Pretreatment with PP2 (50 mu M, 10 mu l it), an Src-family kinase antagonist, reversed the reflex potentiation, as well as Src kinase and NR2B phosphorylation. Together, these results suggest the ephrinB2-dependent EphBR activation, which subsequently provokes Src kinase-mediated N-methyl-D-aspartate receptor NR2B phosphorylation in the lumbosacral dorsal horn, is crucial for the induction of spinal reflex potentiation contributing to the development of visceral pain and/or hyperalgesia in the pelvic area

Variational Approach to the Modulational Instability

We study the modulational stability of the nonlinear Schr\"odinger equation (NLS) using a time-dependent variational approach. Within this framework, we derive ordinary differential equations (ODEs) for the time evolution of the amplitude and phase of modulational perturbations. Analyzing the ensuing ODEs, we re-derive the classical modulational instability criterion. The case (relevant to applications in optics and Bose-Einstein condensation) where the coefficients of the equation are time-dependent, is also examined