The influence of hospital department culture on physicians' job satisfaction: an empirical study

Recently, with the development of economy and the innovation of science and technology in society, the competition in the medical market is becoming increasingly fierce, and human resources are becoming more and more important. The maximum development and utilization of human resources has become an important method to improve the core competitiveness of hospitals. With the continuous improvement of hospital management level, the status and importance of hospital culture has become increasingly prominent. Department culture is not only the foundation and key part of hospital culture, but also is a strong embodiment of hospital culture. Effective construction of department cultures, improvement of the job satisfaction of medical staff and promotion of the quality of medical work are of great significance to improve a hospital’s social and economic benefits. In theory, the study of hospital department culture brings a new perspective to the research of traditional hospital human resources. In practice, it provides a new angle for hospital managers to develop higher-level medical staff. Therefore, research necessarily requires the integration of hospital department culture with physicians' job satisfaction. Based on the relevant theories of hospital department cultures and physicians' job satisfaction, this thesis takes Grade-A tertiary hospitals in Hangzhou, China as examples, conceives and designs hospital department culture, designs and tests the measurement subscales of hospital department culture, introduces two mediating variables, namely professional identity and work engagement, and carries out research in the influence mechanism of hospital department culture on physicians' job satisfaction. Through questionnaire surveys and interviews of staff from some Grade-A tertiary hospitals, for instance, the First Affiliated Hospital of Medical College of Zhejiang University of China, model tests and data analysis are carried out for the proposed hypothesis. Finally, the following conclusions are drawn: hospital department culture is composed of material culture, behavior culture, system culture, spiritual culture and innovation culture; hospital department culture can significantly affect work engagement, professional identity and job satisfaction; work engagement plays a significant role in the intermediary relationship between hospital department culture and physicians' job satisfaction, and there is no necessary mediating effect of professional identity on hospital department culture and physicians' job satisfaction.Nos últimos anos, com o avanço da economia e a inovação da tecnologia, a competição no mercado médico se torna cada vez mais renhida e os recursos humanos constituem um recurso cada dia mais importante. Desenvolver e utilizar maximamente os recursos humanos é uma medida crucial para o aumento da competitividade essencial do hospital. A cultura do hospital desempenha um papel relevante no aumento do nível de gestão hospitalar enquanto que a cultural departamental que é considerada como a parte fundamental e importante da cultura do hospital é apresentação e aprofundamento da cultura hospitalar. O reforço da construção da cultura departamental, a elevação da satisfação profissional dos trabalhadores médicos e a promoção da qualidade dos trabalhos médicos se revestem de um significado considerável para aumentar a eficiência socioeconômica do hospital. O estudo sobre a cultura departamental do hospital serve como uma nova perspectiva, na teoria, para os estudos tradicionais relacionados com os recursos humanos do hospital e, por outro lado, na prática, proporciona um novo ângulo para os gestores hospitalares administrarem e desenvolverem profissionais médicos de alto nível. Portanto, é necessário realizar estudos com base na combinação da cultura departamental hospitalar e satisfação profissional dos médicos. Fundamentado na base teórica associada à cultura departamental do hospital e à satisfação dos médicos em relação ao trabalho, este estudo, tomando como exemplo um hospital de excelência da cidade de Hangzhou, China, trata da influência exercida pela cultura do hospital na satisfação profissional dos médicos por meio da construção e concepção da cultura departamental, da elaboração dos parâmetros de avaliação da cultura departamental e da introdução de duas variáveis mediadoras, ou seja, a identidade profissional e a dedicação ao trabalho. Através de questionários e entrevistas realizadas no Hospital Nº 1, afiliado à Faculdade de Medicina da Universidade de Zhejiang, a hipótese foi avaliada em modelos e os dados foram analisados. Foram obtidas as seguintes conclusões: (1) a cultura departamental do hospital é composta por cultura material, cultura acional, cultura institucional, cultura espiritual e cultura inovadora; (2) a cultura departamental exerce grande influência na dedicação ao trabalho, na identificação profissional e na satisfação em relação ao trabalho; (3) a dedicação ao trabalho faz um papel intermediário significativo na correlação entre a cultura departamental e a satisfação no trabalho enquanto a identificação profissional não possui a mesma função na relação entre eles

Perceived Firm Attributes, Social Identification, and Intrinsic Motivation to Voice in Brand Virtual Communities: Differentiating Brand-General and Innovation-Specific Perceptions

The question about why some brand virtual communities (BVCs) successfully motivate customers to engage in value creation (e.g., voice) while others do not is still an important but understudied research issue. To fill this research gap, we propose a research model to shed light on the antecedents of intrinsic motivation to voice by focusing on the role of perceived firm attributes. Specifically, we argue that firm attributes can be classified into brand-general versus innovation-specific attributes which affect intrinsic motivation through two types of social identification namely brand identification and community identification respectively. The links between these two types of perceptions are examined too. A field study of 291 BVC users was conducted to test the research model. The results show that customer orientation and perceived openness positively affect customers’ brand identification and community identification respectively, and customer orientation has a positive effect on perceived openness. Furthermore, the impact of brand identification on intrinsic motivation is found to be fully mediated by community identification

Real-time Monitoring for the Next Core-Collapse Supernova in JUNO

Core-collapse supernova (CCSN) is one of the most energetic astrophysical events in the Universe. The early and prompt detection of neutrinos before (pre-SN) and during the SN burst is a unique opportunity to realize the multi-messenger observation of the CCSN events. In this work, we describe the monitoring concept and present the sensitivity of the system to the pre-SN and SN neutrinos at the Jiangmen Underground Neutrino Observatory (JUNO), which is a 20 kton liquid scintillator detector under construction in South China. The real-time monitoring system is designed with both the prompt monitors on the electronic board and online monitors at the data acquisition stage, in order to ensure both the alert speed and alert coverage of progenitor stars. By assuming a false alert rate of 1 per year, this monitoring system can be sensitive to the pre-SN neutrinos up to the distance of about 1.6 (0.9) kpc and SN neutrinos up to about 370 (360) kpc for a progenitor mass of 30$M_{\odot}$ for the case of normal (inverted) mass ordering. The pointing ability of the CCSN is evaluated by using the accumulated event anisotropy of the inverse beta decay interactions from pre-SN or SN neutrinos, which, along with the early alert, can play important roles for the followup multi-messenger observations of the next Galactic or nearby extragalactic CCSN.Comment: 24 pages, 9 figure

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Prevalence and risk factors for myopia in older adult east Chinese population

Abstract Background To determine the prevalence and associated factors for myopia and high myopia among older population in a rural community in Eastern China. Methods A community-based, cross-sectional survey was conducted in the Weitang town located in Suzhou, an urban metropolis in East China. A total of 5613 Chinese residents aged 60 years and older were invited to complete a questionnaire and participated in a detailed eye examination,including measurements of visual acuity and refractive error using autorefraction and subjective refraction. Myopia and high myopia was defined as SE < −0.5 diopters (D) and < −5.0 D, respectively. Results Among the 5613 participating individuals, 4795 (85.4%) complete refraction data of phakic right eye was included for analysis. The age-adjusted prevalence was 21.1% (95% confidence interval [CI], 19.9-22.2) for myopia and 2.5% (95% CI, 2.1-2.9) for high myopia. The prevalence of myopia tended to increase significantly with age(p < 0.001),and women had a higher rate of myopia than men (p < 0.001). According to multivariate logistic regression analysis, adults who were older (odds ration[OR]:1.05; 95% CI:1.04-1.07), spent more time for sleeping at night (OR:1.12;95% CI: 1.06-1.18),or had cataract (OR:1.60;95% CI:1.36-1.88) and family history of myopia (OR:1.47;95% CI:1.23-1.77), are more susceptible to myopia (p < 0.001). People who had older age, family history, cataract and specially longer night-time sleep duration, would have a higher risk of myopia. Conclusion Myopia and high myopia among rural old adult population in Eastern China presents common. The current literature unanticipated suggests that there was a positive significant association between prevalence of myopia and night-time sleep duration among adult. Our data provide some evidence of this relationship and highlight the need for larger studies to further investigate this relationship longitudinally and explore mechanism therein

Long-Term Tea Consumption Is Associated with Reduced Risk of Diabetic Retinopathy: A Cross-Sectional Survey among Elderly Chinese from Rural Communities

Aim. To investigate the association between variables related to tea consumption (duration, frequency, and type) and the risk of diabetic retinopathy. Methods. A rural community-based, cross-sectional survey was conducted in Weitang Town, Suzhou, China. People aged 60 years or above were invited to complete the survey. All eligible patients underwent detailed eye examination. Diabetic retinopathy (DR) was diagnosed and graded based on the retinal fundus imaging. Diabetes was defined as fasting glucose concentrations of ≥7.0 mmol/L or self-reported diagnosis of diabetes. Information about tea consumption such as duration, type, and frequency, together with demographics and lifestyle characteristics, were collected using a face-to-face questionnaire interview. The association between tea consumption and the risk of DR was determined by univariate and multivariate logistic regression analyses. Results. Among the 5,281 participants, 614 had diabetes mellitus (prevalence of 11.63%). The prevalence rate of DR was 10.38% in the diabetic population and 1.04% in the general population. Compared with non-tea consumers, the crude OR values for DR in subjects with long-term and short-term tea consumption were 0.34 (95%CI=0.14‐0.82, p=0.016) and 1.64 (95%CI=0.74‐3.64, p=0.221), respectively. When adjusted for age, gender, and other confounders, consumption of tea for ≥20 years was associated with reduced odds of DR (OR=0.29, 95%CI=0.09‐0.97, p=0.044). Thus, long-term tea consumption was significantly associated with a lower risk of DR. There was no statistical significance between frequency or type of tea consumption with DR (p>0.05). Conclusion. Elderly diabetic Chinese residents who consumed tea for more than twenty years had a lower risk of DR compared to non-tea consumers. The long-term tea consumption may be an independent protective factor for DR. However, further studies are warranted to examine the association

Differences in Neural-Immune Gene Expression Response in Rat Spinal Dorsal Horn Correlates with Variations in Electroacupuncture Analgesia

<div><h3>Background</h3><p>Electroacupuncture (EA) has been widely used to alleviate diverse pains. Accumulated clinical experiences and experimental observations indicated that significant differences exist in sensitivity to EA analgesia for individuals of patients and model animals. However, the molecular mechanism accounting for this difference remains obscure.</p> <h3>Methodology/Principal Findings</h3><p>We classified model male rats into high-responder (HR; TFL changes >150) and non-responder (NR; TFL changes ≤0) groups based on changes of their pain threshold detected by tail-flick latency (TFL) before and after 2 Hz or 100 Hz EA treatment. Gene expression analysis of spinal dorsal horn (DH) revealed divergent expression in HR and NR after 2 Hz/100 Hz EA. The expression of the neurotransmitter system related genes was significantly highly regulated in the HR animals while the proinflammation cytokines related genes were up-regulated more significantly in NR than that in HR after 2 Hz and 100 Hz EA stimulation, especially in the case of 2 Hz stimulation.</p> <h3>Conclusions/Significance</h3><p>Our results suggested that differential regulation and coordination of neural-immune related genes might play an important role for individual variations in analgesic effects responding to EA in DH. It also provided new candidate genes related to EA responsiveness for future investigation.</p> </div