Multiple-criteria analysis of the employee satisfaction level at healthcare facilities during the pandemic.

Due to the pandemic, the entire staff employed in healthcare institutions were directly exposed to longer working hours and unstable working conditions. Based on these facts, the research in this article aims to find out more about employees' satisfaction with working conditions and management's engagement in preserving their health and safety. Thus, a multiple-criteria decision analysis (MCDA) model based on the analyzed attitudes and opinions of employees was formed to reveal the interdependencies between working conditions resulting from the undertaken management activities, employee satisfaction and workplace safety. The results show that both nurses and drivers were least satisfied with working conditions during the pandemic while indicating those workplaces to be the most endangered. Additionally, the proposed model can be successfully applied to any type of organization to identify insufficiently effective management activities, address them accordingly and thereby improve the level of employee satisfaction.

Neural abnormalities of reward processing in adolescents with bipolar disorders: An ERP study.

Adolescent onset is common in bipolar disorders (BDs) and is associated with a worse illness course in adulthood. A model of BDs suggests that a dysregulated behavioral approach system (BAS), a neural system that mobilizes reward-seeking behavior, is at the root of BDs. Normative adolescence is often accompanied by dynamic changes to neural structures underlying the BAS and related cognitive processes. It is possible that adolescent-onset BDs is associated with abnormal BAS neurodevelopment. Consistently, the present study is the first to compare specific BAS-relevant anticipatory and consummatory reward processes as indexed by event-related potentials (ERPs) in adolescents with BDs and typically developing peers. Using a sample of 43 adolescents with BDs and 56 without psychopathology, we analyzed N1 and P3 responses to anticipatory cues and feedback-related negativity (FRN) and P3 responses to feedback stimuli during a monetary incentive delay (MID) task. Hierarchical linear models examined relationships between ERP amplitudes and diagnostic group, MID condition, sex, and age. During anticipation phase, adolescent boys with BDs exhibited significantly larger N1 amplitudes in loss than even or gain trials. During feedback phase, compared to their healthy peers, adolescents with BDs had smaller FRN amplitudes across all conditions. Additional effects involving age, sex and trial type were observed. The findings indicate subtle, non-ubiquitous BAS-relevant neural abnormalities involving early attentional processes during reward anticipation and reward learning following feedback in adolescents with BDs. Adolescents with BDs did not show overall hypersensitive neural responses to monetary reward anticipation or feedback observed in adults with BDs.

Evaluation of a Model to Target High-risk Psychiatric Inpatients for an Intensive Postdischarge Suicide Prevention Intervention.

Importance: The months after psychiatric hospital discharge are a time of high risk for suicide. Intensive postdischarge case management, although potentially effective in suicide prevention, is likely to be cost-effective only if targeted at high-risk patients. A previously developed machine learning (ML) model showed that postdischarge suicides can be predicted from electronic health records and geospatial data, but it is unknown if prediction could be improved by adding additional information. Objective: To determine whether model prediction could be improved by adding information extracted from clinical notes and public records. Design, Setting, and Participants: Models were trained to predict suicides in the 12 months after Veterans Health Administration (VHA) short-term (less than 365 days) psychiatric hospitalizations between the beginning of 2010 and September 1, 2012 (299 050 hospitalizations, with 916 hospitalizations followed within 12 months by suicides) and tested in the hospitalizations from September 2, 2012, to December 31, 2013 (149 738 hospitalizations, with 393 hospitalizations followed within 12 months by suicides). Validation focused on net benefit across a range of plausible decision thresholds. Predictor importance was assessed with Shapley additive explanations (SHAP) values. Data were analyzed from January to August 2022. Main Outcomes and Measures: Suicides were defined by the National Death Index. Base model predictors included VHA electronic health records and patient residential data. The expanded predictors came from natural language processing (NLP) of clinical notes and a social determinants of health (SDOH) public records database. Results: The model included 448 788 unique hospitalizations. Net benefit over risk horizons between 3 and 12 months was generally highest for the model that included both NLP and SDOH predictors (area under the receiver operating characteristic curve range, 0.747-0.780; area under the precision recall curve relative to the suicide rate range, 3.87-5.75). NLP and SDOH predictors also had the highest predictor class-level SHAP values (proportional SHAP = 64.0% and 49.3%, respectively), although the single highest positive variable-level SHAP value was for a count of medications classified by the US Food and Drug Administration as increasing suicide risk prescribed the year before hospitalization (proportional SHAP = 15.0%). Conclusions and Relevance: In this study, clinical notes and public records were found to improve ML model prediction of suicide after psychiatric hospitalization. The model had positive net benefit over 3-month to 12-month risk horizons for plausible decision thresholds. Although caution is needed in inferring causality based on predictor importance, several key predictors have potential intervention implications that should be investigated in future studies.

Evaluating resilience in response to COVID-19 pandemic stressors among veteran mental health outpatients.

There is a public health need to understand mental health vulnerabilities to COVID-19 pandemic-related stressors and promote resilience among high-risk populations with preexisting psychiatric conditions. Recent cross-sectional studies suggest increases in mental health distress (e.g., depression and anxiety) during the pandemic. The present study expands upon these emerging findings using longitudinal latent modeling and hierarchical linear regressions. Consistent with the developmental psychopathology literature on resilience, we distinguished between promotive or risk (i.e., main effect), and protective or vulnerability (i.e., moderation) effects on mental health during the pandemic. At a large medical center, 398 veterans receiving outpatient mental health care provided prepandemic (Time 1) and during pandemic (Time 2) assessments of mental and physical health-related distress. Additional Time 2 questionnaires assessed pandemic-related stressors and positive behavioral adaptations in the summer of 2020. As expected, total stressor scores predicted longitudinal worsening of self-reported mental (ß = -.205) and physical health (ß = -.217). Positive behavioral adaptations enacted during the pandemic moderated and protected against stressor effects on mental health (ß = .160). In addition, the presence of substance use disorders moderated and conferred vulnerability to stressor effects on physical health (ß = -.158). Thus, higher COVID-19 pandemic stressor exposure may have exacerbated mental and physical health distress among veterans with common forms of psychopathology. Nevertheless, behavioral activation, purposeful maintenance of social connections, and focused treatment for substance misuse may be important intervention targets for reducing the longitudinal impact of pandemic stressors and enhancing resilience among people with mental illness. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Modeling of occupational safety and health factors in production organizations and the formation of measuring scales of occupational safety climate.

This article explores the impact of the main occupational safety and health (OSH) factors in the overall OSH climate of production organizations in the territory of the Republic of Serbia, South Serbia, as an important segment of their strategic development. The article aims to validate and test the proposed conceptual model of OSH. Hence, the SmartPLS methodology was applied. Statistical analysis was performed using SPSS version 21.0. The hypothesized model was developed and tested on a sample of 871 participants employed in production companies. The results indicate that the development of an OSH climate in production organizations primarily depends on the commitment of the management to the OSH system. The results obtained indicate that the methods used in this research can be successfully used in order to identify the OSH factors in the work process, and thus to manage the quality of the work environment.

The relationship between ethical leadership, organizational commitment and Zero Accident Vision implementation in the defense industry.

The main aim of this research was to measure workers' perceptions of the four crucial success factors (commitment to safety, safety communication, the safety climate and learning from incidents) for Zero Accident Vision (ZAV) implementation by conducting a survey using a questionnaire given to four production plants in the Serbian military industrial complex. Almost 500 respondents participated in this survey with a response rate of over 90%. A possible influence of ethical leadership at work (ELW) and organizational commitment (OC) on ZAV enforcement was also examined. The reliability and validity of all of the measuring instruments were found to be acceptable. ELW was found to have a strong influence on ZAV implementation, whereas OC was found to have the mediating role in this relationship.

Multicriteria ranking of the influential factors of safety as criteria for development of the occupational safety and health climate.

The research in this article aimed at determining the importance of occupational safety and health (OSH) factors at work as criteria for development of the OSH climate. Based on the views of 28 responsible persons of the OSH management system, the significance of the criteria was determined using the rough step-wise weight assessment ratio analysis method. The obtained results show that development of the OSH climate in organizations primarily depends on the factors of the work environment and the commitment of the management to the OSH system. The results also point out that education of employees in the field of safety at work has a significant impact. A comparison of the obtained results was made in the sensitivity analysis using the full consistency method. The specific dimensions of the safety climate at work were determined and ranking of the OSH factors was performed.

Exploring the Relationship of Transdiagnostic Mood and Psychosis Symptom Domains with Motor Dysfunction.

BACKGROUND: A number of motor abnormalities have been reported in psychotic disorders, including dyskinesia and psychomotor slowing. There is also evidence for many of the same motor abnormalities in biological first-degree relatives and accruing evidence for motor abnormalities in bipolar disorder. In addition to motor dysfunction, there are also shared symptom domains amongst these populations. OBJECTIVES: We explored the associations of (1) current and lifetime psychosis and mood symptom domains and (2) domains of psychosis proneness with various domains of motor function in a transdiagnostic sample (n = 149). METHOD: Individuals with schizophrenia, schizoaffective disorder, or bipolar disorder, biological first-degree relatives of individuals with a psychotic disorder, and controls completed measures of psychomotor speed and movement fluidity, and neural activity related to motor preparation (stimulus-locked lateralized readiness potential, S-LRP) and execution (response-locked LRP) was assessed using EEG. All participants completed the Brief Psychiatric Rating Scale; patients were additionally assessed for lifetime psychosis and mood episode symptoms, and relatives and controls completed the Chapman psychosis proneness scales. RESULTS: Multiple regression revealed levels of current negative symptoms and mania were significantly positively associated with psychomotor slowing even after accounting for current antipsychotic medication dosage and duration of illness. S-LRP onset latency was significantly positively associated with magical ideation. CONCLUSION: Domains of motor function are associated with various mood and psychosis symptom domains in a transdiagnostic sample, which may provide insight into brain abnormalities relevant to the expression of symptoms across disorders.

Personality and the Expression of Symptomatology in Schizophrenia and Bipolar Disorder.

Researchers and clinicians have begun using dimensions rather than categories to classify psychopathology with a reliance on personality questionnaires to tap traits that can inform dimensional characterizations. A neglected concern is whether in severe psychopathology questionnaire-based assessments of personality reflect a lifetime propensity toward a diagnosis, as some personality-psychopathology models posit, or reflect the transient effects of current symptoms, as a complication model of personality-psychopathology would suggest. Accurate characterization of psychopathology is necessary to understand etiology and prescribe clinical care. We studied 127 adults with schizophrenia, schizoaffective, or bipolar disorder who completed well-validated measures of personality, current symptomatology, and lifetime psychopathology. We found that normative personality traits were related to current symptoms but unrelated to lifetime symptomatology, whereas the schizotypal trait of cognitive-perceptual distortions predicted lifetime psychosis severity. Questionnaire-based assessments of normative personality are likely affected by current symptom states and may fail to yield a stable characterization of psychopathology.

Neurophysiological correlates of cognitive control and approach motivation abnormalities in adolescent bipolar disorders.

Hypersensitivity to reward-relevant stimuli is theorized to be a core etiological factor in bipolar disorders (BDs). However, little is known about the role of cognitive control dysregulation within reward contexts in BDs, particularly during adolescence. Using electroencephalography (EEG), we explored alterations in cognitive control processes and approach motivation in 99 adolescents with (n=53) and without (n=46) BD during reward striving (target anticipation) and reward attainment (feedback) phases of a monetary incentive delay (MID) task. Time-frequency analysis yielded frontal theta and frontal alpha asymmetry as indices of cognitive control and approach motivation, respectively. Multilevel mixed models examined group differences, as well as age, sex, and other effects, on frontal theta and frontal alpha asymmetry during both phases of the task and on performance accuracy and reaction times. Healthy adolescent girls exhibited lower frontal theta than both adolescent girls with BD and adolescent boys with and without BD during reward anticipation and feedback. Across groups, adolescent boys displayed greater relative left frontal alpha activity than adolescent girls during reward anticipation and feedback. Behaviorally, adolescents with BD exhibited faster responses on both positively and negatively motivated trials versus neutral trials, whereas healthy adolescents had faster responses only on positively motivated trials; adolescents with BD were less accurate in responding to neutral trials compared to healthy controls. These findings shed light on normative and BD-specific involvement of approach motivation and cognitive control during different stages of reward processing in adolescence and, further, provide evidence of adolescent sex differences in these processes.

Steeper aging-related declines in cognitive control processes among adults with bipolar disorders.

BACKGROUND: Little is known about the specificity of executive functioning (EF) decline in older adults with bipolar disorders (OABD), or the impact of bipolar disorders (BD) on the timing and slope of age-related declines in EF processes implicated in both BD etiology and normative aging-cognitive control (CC). This cross-sectional study investigated age-related CC decline in BD. METHODS: Participants were 43 adults with BD (M age = 61.5, SD = 15.8; 86% male) and 45 Controls (M age = 65.2, SD = 12.2; 98% male). Two-way ANOVAs examined the effects of median-age-split and diagnostic groups on cognitive processes with established BD deficits-CC processes (mental flexibility and response inhibition), verbal learning, and verbal fluency. RESULTS: The median-split-age-by-diagnostic-group interaction was significant for mental flexibility; OABD performed significantly worse than younger adults with BD and younger and older Controls. Exploratory multivariate adaptive regression spline characterized non-linear nature of aging-slope changes in mental flexibility for each diagnostic group, yielding an inflection point at older age and steeper subsequent decline in OABD versus Controls. LIMITATIONS: This study is limited by a small sample (particularly for select neuropsychological measures) of mostly Caucasian men and BD diagnoses based on clinical interview and medical records review. CONCLUSIONS: Compared to healthy older adults, OABD showed steeper age-related decline in mental flexibility-select EF processes that depend on the integrity of the CC system. Preliminary evidence links CC integrity to daily functioning in OABD; accelerated aging decline in CC may pose a mechanism for high risk of functional impairment and dementia in OABD.

Probabilistic reinforcement learning abnormalities and their correlates in adolescent bipolar disorders.

Theoretical models of bipolar disorders (BD) posit core deficits in reward system function. However, specifying which among the multiple reward system's neurobehavioral processes are abnormal in BD is necessary to develop appropriately targeted interventions. Research on probabilistic-reinforcement learning deficits in BD is limited, particularly during adolescence, a period of significant neurodevelopmental changes in the reward system. The present study investigated probabilistic-reinforcement learning, using a probabilistic selection task (PST), and its correlates, using self-reported reward/threat sensitivities and cognitive tasks, in 104 adolescents with and without BD. Compared with healthy peers, adolescents with BD were less likely to persist with their choices based on prior positive feedback (i.e., lower win-stay rates) in the PST's acquisition phase. Across groups, a greater win-stay rate appeared to be a more efficient learning strategy-associated with fewer acquisition trials and better testing phase performance. Win-stay rates were also related to verbal learning indices, but not self-reported reward/threat sensitivities. Finally, lower win-stay rates had significant incremental validity in predicting a BD diagnosis, after accounting for effects of current symptoms, reward sensitivities, verbal learning, and IQ. The present findings support multiple dysfunctional processes of the reward system in adolescent BD that require additional examinations. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Longitudinal changes in cognition in young adult cannabis users.

INTRODUCTION: Adolescent cannabis use (CU) is associated with impaired attention, executive function, and verbal learning/memory. These associations are generally observed in cross-sectional studies. Longitudinal studies of cannabis users are lacking. METHOD: The present study examines associations between CU and cognition over time in chronic daily adolescent-onset CUs, as compared to nonusing controls. Both groups completed a neuropsychological battery at study intake and again 2 years later. RESULTS: Baseline group differences have been published and indicated deficits in verbal learning and memory, motivated decision-making, planning, and working memory in CUs. In this follow-up report, the longitudinal performance of users is compared to that of sustained nonusers using the same battery. At follow-up, the majority of CUs continued to report regular and heavy cannabis use. Relative impairments in the domains of working memory, planning and verbal memory remained stable, suggesting that these are enduring vulnerabilities associated with continued CU during young adulthood. Improvements in motivated decision-making were evident in both groups. In addition, CUs demonstrated relatively better performance on short-duration speeded tasks. An earlier age of CU onset was associated with poorer verbal learning and memory and planning performance over time. CONCLUSIONS: Verbal learning and memory and planning processes, as well as their neural correlates, merit further scrutiny within etiological models of cannabis-induced cognitive impairments.

Personality disorder symptom severity predicts onset of mood episodes and conversion to bipolar I disorder in individuals with bipolar spectrum disorder.

Although personality disorders (PDs) are highly comorbid with bipolar spectrum disorders (BSDs), little longitudinal research has been conducted to examine the prospective impact of PD symptoms on the course of BSDs. The aim of this study is to examine whether PD symptom severity predicts shorter time to onset of bipolar mood episodes and conversion to bipolar I disorder over time among individuals with less severe BSDs. Participants (n = 166) with bipolar II disorder, cyclothymia, or bipolar disorder not otherwise specified completed diagnostic interview assessments of PD symptoms and self-report measures of mood symptoms at baseline. They were followed prospectively with diagnostic interviews every 4 months for an average of 3.02 years. Cox proportional hazard regression analyses indicated that overall PD symptom severity significantly predicted shorter time to onset of hypomanic (hazard ratio [HR] = 1.42; p < .001) and major depressive episodes (HR = 1.51; p < .001) and conversion to bipolar I disorder (HR = 2.51; p < .001), after controlling for mood symptoms. Results also suggested that cluster B severity predicted shorter time to onset of hypomanic episodes (HR = 1.38; p = .002) and major depressive episodes (HR = 1.35; p = .01) and conversion to bipolar I disorder (HR = 2.77; p < .001), whereas cluster C severity (HR = 1.56; p < .001) predicted shorter time to onset of major depressive episodes. These results support predisposition models in suggesting that PD symptoms may act as a risk factor for a more severe course of BSDs. (PsycINFO Database Record

Age associations with neural processing of reward anticipation in adolescents with bipolar disorders.

Reward/behavioral approach system hypersensitivity is implicated in bipolar disorders (BD) and in normative development during adolescence. Pediatric onset of BD is associated with a more severe illness course. However, little is known about neural processing of rewards in adolescents with BD or developmental (i.e., age) associations with activation of these neural systems. The present study aims to address this knowledge gap. The present sample included 21 adolescents with BD and 26 healthy adolescents, ages 13 to 19. Participants completed a functional magnetic resonance imaging (fMRI) protocol using the Monetary Incentive Delay (MID) task. Behavioral performance was similar between groups. Group differences in BOLD activation during target anticipation and feedback anticipation periods of the task were examined using whole-brain analyses, as were group differences in age effects. During both target anticipation and feedback anticipation, adolescents with BD, compared to adolescents without psychopathology, exhibited decreased engagement of frontal regions involved in cognitive control (i.e., dorsolateral prefrontal cortex). Healthy adolescents exhibited age-related decreases, while adolescents with BD exhibited age-related increases, in activity of other cognitive control frontal areas (i.e., right inferior frontal gyrus), suggesting altered development in the BD group. Longitudinal research is needed to examine potentially abnormal development of cognitive control during reward pursuit in adolescent BD and whether early therapeutic interventions can prevent these potential deviations from normative development.

Multicriteria ranking of workplaces regarding working conditions in a mining company.

Ranking of workplaces with respect to working conditions is very significant for each company. It indicates the positions where employees are most exposed to adverse effects resulting from the working environment, which endangers their health. This article presents the results obtained for 12 different production workplaces in the copper mining and smelting complex RTB Bor - 'Veliki Krivelj' open pit, based on six parameters measured regularly which defined the following working environment conditions: air temperature, light, noise, dustiness, chemical hazards and vibrations. The ranking of workplaces has been performed by PROMETHEE/GAIA. Additional optimization of workplaces is done by PROMETHEE V with the given limits related to maximum permitted values for working environment parameters. The obtained results indicate that the most difficult workplace is on the excavation location (excavator operator). This method can be successfully used for solving similar kinds of problems, in order to improve working conditions.

Associations of age with reward delay discounting and response inhibition in adolescents with bipolar disorders.

OBJECTIVES: Bipolar disorders' (BD) onset before age 18 is a potential marker for a more severe illness course. Adolescence is also a period of significant normative maturation of inhibitory control and reward-relevant decision-making processes, such as decreased delay discounting (i.e., decreased preference for smaller, immediate versus larger, delayed rewards). Adults with BD exhibit elevated delay discounting rates. Very little is known about developmental changes in delay discounting in adolescents with BD, or about associations between inhibitory control and delay discounting in BD. The present study addresses these questions. METHODS: The sample included 78 participants, ages 13 to 23, with BD or without history of mental illness. Group differences and group by age interaction effects on delay discounting (32 BD, 32 controls with valid responses), probability discounting (34 BD, 37 controls) and inhibitory control indices (34 BD, 38 controls) were assessed. RESULTS: Among healthy controls, less discounting of delayed rewards was associated with older age, whereas adolescents with BD did not show age-related associations. There were no group differences in probability discounting or inhibitory control. LIMITATIONS: The cross-sectional nature of the study cannot fully rule out the less likely interpretation of group differences in cohort effects. CONCLUSIONS: The lack of age-related improvement in delay tolerance in BD suggests disrupted development of executive control processes within reward contexts, which in turn may contribute to understanding more severe course of pediatric onset BD. Longitudinal studies are needed to examine delay discounting in relation to maturation of neural reward systems among adolescents with BD.

Effects of reward sensitivity and regional brain volumes on substance use initiation in adolescence.

This longitudinal study examines associations between baseline individual differences and developmental changes in reward [i.e. behavioral approach system (BAS)] sensitivity and relevant brain structures' volumes to prospective substance use initiation during adolescence. A community sample of adolescents ages 15-18 with no prior substance use was assessed for substance use initiation (i.e. initiation of regular alcohol use and/or any use of other substances) during a 2-year follow-up period and for alcohol use frequency in the last year of the follow-up. Longitudinal 'increases' in BAS sensitivity were associated with substance use initiation and increased alcohol use frequency during the follow-up. Moreover, adolescents with smaller left nucleus accumbens at baseline were more likely to initiate substance use during the follow-up period. This study provides support for the link between developmental increases in reward sensitivity and substance use initiation in adolescence. The study also emphasizes the potential importance of individual differences in volumes of subcortical regions and their structural development for substance use initiation during adolescence.

Pubertal status associations with reward and threat sensitivities and subcortical brain volumes during adolescence.

Adolescence is characterized by complex developmental processes that impact behavior, biology, and social functioning. Two such adolescence-specific processes are puberty and increases in reward sensitivity. Relations between these processes are poorly understood. The present study focused on examining unique effects of puberty, age, and sex on reward and threat sensitivities and volumes of subcortical brain structures relevant for reward/threat processing in a healthy sample of 9-18year-olds. Unlike age, pubertal status had a significant unique positive relationship with reward sensitivity. In addition, there was a trend for adolescent females to exhibit higher threat sensitivity with more advanced pubertal development and higher reward and threat sensitivity with older age. Similarly, there were significant puberty by sex interaction effects on striatal volumes, i.e., left nucleus accumbens and right pallidum. The present pattern of results suggests that pubertal development, independent of chronological age, is uniquely associated with reward hypersensitivity and with structural differences in striatal regions implicated in reward processing.