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AIMS: This study aims to explore the association between the implementation of the adverse event reporting system (AERS), burnout, and job satisfaction among psychiatric nurses, with a focus on examining the mediating effect of workplace violence from patients. BACKGROUND: Many organizational and personal factors contribute to burnout and job satisfaction experienced by nurses. AERS, serving as a key component of organizational-level quality improvement system, impacts the overall workplace wellness of nurses. METHODS: A national sample of 9,744 psychiatric nurses from 41 psychiatric hospitals across 29 provinces in China participated. Burnout was measured by the Maslach Burnout Inventory. Job satisfaction was measured using the Minnesota Satisfaction Questionnaire. Workplace violence was assessed by nurses' experience of verbal and physical violence. Multilevel linear regression analyses were carried out to examine if AERS impacts burnout and job satisfaction and to identify the mediating role of workplace violence. RESULTS: AERS was positively associated with job satisfaction, but negatively with burnout and workplace violence. Workplace violence exhibited a positive association with burnout and a negative association with job satisfaction. Mediation analyses indicated that the associations between AERS, burnout, and job satisfaction were mediated by workplace violence. CONCLUSIONS: The application of AERS is associated with a reduction in workplace violence in hospitals, which contributes to the diminished burnout and heightened job satisfaction among psychiatric nurses. IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICY: The study highlights the importance of organizational efforts and mechanisms in promoting nurses' well-being. It is necessary for hospital management to create a safe workplace through the implementation of AERS.
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BACKGROUND: Exploring factors that may influence general practitioners (GPs)' intentions to remain in rural area is necessary to inform the training and placement of future medical workforce in rural area. However, little is known about how GPs' perception towards the National Compulsory Service Programme (NCSP) and job satisfaction impact their turnover intention. This paper explores GPs' intentions to remain in rural China and how their policy perception and job satisfaction predict the intentions. METHODS: We conducted a cross-sectional, online survey from December 2021 to February 2022 to investigate GPs' perception towards NCSP, job satisfaction, and intentions to remain in rural area. Eligible participants were GPs who were required to provide health services as part of NCSP at township health centres of 9 provinces which could represent all NCSP GPs in China. Multinomial logistic regression analyses were performed to explore the associations between policy perceptions, job satisfaction, and intentions to remain. RESULTS: Of 3615 GPs included in the analysis, 442 (12.2%) would like to remain in rural area and 1266 (35.0%) were unsure. Results of the multinomial logistic regression analyses showed that compared with GPs who would leave, GPs with higher perception scores for the restriction on taking postgraduate exam (RRR: 1.93, 95% CI 1.72, 2.16) and the commitment to work for six years (RRR: 1.53, 95% CI 1.31, 1.78) were more likely to remain. In contrast, GPs who had higher perception scores for completing standardised residency training (RRR: 0.75, 95% CI 0.64, 0.88) and passing National Medical Licensing Examinations (RRR: 0.74, 95% CI 0.62, 0.87) were more likely to leave. GPs who were satisfied with the freedom of choosing work methods (RRR: 1.52, 95% CI 1.25, 1.84) and chances of promotion (RRR: 1.60, 95% CI 1.32, 1.94) were more likely to remain. CONCLUSIONS: This study highlights the significance of policy perception and job satisfaction on GPs' intentions to remain in rural area. Factors such as career advancement and the empowerment of GPs to build on and use their skills and abilities should be taken into account when designing rural placement programmes.
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Clínicos Gerais , Intenção , Satisfação no Emprego , Serviços de Saúde Rural , China , Humanos , Estudos Transversais , Masculino , Feminino , Adulto , Clínicos Gerais/psicologia , Clínicos Gerais/estatística & dados numéricos , Pessoa de Meia-Idade , Serviços de Saúde Rural/estatística & dados numéricos , Atitude do Pessoal de Saúde , Reorganização de Recursos Humanos/estatística & dados numéricos , Política de SaúdeRESUMO
BACKGROUND: Medical error (ME) is a serious public health problem and a leading cause of death. The reported adverse incidents in China were much less than western countries, and the research on patient safety in rural China's primary care institutions was scarce. This study aims to identify the factors contributing to the under-reporting of ME among general practitioners in township health centres (THCs). METHODS: A qualitative semi-structured interview study was conducted with 31 general practitioners working in 30 THCs across 6 provinces. Thematic analysis was conducted using a grounded theory approach. RESULTS: The understanding of ME was not unified, from only mild consequence to only almost equivalent to medical malpractice. Common coping strategies for THCs after ME occurs included concealing and punishment. None of the participants reported adverse events through the National Clinical Improvement System website since they worked in THCs. Discussions about ME always focused on physicians rather than the system. CONCLUSIONS: The low reported incidence of ME could be explained by unclear concept, unawareness and blame culture. It is imperative to provide supportive environment, patient safety training and good examples of error-based improvements to rural primary care institutions so that ME could be fully discussed, and systemic factors of ME could be recognised and improved there in the future.
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Clínicos Gerais , Humanos , Pesquisa Qualitativa , Erros Médicos , Segurança do Paciente , ChinaRESUMO
INTRODUCTION: It has been acknowledged in China that actions should be taken immediately to ease the critical shortage of psychiatric nurses. However, with national data lacking, little is known about nurses' mental health status. AIM: To evaluate psychiatric nurses' mental health status by measuring their burnout, depression, anxiety and stress. METHODS: All psychiatric nurses in the 41 selected hospitals in China were invited to participate in the survey. The Maslach Burnout Inventory-Human Service Survey and Depression Anxiety Stress Scale were used to assess variables of interest. RESULTS: 38.6% of psychiatric nurses met the criteria for burnout. The rates of depression, anxiety and stress were 26.3%, 36.4% and 12.5%, respectively. It was found that workplace region, educational level, working years, longer working hours and night shifts were associated with risk of burnout and DASS. CONCLUSIONS: More than a quarter of psychiatric nurses are suffering from burnout, depression or anxiety in China. Policymakers and hospital administrators should design a flexible schedule and restrict working hours for psychiatric nurses to achieve work-life balance. IMPLICATIONS FOR PRACTICE: The study informs policymakers and administrators on addressing the nursing shortage by identifying nurses immersed in negative emotions and preventing mental health problems.
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Esgotamento Profissional , Enfermeiras e Enfermeiros , Humanos , Saúde Mental , Satisfação no Emprego , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Inquéritos e Questionários , China/epidemiologia , Nível de SaúdeRESUMO
BACKGROUND: National data on the satisfaction of radiology residents enrolled in standardized residency training (SRT) are rather scarce in China. This study identified a set of potential factors concerning SRT satisfaction among radiology residents as well as the association between SRT satisfaction and post-competency and well-being. METHODS: A total of 3666 radiology residents who were receiving SRT during 2020 in China were recruited across all 31 provinces. The cumulative odds logistic regression was used to examine the potential factors associated with SRT satisfaction as well as associations between satisfaction and well-being, burnout, professional identity and competency. RESULTS: The prevalence of satisfaction with SRT was 68.6%. Participants who were male, worked in central China, aged more than 28 years old, had long working hours and claimed increased workload during the COVID-19 pandemic were more likely to be unsatisfied with the SRT program. Participants who were more satisfied with the radiation protection were more likely to report higher degree of SRT satisfaction (OR = 3.00, 95% CI 2.58-3.50). In addition, SRT satisfaction was positively associated with well-being, professional identity, competency and lower burnout. CONCLUSIONS: Perceived satisfaction can be introduced into hospital management, as it may reflect the overall situation of the residents during residency training and influence radiologists' well-being, professional identification and competency. Appropriate measures should be taken to reduce the risk of radiation exposure, ensure employee safety (such as risk assessment system and paid time off), provide radiology residents with fair treatment and guarantee the time out of working for optimizing their professional ability.
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The rapid advancements in information technology require new information storage and display materials. However, the development of on-demand information storage systems with multiple modes remains a significant challenge. As a pioneering approach, this study designed an integrated visual and haptic information storage and display using a reconfigurable fluorescent liquid crystal elastomer (FLCE) with dynamic covalent bonds. The FLCEs were fabricated in two steps of amine-acrylate aza-Michael addition and photopolymerization, and they simultaneously exhibited phototunable fluorescence caused by the reversible Z/E photoisomerization of the chromophores and a reprogrammable shape owing to the catalyst-free transesterification. In addition, we established various information storage and display modes featuring the characteristics of reversibly photoswitchable fluorescence, shape memory, and thermally reconfigurable shape with a reconfigurable FLCE system. Moreover, a strategy to display the information by incorporating both visual and haptic feedback is implemented for fulfilling the needs of the visually impaired and related users. Such reconfigurable FLCE systems will aid in the development of on-demand information storage, display, and protection devices.
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AIMS: This study aims to investigate the association between stressors, coping strategies and intention to leave the nursing profession among nurses. BACKGROUND: Job stressors and coping strategies are believed to affect turnover intention among nurses, but no large-scale study has been conducted on these associations in China yet. METHOD: A cross-sectional secondary analysis was conducted among 51,406 nurses from 1858 hospitals. Univariable and multivariable logistic regression analyses were carried out, and odds ratios were reported. RESULTS: Overall, 49.58% nurses had an intention to leave the profession. It is found that stress from health condition, family, occupational injuries, nurse-patient tension, high job demands, strict leaders and colleague relationships were significantly associated with higher intention to leave. Coping strategies such as talking to family and friends, talking to leaders, doing outdoor activities, engaging in hobbies and attending on-the-job training were significantly associated with lower intention, but social gathering, psychological counselling and suffering in silence had an opposite effect. CONCLUSIONS: Our study provides new insights into the association between stressors, coping strategies and turnover intention among nurses in China. IMPLICATIONS FOR NURSING MANAGEMENT: Evidence from this study indicates that policies promoting a safe and supportive work environment should be developed to help nurses cope with stress.
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Intenção , Recursos Humanos de Enfermagem Hospitalar , Humanos , Estudos Transversais , Satisfação no Emprego , Recursos Humanos de Enfermagem Hospitalar/psicologia , Adaptação Psicológica , China , Reorganização de Recursos Humanos , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Mental health symptoms are common among health professionals and the influence of lifestyle behaviors on psychiatrists' mental health is insufficiently understood. Based on a nationwide sample, we aimed to survey the lifestyle behaviors and mental health status among psychiatrists, and to identify the co-occurrence and gender differences in lifestyle behaviors. METHODS: Data were collected through an anonymous questionnaire among psychiatrists in China. Depression, Anxiety and Stress Scale - 21 (DASS-21) was used to evaluate mental health symptoms. Latent class analysis (LCA) was used to explore the co-occurrence of lifestyle behaviors. The multivariate logistic regression model was used to examine the effects of demographic and lifestyle factors. RESULTS: 4520 psychiatrists were included in the analysis with 11.5 % of them reporting smoking, 10 % reporting alcohol misuse, 35.2 % reporting physical inactivity, and 23.1 % reporting insomnia. The prevalence of depression, anxiety and stress symptoms were 29.2 %, 34.5 %, and 12.2 %, respectively. Significant gender differences were found in smoking (P < 0.001), alcohol misuse (P < 0.001), and physical inactivity (P < 0.001), but not in insomnia. Based on these four high-risk health behaviors above, three lifestyle behavior clusters with huge gender differences were identified through the LCA. Accordingly, the unhealthy lifestyle classes, though defined differently for males and females, were significantly associated with depression, anxiety, and stress. CONCLUSIONS: The co-occurrence and significant gender differences in multiple lifestyle behaviors exist in this group, highlighting the need for gender-specific comprehensive interventions against mental health symptoms and the urgency of promoting their well-being.
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Alcoolismo , Psiquiatria , Distúrbios do Início e da Manutenção do Sono , China/epidemiologia , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Estilo de Vida , Masculino , Saúde Mental , Fatores SexuaisRESUMO
Background: Workplace violence (WPV) in healthcare has received much attention worldwide. However, scarce data are available on its impact on turnover intention among psychiatrists, and the possible mechanisms between WPV and turnover intention have not been explored in China. Methods: A cross-sectional survey was conducted among psychiatrists in 41 tertiary psychiatric hospitals from 29 provinces and autonomous regions in China. A stress-strain-outcome (SSO) model was adopted to examine the effects of WPV on mental health and turnover intention. The association and mediation by burnout and stress were examined by multivariate logistic regression (MLR) and generalized structure equation modeling (GSEM). Results: We invited 6,986 psychiatrists to participate, and 4,520 completed the survey (64.7% response rate). The prevalence of verbal and physical violence against psychiatrist in China was 78.0 and 30.7%, respectively. MLR analysis showed that psychiatrists who experienced verbal violence (OR = 1.15, 95% CI = 1.10-1.21) and physical violence (OR = 1.15, 95% CI = 1.07-1.24) were more likely to report turnover intention. GSEM analysis showed that burnout (ß = 4.00, p < 0.001) and stress (ß = 1.15, p < 0.001) mediated the association between verbal violence and turnover intention; similarly, burnout (ß = 4.92, p < 0.001) and stress (ß = 1.80, p < 0.001) also mediated the association between physical violence and turnover intention. Conclusions: Experience of WPV is a significant contributor to turnover intention among psychiatrists. Mental health status, such as burnout and stress level significantly mediated the association. Policy makers and hospital administrators need to be aware of this association. Action is needed to promote mental health among the psychiatrists to improve morale and workforce sustainability.
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Surface cracking is a major issue in amino resin-based flame-retardant coatings, which can be reduced by mixing flexible resins into the coatings. In this study, flexible waterborne polyurethane (WPU) was added into a melamine-modified, urea-formaldehyde, resin-based intumescent flame retardant (MUF-IFR) coating. A molecular chain of WPU was inserted into the MUF network and formed a WPU/MUF-semi-IPN structure. The cracking resistance of the coating was gradually enhanced with the increase in WPU content. When the WPU content exceeded 25% of the total resin, there were no cracks in the coatings after crack-resistance tests. The coatings before and after toughening showed good transparency on wood surfaces. The influence of WPU on char formation and flame retardant properties were explored by TGA, SEM, and cone calorimetry. The results showed that the decomposition of WPU occurred before char formation, which decreased the integrity of the coating and damaged the compactness of the char. Therefore, the addition of WPU reduced the expansion height and the barrier capacity of the char as well as the flame retardant properties of the coating. When the amount of WPU was 25% of the total resin, compared to the non-WPU coating, the average heat release rate in 300 s (AveHRR300s) and the total heat release at 300 s (THR300s) of the samples were increased by 45.8% and 35.7%, respectively. However, compared to the naked wood, the peak heat release rate (pHRR1), AveHRR300s, and THR300s of the samples with the coating containing 25% WPU were decreased by 64.2%, 39.0%, and 39.7%, respectively. Therefore, the thermal stability of WPU affected char formation. The amount of WPU added should be chosen to be the amount that was added just before the coating cracked.
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Two light-driven chiral fluorescent molecular switches, (R,S,R)-switch 1 and (R,S,R)-switch 2, are prepared by means of hydrogen-bonded (H-bonded) assembly of a photoresponsive (S) chiral fluorescent molecule, respectively with a cyano substitution at different positions as an H-bond acceptor and an opposite (R) chiral molecule as an H-bond donor. The resulting two switches exhibit tunable and reversible Z/E photoisomerization irradiated with 450â nm blue and 365â nm UV light. When doped into an achiral liquid crystal, both switches are found to be able to form a CPL tunable luminescent helical superstructure. In contrast to the tunable CPL characteristics of the system incorporating switch 2, exposure of the system incorporating switch 1 to 365â nm and 450â nm radiation can lead to controllable different photostationary CPL behavior, including switching-off and polarization inversion. In addition, optical information coding is demonstrated using the system containing switch 1.
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Crop residue burning is one of the major sources of particulate matter (PM) in the air. The burning behaviors and PM emissions of the three typical crop residues (rice straw, wheat straw, corn straw) in China were characterized by a cone calorimeter (CONE) coupled with a laser dust meter. The water-soluble compounds, carbonaceous content, and morphology of PM were measured by ion chromatography, elemental analyzer, transmission electron microscopy (TEM) and energy-dispersive X-ray spectrometer (EDS). The results showed that thermal stability of corn straw was the worst among the three crop straws. The heat release rate (HRR) curves of the three crop straws were the typical curves of thermally thick charring (residue forming) samples. Wheat straw had the highest smoke yield, which was 2.9 times that of rice straw. The PM emission factor of wheat straw was 180.91 µg/g, which was about three times that of rice straw. The contents of K+, Na+, and Cl- in PM were significantly higher than those of the other six water-soluble inorganic ions. The ratio of organic carbon and elemental carbon (OC/EC) ranged from 14.82 to 30.82, which was similar to the results of open burning. There were mainly three kinds of aggregates in the PM of crop straws: network, chain-like, and soot. Individual particles were mixtures of KCl and organic matters. Core-shell structures were found in PM of rice straw and corn straw. The results in this study were provided based on CONE, an ISO-standard apparatus, which could avoid data conflicts caused by the difference of combustion devices. The relationship between the burning behavior and PM emission characteristics of crop straws was established, which is helpful to understand emissions of crop straws and to find a novel way to solve the problems from the burning of crop residues.
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Upconversion-luminescence-induced reflective color switching and fluorescence tuning of a cholesteric liquid crystal (CLC) cells were investigated. The CLC system was constructed by co-doping a chiral fluorescence photoswitch, switch 5, and upconversion nanoparticles (UCNPs) into nematic LC media. Under irradiation with 980 nm NIR light, the UCNPs emit both 450 nm blue light and 365 nm UV light to induce the simultaneous Z-to-E and E-to-Z photoisomerization of switch 5. This continuous rotation-inversion movement further leads to an irreversible photoisomerization and photodissociation of dicyanodistyrylthiophene moieties in switch 5. As a result, the reflective color of the CLC cell changed from blue to red and the fluorescence intensity decreased as well when exposed to 980 nm NIR light. Finally, optically written reflective-photoluminescent dual mode CLC cells were further demonstrated.
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Self-cross-linked aerogel based on pectin and melamine-formaldehyde resin (MF) was fabricated via freeze-drying method using water as solvent, where pectin is structural material meanwhile acting as acid to catalyse the cross-linking of MF. The cross-linking reaction easily occurs without additional additives, which can be significantly accelerated at elevated temperatures, with a critical value of about 55 °C. The obtained aerogel shows network microstructures as observed with SEM. With increasing pectin content, the aerogel shows significantly increased compressive modulus. The compressive modulus of M10Pe5 arrives 23.2 MPa, the specific modulus of which arrives 188 MPa cm3/g, while pure MF aerogel are too fragile to keep intact after freeze-dried. The resulting aerogel has good thermal stability, excellent water resistance (can be second dried with limited strength loss) and low flammability. This partially bio-based novel aerogel with impressive properties is promising in many applications.
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Disposal and recycling of the large scale biomass waste is of great concern. Themochemically converting the waste biomass to functional carbon nanomaterials and bio-oil is an environmentally friendly apporach by reducing greenhouse gas emissions and air pollution caused by open burning. In this work, we reported a scalable, "green" method for the synthesis of the nanofibers/mesoporous carbon composites through pyrolysis of the Fe(III)-preloaded biomass, which is controllable by adjustment of temperature and additive of catalyst. It is found that the coupled catalytic action of both Fe and Cl species is able to effectively catalyze the growth of the carbon nanofibers on the mesoporous carbon and form magnetic nanofibers/mesoporous carbon composites (M-NMCCs). The mechanism for the growth of the nanofibers is proposed as an in situ vapor deposition process, and confirmed by the XRD and SEM results. M-NMCCs can be directly used as electrode materials for electrochemical energy storage without further separation, and exhibit favorable energy storage performance with high EDLC capacitance, good retention capability, and excellent stability and durability (more than 98% capacitance retention after 10,000 cycles). Considering that biomass is a naturally abundant and renewable resource (over billions tons biomass produced every year globally) and pyrolysis is a proven technique, M-NMCCs can be easily produced at large scale and become a sustainable and reliable resource for clean energy storage.
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Biomassa , Técnicas Eletroquímicas/instrumentação , Nanofibras , Nanoestruturas , Carbono/análise , Cloretos/química , Capacitância Elétrica , Compostos Férricos/química , Incineração , Fenômenos Magnéticos , Reciclagem , Eliminação de ResíduosRESUMO
The enhanced electricity generation in a biocathode bio-electrochemical system (BES) with Microcystis aeruginosa IPP as the cathodic microorganism under illumination is investigated. The results show that this cyanobacterium is able to act as a potential cathodic microorganism under illumination. In addition, M. aeruginosa IPP is found to produce reactive oxygen species (ROS) in its growth in the BES. ROS, as more competitive electron acceptors than oxygen, are utilized prior to oxygen. The BES current is substantially reduced when the ROS production is inhibited by mannitol, indicating that the ROS secreted by the cyanobacterium play an important role in the electricity generation of such a biocathode BES. This work demonstrates that the ROS released by cyanobacteria benefit for an enhanced electricity generation of BES.
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Fontes de Energia Bioelétrica/microbiologia , Luz , Microcystis/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Eletrodos , Transporte de Elétrons , Microcystis/efeitos da radiação , Oxigênio/metabolismoRESUMO
One current major hurdle to practical implementation of aerobic granule technology is the frequent occurrence of granule disintegration during long-term operation. However, the mechanism behind this is largely unclear today. Here, 2-decenoic acid, which has been previously demonstrated to be released by Pseudomonas aeruginosa and disperse biofilms, was found to also induce the disintegration of aerobic granules. A comparison of the solution compositions from samples of only trans-2-decenoic acid, only aerobic granules, and granules added with trans-2-decenoic acid shows that bacteria and extracellular polymeric substances (EPS) were stripped from granule surface upon trans-2-decenoic acid dosing. Due to the possible toxicity of trans-2-decenoic acid at a saturation concentration, the disintegrated granules and the milky suspension in the disintegration test showed a significantly lower oxygen uptake rate than the un-integrated granules. This work suggests that trans-2-decenoic acid released by microbes might play a critical role in regulating the disintegration of aerobic granules.
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Biopolímeros/química , Ácidos Graxos Monoinsaturados/química , Esgotos/química , Ar , Coloides/química , Teste de Materiais , ViscosidadeRESUMO
Microbial fuel cells (MFC) provide a new opportunity for simultaneous electricity generation and waste treatment. An improvement in the anode capacity of MFCs is essential for their scale-up and commercialization. In this work we demonstrate, for the first time, that plasma-based ion implantation could be used as an effective approach to modify carbon paper as an anode for MFC to improve its electricity-generating capacity. After the N(+) ion implantation, a decreased charge-transfer resistance is achieved, which is attributed to the increased C-N bonds after N(+) ion implantation. In addition, the surface roughness and hydrophobicity are also changed, which favor microbial adhesion on the anode surface. The cyclic voltammetry results show that both the electrochemical activity and the electron transfer are enhanced remarkably, leading to better MFC performance compared to the control. Such a plasma surface modification technique provides an effective way to modify the electrode for enhancing MFC performance for power generation.
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Fontes de Energia Bioelétrica , Carbono/química , Eletricidade , Técnicas Eletroquímicas , Eletrodos , Papel , Propriedades de SuperfícieRESUMO
In this work, we investigated the anaerobic decolorization of methyl orange (MO), a typical azo dye, by Shewanella oneidensis MR-1, which can use various organic and inorganic substances as its electron acceptor in natural and engineered environments. S. oneidensis MR-1 was found to be able to obtain energy for growth through anaerobic respiration accompanied with dissimilatory azo-reduction of MO. Chemical analysis shows that MO reduction occurred via the cleavage of azo bond. Block of Mtr respiratory pathway, a transmembrane electron transport chain, resulted in a reduction of decolorization rate by 80%, compared to the wild type. Knockout of cymA resulted in a substantial loss of its azo-reduction ability, indicating that CymA is a key c-type cytochrome in the electron transfer chain to MO. Thus, the MtrA-MtrB-MtrC respiratory pathway is proposed to be mainly responsible for the anaerobic decolorization of azo dyes such as MO by S. oneidensis.