Structural empowerment is a strong predictor of organizational commitment in nurses: A systematic review and meta-analysis.

AIMS: The aim of this systematic review and meta-analysis is to explore the relationship between structural empowerment and organizational commitment and to examine a theoretical model under which empowerment could potentially affect organizational performance. DESIGN: PRISMA guidelines for systematic reviews and meta-analyses were used and quality assessment of articles was performed. DATA SOURCES: Electronic database searches were conducted in Google Scholar, PubMed/Medline, CINAHL, Scopus, and EMBASE from January 1950-1 January 2019, which resulted in 204 retrieved studies, published between 1994-2018. REVIEW METHODS: A random effects model was used to produce a pooled estimate of effect sizes (correlation coefficient, Cronbach's alpha), with analysis of heterogeneity and publication bias. A meta-analytic structural equation model of the constructs analysed was also performed. RESULTS: The final review included 22 studies. The meta-analytic means of structural empowerment, organizational commitment, job satisfaction, and psychological empowerment alpha reliabilities were 0.87, 0.84, 0.85, and 0.87, respectively. Heterogeneity but no publication bias was present in these outcomes. Structural empowerment was strongly correlated with organizational commitment (r = 0.43). The meta-analytic correlation coefficients of organizational commitment with psychological empowerment and job satisfaction were 0.53 and 0.47, respectively. Structural empowerment was correlated with job satisfaction and psychological empowerment with correlation coefficients of 0.57 and 0.44, respectively. Finally, job satisfaction was correlated with psychological empowerment with a correlation coefficient of 0.53. A meta-analytic structural equation model was tested with good fit which predicted performance (commitment and job satisfaction) from empowerment (structural and psychological). CONCLUSION: Structural empowerment is strongly correlated to organizational commitment and with psychological empowerment, they increase organizational performance. Organizations should attempt to make structural empowerment as widespread as possible to create an effective workplace culture. IMPACT: Structural empowerment in nurses is important to help deliver an effective workplace culture where nurses can be committed and have reduced intention-to-leave. Structural empowerment was strongly correlated with organizational commitment. Organizational commitment was significantly correlated with psychological empowerment and job satisfaction. Structural empowerment was correlated with job satisfaction and psychological empowerment as well. A meta-analytic structural equation model with good fit predicted performance. These results will affect nursing researchers and practitioners. Results indicate a need for organizational restructuring that promotes empowerment and formation of theoretical models that connect empowerment to performance.

George Higoumenakis (1895-1983): Greek dermatologist.

This paper describes the Higoumenakis sign, enlargement of the sternal end of the clavicle in patients with late congenital syphilis and the dermatologist after whom it is named. Several professors and doctors from the Medical School of the University of Athens opposed his actions especially at the University in Greece. His persistence led him to productive scientific activity in syphilis, leishmaniasis and psoriasis. He became a member of the Greek Parliament from 1964 to 1967 and eventually Minister of Hygiene - even though this may have been an imprudent political choice, due to the unstable socio-political status of that period. He died on 27 December 1983 at the age of 88.

What about clonidine for diarrhoea? A systematic review and meta-analysis of its effect in humans.

BACKGROUND: Clonidine is considered an alternative treatment for refractory diarrhoea. The evidence in the literature is scarce and not conclusive. The present paper's purpose is to gather available evidence and provide a systematic answer regarding the effectiveness of clonidine for diarrhoea. METHOD: We performed a systematic review of clonidine and its effect on diarrhoea. Meta-analysis was performed with a random effects model of the standardized mean difference (SMD) or the weighted mean difference and heterogeneity was quantified with I (2) and publication bias was assessed with Egger's and Begg's test. Subgroup analyses and meta-regression were performed to investigate sources of heterogeneity. Any empirical study describing use of clonidine for diarrhoea in humans independent of age was included. For the meta-analysis, papers had to provide sufficient data to produce an effect measure, while case reports were not included in the meta-analysis and are discussed narratively only. RESULTS: A total of 24 trials and seven case reports were identified. Clonidine (median dose 300 µg/day) has been used for treatment of diarrhoea in irritable bowel syndrome, faecal incontinence, diabetes, withdrawal-associated diarrhoea, intestinal failure, neuroendocrine tumours and cholera; studies were also performed on healthy volunteers. Results indicate a strong effect of clonidine on diarrhoea (SMD = -1.02, 95% confidence interval [CI] -1.46 to -0.58) with a decrease of stool volume by 0.97 l/day, stool frequency by 0.4 times/day and increase in transit time by 31 minutes. In a sensitivity analysis of studies with functional diarrhoea and sample size over 10 subjects, the effect was similar -0.99 (95% CI -1.54 to -0.43). There is however significant heterogeneity and publication bias. Heterogeneity decreased in subgroup analyses by condition but not with other factors examined. A limitation of the present study includes small study effects. CONCLUSION: Clonidine is effective for treatment of diarrhoea and should be considered as an alternative when all other medications have failed.

Publication Bias in Meta-Analysis: Confidence Intervals for Rosenthal's Fail-Safe Number.

The purpose of the present paper is to assess the efficacy of confidence intervals for Rosenthal's fail-safe number. Although Rosenthal's estimator is highly used by researchers, its statistical properties are largely unexplored. First of all, we developed statistical theory which allowed us to produce confidence intervals for Rosenthal's fail-safe number. This was produced by discerning whether the number of studies analysed in a meta-analysis is fixed or random. Each case produces different variance estimators. For a given number of studies and a given distribution, we provided five variance estimators. Confidence intervals are examined with a normal approximation and a nonparametric bootstrap. The accuracy of the different confidence interval estimates was then tested by methods of simulation under different distributional assumptions. The half normal distribution variance estimator has the best probability coverage. Finally, we provide a table of lower confidence intervals for Rosenthal's estimator.

Assessing eating disorder risk: the pivotal role of achievement anxiety, depression and female gender in non-clinical samples.

The objective of the present study was to assess factors predicting eating disorder risk in a sample of undergraduate students. A structured questionnaire was employed on a random sample (n = 1865) consisting of the following sections: demographics, SCOFF (Sick, Control, One stone, Fat, Food) questionnaire for screening eating disorders and the Achievement Anxiety Test and the Depression, Anxiety and Stress Scale. The students at risk for eating disorders (SCOFF score ≥2) were 39.7%. Eating disorder risk was more frequent in females, students with divorced parents, students who lived alone, students who were seeking a romantic relationship or were married, students who were at a post-secondary vocational institute/college (private-public) educational level and who were more likely to have marks under merit level. Also, the mean scores for the psychological factors of depression, stress and anxiety were higher in students with eating disorder risk. A logistic regression model was produced depicting that depression, stress, female gender, being married and searching for a romantic relationship were risk factors of having an eating disorder risk. The suggested psychological model examined with structural equation modelling signified the role of academic anxiety as an immediate precursor of general anxiety. Hence, college populations in Greece need organized infrastructures of nutrition health services and campaigns to assist in reducing the risk of eating disorders.

Higoumenakis' sign in the diagnosis of congenital syphilis in anthropological specimens.

Higoumenakis' sign (HS) is a diagnostic criterion referring to the enlargement of the sternal end of the (right) clavicle, frequently observed in patients with late congenital syphilis. Although indexed for several years in clinical medicine textbooks, it has not been extensively applied for the diagnosis of congenital syphilis among anthropological specimens. This is highly significant, since the other major palaeopathology findings refer almost exclusively to the skull and diagnosis thus becomes difficult if only peripheral skeletal remains are available for evaluation. The potential effectiveness of the proposed use of HS as a marker of syphilis in anthropology appears adequate, since descriptions very similar to that of HS have been reported for certain findings, although no attempt has been made to correlate them with the presence of the disease. Higoumenakis himself originally observed this sign in 86% of his patients with congenital syphilis, and this report was subsequently verified by other independent researchers. His attempt to explain the pathophysiology of the sign and its localisation, on the basis of anatomical, biological, and mechanical reasons, however, has been questioned. On the other hand, the application of the remaining markers of congenital syphilis is also problematic, due to sensitivity and/or specificity limitations, and other signs may not be detected due to inability to retain soft tissue samples in anthropological populations and a lack of reliable techniques for treponematous DNA amplification in such old samples. Thus, the fact that the onset of any of the signs of syphilis is not a constant finding justifies the authors' suggestion that HS should be checked for in any available anthropological specimen, because it is highly indicative of possible infection by Treponema pallidum.

Problematic Internet Use among Greek university students: an ordinal logistic regression with risk factors of negative psychological beliefs, pornographic sites, and online games.

The aim of this paper is to investigate the relationships between Problematic Internet Use (PIU) among university students in Greece and factors such as gender, age, family condition, academic performance in the last semester of their studies, enrollment in unemployment programs, amount of Internet use per week (in general and per application), additional personal habits or dependencies (number of coffees, alcoholic drinks drunk per day, taking substances, cigarettes smoked per day), and negative psychological beliefs. Data were gathered from 2,358 university students from across Greece. The prevalence of PIU was 34.7% in our sample, and PIU was significantly associated with gender, parental family status, grade of studies during the previous semester, staying or not with parents, enrollment of the student in an unemployment program, and whether the student paid a subscription to the Internet (p < 0.0001). On average, problematic Internet users use MSN, forums, YouTube, pornographic sites, chat rooms, advertisement sites, Google, Yahoo!, their e-mail, ftp, games, and blogs more than non-problematic Internet users. PIU was also associated with other potential addictive personal habits of smoking, drinking alcohol or coffee, and taking drugs. Significant risk factors for PIU were being male, enrolment in unemployment programs, presence of negative beliefs, visiting pornographic sites, and playing online games. Thus PIU is prevalent among Greek university students and attention should be given to it by health officials.