Leadership styles' influence on ICU nurses' quality of professional life: A cross-sectional study.

BACKGROUND: Intensive Care Units are emotionally intense environments where professional autonomy and interprofessional collaboration are essential. Nurses are at high risk of burnout, and the level of compassion satisfaction has a deep impact on the quality of their professional life. Although leadership styles and burnout have been the subject of an extensive body of research, there is an existing gap regarding the relationship between leadership strategies and intensive care nurses' quality of working life and the impact on their compassion satisfaction. Specifically, there is a lack of literature in southern European countries concerning the influence of organizational and cultural contexts. AIM: To evaluate the impact of nurse managers' leadership styles on Intensive Care Unit nurses' job satisfaction and compassion satisfaction. DESIGN: A cross-sectional study. METHODS: An online set of validated tests was sent to a non-probabilistic sample of nurses, recruited via the Italian association of intensive care and emergency nursing website. The set of tests consisted of the Empowering Leadership Questionnaire, Compassion Satisfaction Scale, and McCloskey Mueller Satisfaction Scale. Nurses actively working in intensive care and critical care settings were included in this study. ICU managers and leaders were excluded. RESULTS: 308 nurses (response rate 63,2%) completed the questionnaires. Statistical analysis showed that the Leadership dimension of "Showing concern towards the team" had a significant effect on Compassion Satisfaction. In addition, this dimension had an effect on nurses' overall job satisfaction on five out of eight subscales. CONCLUSIONS: Leaders' authentic listening, communication, and participation capabilities have a positive impact on nurses' job and compassion satisfaction. The interest for team well-being, taking time to discuss team concerns, and working closely with the team affects unpredicted factors like working hours, flexibility in shift scheduling, satisfaction about recognition, and career advancement. RELEVANCE TO CLINICAL PRACTICE: Results suggest that nurse managers can draw on/adopt leadership strategies oriented to authentic listening and interaction with the team in order to manage organizational issues, increase nurses' professional quality of life and prevent burnout.

The Uznadze illusion reveals similar effects of relative size on perception and action.

Milner and Goodale (the visual brain in action, Oxford University Press Inc., Oxford, 1995) proposed a functional dissociation between vision-for-action and vision-for-perception (i.e., the "two-visual system hypothesis", TVSH). Supporting the TVSH, it has been claimed that visual illusions affect perception but not actions. However, at least for the Ebbinghaus illusion, numerous studies have revealed consistent illusion effects on grasping. Thus, whether illusions affect actions remains controversial. To further investigate the dissociation predicted by the TVSH, we used a visual version of the Uznadze illusion (the same stimulus will feel smaller after feeling a larger stimulus and larger after feeling a smaller stimulus). Based on kinematic recordings of finger aperture in a motor (precision grip) and a perceptual task (manual estimation), we report two main findings. First, both action and perception are strongly affected by the Uznadze illusion. Second, the illusion decreases similarly in both tasks when inducing-induced pairs had different shape and color, in comparison to the equivalent condition where these features are the same. These results are inconsistent with a perception-action dissociation as predicted by the TVSH and suggest that, at least in the present conditions, vision-for-perception and vision-for-action are similarly affected by contextual cues.

The effect of the Uznadze illusion is temporally dynamic in closed-loop but temporally constant in open-loop grasping.

Although it is known that the availability of visual feedback modulates grasping kinematics, it is unclear whether this extends to both the early and late stages of the movement. We tackled this issue by exposing participants to the Uznadze illusion (a medium stimulus appears larger or smaller after exposure to smaller or larger inducers). After seeing smaller or larger discs, participants grasped a medium disc with (closed-loop [CL]) or without (open-loop [OL]) visual feedback. Our main aim was to assess whether the time course of the illusion from the movement onset up to the grasp differed between OL and CL. Moreover, we compared OL and CL illusory effects on maximum grip aperture (MGA) and tested whether preparation time, movement time, and time to MGA predicted illusion magnitude. Results revealed that CL illusory effects decreased over movement time, whereas OL ones remained constant. At the time of MGA, OL, and CL effects were, however, of similar size. Although OL grasps were longer to prepare and showed earlier and larger MGAs, such differences had little impact on modulating the illusion. These results suggest that the early stage of grasping is sensitive to the Uznadze illusion both under CL and OL conditions, whereas the late phase is sensitive to it only under OL conditions. We discuss these findings within the framework of theoretical models on the functional properties of the dorsal stream for visually guided actions.

Emergent and planned interpersonal synchronization are both sensitive to 'tempo aftereffect contagion'.

Interpersonal synchronization is fundamental for motor coordination during social interactions. Discerning emergent (entrainment) from planned synchronization represents a non-trivial issue in visually bonded individuals acting together, as well as assessing whether inter-individual differences, e.g., in autistic traits, modulate both types of synchronization. In a visuomotor finger-tapping task, two participants replicated a target tempo either synchronizing ('joint' condition) or not ('non-interactive' condition, 'non-int') with each other. One participant was exposed ('induced') to tempo aftereffect (a medium tempo seems faster or slower after exposure to slower or faster inducing tempi), but not the other participant ('not induced'); thus they had different timing perceptions of the same target. We assessed to what degree emergent and/or planned synchronization affected dyads by analyzing inter-tap-intervals, synchronization indexes, and cross-correlation coefficients. Results revealed a 'tempo aftereffect contagion': inter-tap-intervals of both induced and not-induced participants showed aftereffect in both the joint and non-int conditions. Moreover, aftereffects did not correlate across conditions suggesting they might be due to (at least in part) different processes, but the propensity for tempo aftereffect contagion correlated with individuals' autistic traits only in the non-int condition. Finally, participants co-adjusted their tapping more in the joint condition than in the non-int one, as confirmed by higher synchronization indexes and the mutual adaptation pattern of cross-correlation coefficients. Altogether, these results show the subtle interplay between emergent and planned interpersonal synchronization mechanisms that act on a millisecond timescale independently from synching or not with the partner.

The influence of sensorimotor experience on beauty evaluation of preschool children.

Nowadays there is a broad consensus on the role of multimodality in the construction of an embodied aesthetic experience in adults, whereas little is known about the relationship between sensorimotor and aesthetic experience during development. To fill this gap, the present study investigated whether sensorimotor experience with sculpting natural materials (i.e., clay or sand) influences beauty judgments offered to abstract artifacts made by the same materials. Five years old children (n.47) were asked to rate tactile (How smooth is it?), visual (How dark is it?) and beauty (How much do you like it?) proprieties of two artifacts using a visual-analog measurement-tool ad hoc developed to fit children's cognitive skills. Participants rated the artifacts before and after a free-hands manipulation with only one of the two sculpting materials, either sand or clay. Results showed that the greater the sensorimotor interaction experienced with the artifacts, the higher the increment of beauty rating offered to the artifacts made by the same material previously manipulated. No modulations were found for tactile and visual ratings. These results demonstrate that, even in pre-school children, aesthetic experience is specifically linked to its sensorimotor component, supporting, from a developmental perspective, the definition of aesthetic experience as intrinsically rooted on beholders' bodily experience.

Precision in grasping: Consistent with Weber's law, but constrained by "safety margins".

Whether the visuomotor coding of size in grasping obeys Weber's law is currently debated. Following up on previous work from our laboratory, here we investigated the precision associated with the maximum in-flight index-thumb aperture (MGA) in grasping small-to-medium sized objects. We report three main findings. First, grasp preparation was longer with 5 mm objects and became increasingly faster as object size increased from 10 to 20-40 mm. Second, MGA variable errors increased as sizes increased from 5 to 10-20 mm, whereas they decreased as size reached 40 mm. Third, MGA distributions were symmetrical with 5 mm objects, but became increasingly right-skewed as size increased. These results, as well as a re-analysis of previous findings, suggest that the precision of visuomotor representations varies as a function of size, consistent with the key principle underlying Weber's law. However, a fundamental constraint on precision grips (the MGA must always exceed physical size) changes the skew of the distribution and reduces the variability of MGAs as size increases from very small to medium.

Action preparation in grasping reveals generalization of precision between implicit and explicit motor processes.

It is often claimed that merely seeing a graspable object can elicit the implicit representation of a potential grasp. But can this representation affect the explicit execution of an actual grasp, and if so, how? In an open-loop paradigm, we instructed participants to grasp small, medium, or large test disks with the appropriate grip configuration (pincer, tripod, or pentapod). Before the presentation of these tests, we presented congruent or incongruent distractors. To assess interactions between implicit (putatively elicited by the distractors) and explicit (actually executed) sensorimotor processes, we measured preview reaction times (as an index of action preparation) and grasp kinematics (as an indicator of sensorimotor representations for motor control). Results indicate that action preparation is indeed affected by the presentation of preceding distractors. However, costs in action preparation were measured only when the first, implicit process was less precise than that of the actual grasp. We suggest that an interaction occurs at the level of sensorimotor processes through a mechanism which generalizes a precision parameter. We interpret these findings in relation to processes involved in real-time motor control and within the framework of theories of motor cognition.

Asymmetric effects of graspable distractor disks on motor preparation of successive grasps: A behavioural and event-related potential (ERP) study.

There is evidence that seeing a graspable object automatically elicits a preparatory motor process. However, it is unclear whether this implicit visuomotor process might influence the preparation of a successive grasp for a different object. We addressed the issue by implementing a combined behavioural and electrophysiological paradigm. Participants performed pantomimed grasps directed to small or large disks with either a two (pincer) or a five-finger (pentapod) grip, after the presentation of congruent (same size) or incongruent (different size) distractor disks. Preview reaction times (PRTs) and response-locked lateralized readiness potentials (R-LRPs) were recorded as online indices of motor preparation. Results revealed asymmetric effects of the distractors on PRTs and R-LRPs. For pincer grip disks, incongruent distractors were associated with longer PRTs and a delayed R-LRP peak. For pentapod grip disks, conversely, incongruent distractors were associated with shorter PRTs and a delayed R-LRP onset. Supporting an interpretation of these effects as tapping into motor preparation, we did not observe modulations of stimulus-locked LRP's (sensitive to sensory processing), or of the P300 component (related to reallocating attentional resources). These results challenge models (i.e., the "dorsal amnesia" hypothesis) which assume that visuomotor information presented before a grasp will not affect how we later perform that grasp.

Infectious risk in ostomy patient: the role of nursing competence.

BACKGROUND AND AIM OF THE WORK: The risk of peristomal infections in ostomy patients is well documented in the literature. The nurse and the stoma therapist play a fundamental role in the management and prevention of ostomy-related infections. The present research aims to investigate, across the different phases of the nursing process, the level and characteristics of nursing expertise and highlight their impact on reducing infectious risk in ostomy patients. METHODS: 40 nurses (31 women; mean age = 47.7; SD= 7.68) working with ostomy patients were interviewed, in three Italian Local Healthcare Company (LHC) of Northern Italy, Central Italy, and Southern Italy. Nurses compiled a semi-structured ad-hoc interview concerning the level of skills, training, and experience with ostomy patients. The declared expertise has been compared to the retrospective archive data related to the peristomal skin infections of the three LHC. RESULTS: Several differences have emerged in terms of nurses' expertise and care settings: for instance, ostomy complications in Southern Italy being managed with specific checklists, whereas in the Northern Italy complications being managed by stoma therapists and in Central Italy by hospital ward general nurses. Moreover, the level of professional training was very important for all respondents. The incidence rates of infections after training are lower than a pre-training period. CONCLUSIONS: The expertise resulting from specific training for nurses and stoma therapists are crucial for the management of the ostomy and the prevention of complications, in particular of infections. If the training reduces the peristomal complications, therefore, it is necessary to provide and preserve nurses' expertise, to guarantee patients an optimal treatment path.

Both vision-for-perception and vision-for-action follow Weber's law at small object sizes, but violate it at larger sizes.

According to a previous report, the visual coding of size does not obey Weber's law when aimed at guiding a grasp (Ganel et al., 2008a). This result has been interpreted as evidence for a fundamental difference between sensory processing in vision-for-perception, which needs to compress a wide range of physical objects to a restricted range of percepts, and vision-for-action when applied to the much narrower range of graspable and reachable objects. We compared finger aperture in a motor task (precision grip) and perceptual task (cross modal matching or "manual estimation" of the object's size). Crucially, we tested the whole range of graspable objects. We report that both grips and estimations clearly violate Weber's law with medium-to-large objects, but are essentially consistent with Weber's law with smaller objects. These results differ from previous characterizations of perception-action dissociations in the precision of representations of object size. Implications for current functional interpretations of the dorsal and ventral processing streams in the human visual system are discussed.