Reducing work-related stress among health professionals by using a training-based intervention programme for leaders in a cluster randomised controlled trial.

Healthcare organisations worldwide are affected by the shortage of health professionals due to work-related stress and health professional leaders play an important role by implementing effective strategies. Therefore, this study aims to investigate whether the STRAIN intervention program (using evidence-based training for health professional leaders) can reduce work-related stress among health professionals. This study is based on a cluster randomised controlled trial, consists of three measurements and includes 165 participating hospitals, nursing homes and home care organisations. A total of 206 health professional leaders took part in the intervention programme and 19,340 health professionals participated in the study. Results showed no significant differences (p > 0.05) between the intervention and control group regarding the effort-reward imbalance ratio, quantitative demands, opportunities for development, bond with the organisation, quality of leadership, social community, role clarity, rewards, difficulties with demarcation and work-private life conflict. Pre-/post-test analysis revealed a tendency for significant positive results (p < 0.05) for stressors, stress symptoms and long-term consequences for organisations with a leaders' participation rate of ≥ 75%. Leaders' awareness, commitment and readiness is essential to implement effective strategies reducing work-related stress.

Post-ecological discourse in the making.

This article analyses the discourse of 15- to16-year-old Swiss junior high school students in order to understand public discourse on the environment and environmental protection. Discourse analysis reveals four interpretive repertoires as the building blocks for the so-called post-ecological discourse, which can be used to describe important aspects of current ways of talking about ecological issues in Europe. We show that 10 theoretically identifiable dimensions of this discourse can be understood in terms of a mutual interplay between the four interpretive repertoires. Post-ecological discourse in today's (Swiss) society appears to be at its core a loss-of-control-discourse, which leads (in our students) to a latent eco-depression. Thus, the public understanding of science can be affected by unintended consequences of the talk itself (in this case an unintended environmental depression), that is, by the inherent characteristics of the involved repertoires, here especially the so-called folk science repertoire. Fostering public understanding of science is thus not merely a question of providing the public with scientific 'facts'. It is also an issue of paying attention to the available discursive repertoires. If necessary, viable alternative repertoires may have to be offered. In school, for example, conversations about the nature of science, and about complexity and applied ethics might help students learn new interpretive repertoires and how to mobilize these in talking about the environment and environmental protection.

Tipping the Fencesitters-The Impact of a Minimal Intervention Enhanced with Biological Facts on Swiss Student Teachers' Perception of HPV Vaccination Safety.

Not much is known about the role of scientific knowledge in vaccination decision making. This study is based on previous findings that the concern about the human papillomavirus (HPV) agent mutating back to a virulent HPV was common among Swiss student teachers and turned out to be one factor of vaccine hesitancy. The study investigate the impact of a standard public health brochure describing the effectiveness, safety, and importance of HPV vaccination on young student teachers, and the additional effect of supplementing the standard brochure with biological arguments against the mutation concerns. It uses a pre-posttest design and assigns participants randomly to two groups, one reviewing a standard public health brochure, the other the same brochure enhanced with additional biological information. Participants in both groups showed a significant positive change in their beliefs about vaccination safety, effectiveness, and importance in preventing cervical cancer. Post hoc analysis showed significant safety beliefs gain for the subgroup of participants who received the biology-enhanced text and held moderate, rather than high or low, pretest safety beliefs-the so-called fencesitters. We conclude that these fencesitters may particularly profit from even minimal (biologically supplemented) interventions, an effect that should receive more attention in future research.

[Health literacy: what can doctors contribute? The doctor's practice as an educational institution]. / Die Arztpraxis als Bildungsinstitution.

In medicine, there is growing awareness about the crucial role health literacy can play in the health system. Generally, the focus lies on functional health literacy, which is closely linked to the common understanding of literacy as being able to read and write. Useful rules of communication are available for fostering patients' literacy. However, critical literacy is a much more demanding concept. Here the hermeneutics of biomedical knowledge plays is important, and so far rather neglected. The physician--and in particular the general practitioner--has an important part in this process, as a guide and a teacher. For this, it is necessary to have educational professionalism that goes beyond applying communication rules. It is important to know that the process of teaching and learning is not transmissive but constructive. Educational reconstruction is a useful instrument for taking this into account.