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OBJECTIVES: The aetiology of mental disorders involves genetic and environmental factors, both reflected in family health history. We examined the intergenerational transmission of multiple mental disorders from parents and grandparents using population-based, objectively measured family histories. METHODS: This population-based retrospective cohort study used administrative healthcare databases in Manitoba, Canada and included adults living in Manitoba from 1977 to 2020 with linkages to at least one parent and one grandparent. Index date was when individuals turned 18 or 1 April 1977, whichever occurred later. Mental disorder diagnoses (mood and anxiety, substance use and psychotic disorders) were identified in individuals, parents and grandparents from hospitalization and outpatient records. Cox proportional hazards regression models included sociodemographic characteristics, individual's comorbidity and mental disorder history in a grandparent, mother and father. RESULTS: Of 109,359 individuals with no mental disorder prior to index date, 47.1% were female, 36.3% had a mental disorder during follow-up, and 90.9% had a parent or grandparent with a history of a mental disorder prior to the index date. Both paternal and maternal history of a mental disorder increased the risk of the disorder in individuals. Psychotic disorders had the strongest association with parental history and were mostly influenced by paternal (hazards ratio [HR] 3.73, 95% confidence interval [CI] 2.99 to 4.64) compared to maternal history (HR 2.23, 95% CI, 1.89 to 2.64). Grandparent history was independently associated with the risk of all mental disorders but had the strongest influence on substance use disorders (HR 1.42, 95% CI, 1.34 to 1.50). CONCLUSIONS: Parental history of mental disorders was associated with an increased risk of all mental disorders. Grandparent history of mental disorders was associated with a small risk increase of the disorders above and beyond parental history influence. This three-generation study further highlights the need for family-based interventional programs in families affected by mental disorders. PLAIN LANGUAGE SUMMARY TITLE: The Intergenerational Transfer of Mental Illnesses.
ObjectivesBoth genetics and environmental factors, such as poverty, maltreatment and parental education, have a role in the development of mental illnesses. Some genetic and environmental risk factors for mental illnesses are shared within families. We conducted a large study to test the extent to which mental illnesses are passed down through generations.MethodsThis study used healthcare data from Manitoba, Canada captured during the delivery of healthcare services for administrative purposes. These data included all adults from 1977 to 2020 who had at least one parent and one grandparent with linked data. Mental illnesses were diagnosed in individuals, parents and grandparents by doctors during hospitalizations or physician visits. The illnesses included mood and anxiety, substance use, and psychotic illnesses. We estimated the likelihood of developing a mental illness when parents and/or grandparents had a mental illness as well.ResultsThe study included 109,359 individuals; a third developed a mental illness during the study period. The majority had a history of a mental illness in a parent or grandparent. We found that a history of mental illness in a mother and father increased the chance of developing the illness. Psychotic illnesses had the strongest relation with parental history. In particular, having a father with a psychotic illness increased the chance of developing the illness by four times. The likelihood of developing a mental illness was higher if a grandparent had a mental illness, above and beyond parental history influence, particularly for substance use disorders.ConclusionsHaving a parent or grandparent with a mental illness increases an individual's chance of developing a mental illness. Family-based intervention programs are needed to support families affected by mental illnesses in coping with their heavy burden.
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Avós , Relação entre Gerações , Transtornos Mentais , Humanos , Feminino , Masculino , Adulto , Manitoba/epidemiologia , Pessoa de Meia-Idade , Transtornos Mentais/epidemiologia , Transtornos Mentais/genética , Estudos Retrospectivos , Adulto Jovem , Adolescente , Idoso , PaisRESUMO
This longitudinal study (N = 1078, 46% boys; 54% girls) examined profiles of loneliness and ostracism during adolescence and their consequences and antecedents. Longitudinal latent profiles analyses identified four distinct profiles: (1) High emotional loneliness (25%), High and increasing social loneliness (15%), High peer exclusion and high social impact (9%) and No peer problems (51%). Subsequent internalizing problems were typical for the High and increasing social loneliness profile and externalizing problems for the High emotional loneliness and High peer exclusion and high social impact profiles. Furthermore, effortful control, prosocial skills, and relationship quality with parents and teachers were highest in the No peer problems profile, whereas the High and increasing social loneliness profile had the lowest self-esteem and was characterized by low surgency/extraversion, high affiliativeness, and high negative affectivity.
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Psychopathological conditions in adolescence and young adulthood often result from an altered neurodevelopment already phenotypically expressed in childhood. Child and adolescent mental health services are ideally placed to intercept in the developmental trajectories of younger adolescents and contribute to the early detection of a risk for psychosis, as proposed by Salazar de Pablo and Arango (2023, Child and Adolescent Mental Health), opening a debate to which we contribute. The early detection of a specific risk for psychosis and of a broader risk for severe mental illness requires an understanding of the clinical staging of psychosis, neurodevelopmental antecedents of severe mental illness and of heterotypic trajectories between childhood phenotypes and adult disorders.
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Serviços de Saúde do Adolescente , Serviços de Saúde Mental , Transtornos Psicóticos , Adolescente , Criança , Humanos , Saúde do Adolescente , Saúde Mental , Transtornos Psicóticos/terapiaRESUMO
OBJECTIVES: Childhood disturbances in social, emotional, language, motor and cognitive functioning, and schizotypy have each been implicated as precursors of schizophrenia-spectrum disorders. We investigated whether relationships between early childhood developmental vulnerabilities and childhood schizotypy are mediated by educational underachievement in middle childhood. METHODS: Participants were members of a large Australian (n = 19,216) population cohort followed longitudinally. Path analyses were used to model relationships between developmental vulnerabilities at age ~5 years, educational underachievement from ages ~8 to 10 years and three distinct profiles of schizotypy at age ~11 years (true, introverted and affective schizotypy). RESULTS: Early childhood developmental vulnerabilities on five broad domains (related to physical, emotional, social, cognitive and communication development) were associated with schizotypy profiles in middle childhood. Educational underachievement in middle childhood was associated with all schizotypy profiles, but most strongly with the true schizotypy profile (OR = 3.92, 95% CI = 3.12, 4.91). The relationships between schizotypy profiles and early childhood developmental vulnerabilities in 'language and cognitive skills (school-based)' and 'communication skills and general knowledge' domains were fully mediated by educational underachievement in middle childhood, and the relationships with early childhood 'physical health and well-being' and 'emotional maturity' domains were partially mediated. CONCLUSION: Developmental continuity from early childhood developmental vulnerabilities to schizotypy in middle childhood is mediated by educational underachievement in middle childhood. While some domains of early developmental functioning showed differential relationships with distinct schizotypy profiles, these findings support a developmental pathway to schizotypy in which cognitive vulnerability operates from early childhood through to middle childhood.
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Esquizofrenia , Transtorno da Personalidade Esquizotípica , Humanos , Criança , Pré-Escolar , Transtorno da Personalidade Esquizotípica/psicologia , Austrália , Emoções , Desenvolvimento InfantilRESUMO
An awareness of antecedents of acceptance of digital contact tracing (DCT) can enable healthcare authorities to design appropriate strategies for fighting COVID-19 or other infectious diseases that may emerge in the future. However, mixed results about these antecedents are frequently reported. Most prior DCT acceptance review studies lack statistical synthesis of their results. This study aims to undertake a systematic review and meta-analysis of antecedents of DCT acceptance and investigate potential moderators of these antecedents. By searching multiple databases and filtering studies by using both inclusion and exclusion criteria, 76 and 25 studies were included for systematic review and meta-analysis, respectively. Random-effects models were chosen to estimate meta-analysis results since Q, I 2, and H index signified some degree of heterogeneity. Fail-safe N was used to assess publication bias. Most DCT acceptance studies have focused on DCT related factors. Included antecedents are all significant predictors of DCT acceptance except for privacy concerns and fear of COVID-19. Subgroup analysis showed that individualism/collectivism moderate the relationships between norms/privacy concerns and intention to use DCT. Based on the results, the mean effect size of antecedents of DCT acceptance and the potential moderators may be more clearly identified. Appropriate strategies for boosting the DCT acceptance rate can be proposed accordingly.
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COVID-19 , Busca de Comunicante , Humanos , COVID-19/prevenção & controle , Bases de Dados Factuais , Processos Grupais , Instalações de SaúdeRESUMO
The objective of this study is to investigate the prevalence of autism (ASD) symptoms, i.e. , social difficulties, repetitive behaviors, and communicational problems, among children born extremely preterm (EP) compared to a reference group, and to investigate possible antecedents of ASD symptoms among EP children. Method is a national Norwegian cohort of 11 year old EP children, excluding those with intellectual disabilities, non-ambulatory cerebral palsy, blindness, and/or deafness. Parents and teachers reported ASD symptoms using The Autism Spectrum Screening Questionnaire (ASSQ). Social difficulties, repetitive behaviors, communicational problems, and a total ASSQ score were presented. Combined ratings on the ASSQ was defined as parent and/or teacher scoring the child ≥ 98th percentile of the reference group, which was the population-based Bergen Child Study. Of eligible children, 216 (64%) EP and 1882 (61%) reference children participated. EP children had significantly higher mean scores and combined ratings on social difficulties (14.5% vs. 4.1%, OR: 3.2), repetitive behaviors (23.7% vs. 4.0%, OR: 6.4), communicational problems (23.1% vs. 4.8%, OR: 5.4), and the total ASSQ score (18.3% vs. 3.4%, OR: 5.7) compared to reference children. Only no prenatal steroids, IQ 70-84, and mental health problems at 5 years of age were significantly associated with ASD symptoms at 11 years of age. EP children were at increased risk of social difficulties, repetitive behaviors, and communicational problems, and approximately one out of five were reported as high scorers of ASD symptoms. No prenatal steroids use, IQ in the lower range, and mental health problems at 5 years of age were associated with ASD symptoms.
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Transtorno do Espectro Autista , Transtorno Autístico , Deficiência Intelectual , Nascimento Prematuro , Recém-Nascido , Feminino , Humanos , Criança , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/epidemiologia , Cognição , Noruega/epidemiologia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologiaRESUMO
Vaccination hesitancy is an important barrier for the effective control of the COVID-19 pandemic. Identifying determinants of COVID-19 vaccination hesitancy is essential in order to reduce mortality rates. Further, given the variability of the factors and the different recommendations used in each country, it is important to conduct cross-country research to profile individuals who are hesitant toward COVID-19 vaccinations. This cross-sectional study aimed to examine cross-country differences and the behavioral, attitudinal and demographic characteristics of vaccine hesitant individuals. Adults living in six European countries (Cyprus, France, Germany, Italy, Poland, and Spain) were eligible to participate. A total of 832 individuals completed the online survey, with 17.9% reporting being hesitant to COVID-19 vaccination. Vaccine accepters were significantly older (M = 38.9, SD = 14.3), more educated (master/postgraduate studies) and lived in a place with a higher number of residents (>500,000 people) compared to those hesitant to COVID-19 vaccination. Discriminant analysis confirmed that the hesitant profile includes a person of younger age, living alone in smaller communities, and without children. Additionally, hesitant participants reported COVID-19-specific characteristics such as lower institutional trust, less adherence to COVID-19 protective behaviors and higher pandemic fatigue. When tackling COVID-19 vaccination hesitancy both socio-demographic and behavioral/attitudinal aspects should be taken into account. Stakeholders are advised to implement targeted vaccination programs while at the same time building trust with population illness cognitions addressed in order to reduce hesitancy rates. Further, stakeholders and public health authorities in each country are suggested to target interventions according to different population characteristics as behavioral and attitudinal determinants of COVID-19 vaccination hesitancy differed between countries.
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BACKGROUND: Nursing professionalism plays an important role in clinical nursing. However, a clear conceptual understanding of nursing professionalism is lacking. METHOD: Walker and Avant's strategy was used to analyse the concept of nursing professionalism. We searched electronic databases, including PubMed, Scopus, and CINAHL, for studies published from 1965 to 2021. Quantitative or qualitative studies published in English that focused on nursing professionalism were included in the study. RESULTS: The three attributes of nursing professionalism are multidimensional, dynamic, and culture oriented. Based on the analysis, nursing professionalism is defined as providing individuals care based on the principles of professionalism, caring, and altruism. CONCLUSIONS: This study offers a theoretical definition and conceptual model of nursing professionalism that may be applied to develop standardized assessment tools or nursing professionalism training programs.
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BACKGROUND: Unfinished Nursing Care (UNC) concept, that express the condition when nurses are forced to delay or omit required nursing care, has been largely investigated as tasks left undone, missed care, and implicit rationing of nursing care. However, no summary of the available evidence regarding UNC antecedents has been published. The aim of this study is to identify and summarise antecedents of UNC as documented in primary studies to date. METHODS: A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. MEDLINE, CINAHL, SCOPUS, and PROSPERO databases were searched for quantitative studies reporting the relationships between antecedents and UNC published after 2004 up to 21 January 2020. The reference lists of secondary studies have been scrutinised to identify additional studies. Two reviewers independently identified studies and evaluated them for their eligibility and disagreements were resolved by the research team. The quality appraisal was based on the Joanna Briggs Institute Critical Appraisal tools, according to the study designs. A data extraction grid was piloted and then used to extract data. The antecedents that emerged were thematically categorised with an inductive approach. RESULTS: Fifty-eight studies were included; among them, 54 were cross-sectional, three were cohort studies, and one was a quasi-experimental study. They were conducted mainly in the United States and in hospital settings. The UNC antecedents have been investigated to date at the (a) unit (e.g., workloads, non-nursing tasks), (b) nurse (e.g., age, gender), and (c) patient levels (clinical instability). CONCLUSIONS: At the unit level, it is highly recommended to provide an adequate staff level, strategies to deal with unpredictable workloads, and to promote good practice environments to reduce or minimise UNC. By contrast, at the nurse and patient levels, there were no clear trends regarding modifiable factors that could decrease the occurrence of UNC. The map of antecedents that emerged can be used to design interventional studies aimed at changing research from merely descriptive to that which evaluates the effectiveness of interventions.
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AIM: This study aimed to investigate reasons for unfinished nursing care across the whole levels of the nursing service as perceived by clinical nurses, ward managers and executive nurses. BACKGROUND: Even though unfinished nursing care has been considered an issue affected by the system, no studies to date have attempted to investigate reasons across the whole levels of the nursing service by involving clinical nurses, ward managers and executive nurses. METHOD: A descriptive qualitative approach was performed in 2021 according to the COnsolidated criteria for REporting Qualitative research guidelines. A large public health care trust was approached, and a purposeful sample of clinical nurses, ward managers and executive nurses was invited to attend face-to-face or online interviews. Twenty-nine interviews were performed (19 clinical nurses, 7 ward managers and 3 executive nurses) and transcribed verbatim. Then, a content analysis was conducted by considering all narratives together followed by an analytic process to identify themes and subthemes at the clinical, ward manager and executive levels. RESULTS: Reasons for unfinished nursing care have emerged at five levels: system (e.g., poor support towards nursing care), unit (e.g., ineffective models of nursing care delivery), nurse managers (e.g., inadequate nurse manager leadership), nurses (e.g., weaknesses in education) and patients (e.g., increased demand for patients' care). CONCLUSION: The evidence available should be expanded to include also unfinished nursing care reasons identified at the system and at the ward manager levels, that both can complete the perceptions of the clinical nurses. IMPLICATIONS FOR NURSING MANAGEMENT: The actors composing the nursing service perceive different reasons and therefore should be involved in detecting and contrasting the unfinished nursing care. The reasons applied or established at the upper level influence the bedside levels: Therefore, strategies to prevent or minimize the unfinished nursing care should be designed at multi-levels in a system-inclusive approach.
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Enfermeiros Administradores , Cuidados de Enfermagem , Serviços de Enfermagem , Humanos , Pesquisa Qualitativa , LiderançaRESUMO
Cohesion is one of the most studied group phenomena and there is an agreement among scholars today that cohesion is a key contributor to team functioning and performance. A large body of research has shown that cohesion has several positive effects on psychological, social, and behavioral outcomes. Since research on cohesion has increased significantly in recent decades there is a need for an updated overview of research regarding antecedents and outcomes of cohesion in a military context. In this paper, a systematic literature review is conducted. The paper adheres to suggestions by scholars, relating the results in accordance with the dimensionality (i.e. social, task, or general) and organizational level of the construct (i.e. horizontal, vertical, or organizational) as well as focusing exclusively on studies with a longitudinal design. The paper highlights gaps in the literature and provides direction for future research.
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BACKGROUND: The paper aims to understand the main antecedents related to the blood donation propensity related to both donors and non-donors. With our research, we will analyse the two perspectives to identify similarities and differences concentrating on the Italian context. Blood is a vital resource that strongly affects every national healthcare system's efficacy and sustainability and the system's ability to achieve the goal of universal coverage. METHODS: The purpose of this paper is to understand the main antecedents of citizens' blood donation intention and the propensity to encourage communication about blood donation among both donors and non-donors. The Theory of Planned Behaviour is adopted as a theoretical lens. An empirical investigation was performed in Italy, adopting a mixed methods research design. First, a qualitative analysis was carried out through 30 in-depth interviews. Then, a survey was used to quantitatively investigate the intention to donate among both donors (N = 173) and non-donors (N = 87). A conceptual model was developed and tested through Structural Equation Modelling, developing a multi-group approach. RESULTS: The present study confirms the relations proposed by the Theory of Planned Behaviour, even though some differences between the two groups are shown. The construct Information and Communication is crucial for donors, non-donors, whereas for non-donor inhibitors is vital. Service quality has an impact on the propensity to recommend and communicate the value of blood donation. CONCLUSION: This paper reveals the main differences between donor and non-donor perspectives. Fruitful insights for enhancing blood donation awareness are provided.
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Doadores de Sangue , Intenção , Humanos , Itália , Motivação , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Patient safety is defined as an activity that minimizes and removes possible errors and injuries to patients. A number of factors have been found to influence patient safety management, including the facilities available in the practice, communication and collaboration, education regarding patient safety and generic conditions. This study tested a theoretical model of patient safety interventions based on safety antecedents. METHODS: Medical professionals were surveyed using a questionnaire developed by Gaal et al. The results were analyzed with SPSS 20 and AMOS. A hypothetical model of direct and indirect effects on patient safety in a primary care environment was created and analyzed using structural equation modeling (SEM). RESULTS: SEM proved to be an effective tool to analyse safety in primary care. The facilities in the practice appear to have no significant influence on patient safety management in the case of female respondents, those below mean age, those who are not GPs (general practitioner) and respondents not working in counselling centres. CONCLUSIONS: The integrated safety model described in the study can improve patient safety management.
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Clínicos Gerais , Segurança do Paciente , Feminino , Humanos , Análise de Classes Latentes , Atenção Primária à Saúde , Gestão da SegurançaRESUMO
AIMS: This study examined the moderating role of two resources (social support and recognition) in the longitudinal relationship between workload and bullying behaviours in nurses. DESIGN: A two-wave (12-month) longitudinal study was conducted. METHOD: French-Canadian nurses (n = 279) completed an online survey (October 2014 and October 2015) assessing their perceptions of job characteristics within the work environment (workload, social support, job recognition) as well as exposure to negative behaviours at work. RESULTS: Workload positively predicted exposure to bullying behaviours over time, but only when job recognition and social support were low. Workload was unrelated to bullying when social support was high and was negatively related to bullying when job recognition was high. CONCLUSION: This study aligns with the work environment hypothesis, showing that poorly designed and stressful job environments provide fertile ground for bullying behaviours. IMPACT: Bullying is a growing concern in the nursing profession that not only undermines nurses' well-being but also compromises patient safety and care. It is thus important to identify work-related factors that can contribute to the presence of bullying behaviours in nurses in the hopes of reducing their occurrence and repercussions. This study contributes to this endeavour and identifies two key social coping resources that can help manage the stress associated with workload, resulting in less perceived bullying behaviour among nurses.
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Bullying , Enfermeiras e Enfermeiros , Canadá , Humanos , Satisfação no Emprego , Estudos Longitudinais , Apoio Social , Inquéritos e Questionários , Carga de Trabalho , Local de TrabalhoRESUMO
BACKGROUND: the available studies on Hurthle cell carcinoma (HCC) in pediatric age are scarce and based on isolated case reports. Aims of the present study were to review the available pediatric literature on HCC (2000-2019), to describe the cohort of children with this cancer histotype, and to estimate its relative prevalence in pediatric age. PROCEDURE: We retrospectively reconstructed an HCC course in five patients < 19 years who were identified in our departments during the period 2000-2019, and we reviewed the available pediatric studies on this differentiated thyroid cancer (DTC) variant. RESULTS: HCC occurred with a relative prevalence of 5.8% at a median chronological age of 12.5 years. None of HCC patients exhibited, at diagnosis, thyroid dysfunction, extensive lateral neck disease, or distant metastases, and all showed a persistent remission over time. Three patients showed, at diagnosis, antecedents of other diseases (Hashimoto's thyroiditis, neurofibromatosis type 1, and osteosarcoma). CONCLUSIONS: (1) In childhood, the relative prevalence of HCC among different thyroid cancer histotypes is 5.8%, that is close to the one previously reported both in the general population and in other less numerous children's cohorts; (2) HCC may develop even early, at the age of 7; (3) in childhood, HCC does not seem to have a more aggressive behavior when compared with other DTC histotypes; (4) antecedents of other diseases are not infrequent in the history of children with HCC.
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Adenoma Oxífilo/epidemiologia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/epidemiologia , Adenoma Oxífilo/complicações , Adolescente , Criança , Feminino , Doença de Hashimoto/complicações , Humanos , Masculino , Neurofibromatose 1/complicações , Osteossarcoma/complicações , Estudos Retrospectivos , Testes de Função Tireóidea , Neoplasias da Glândula Tireoide/complicações , Adulto JovemRESUMO
BACKGROUND: The world's population is ageing, resulting in rising care demands and healthcare costs, which in turn lead to a shift from formal to informal care. However, not only is the number of potential informal carers fast decreasing, but also informal caregivers are experiencing a higher caregiver burden. This literature review aims to synthesize the literature on the common determinants of caregiver burden in Western countries, to help ensure future continuation of informal care in the home context, and to improve or sustain the quality of life of caregivers and patients alike. METHOD: A systematic review of peer-reviewed articles included in PubMed, Scopus, and/or PsychInfo was conducted. RESULTS: Seventeen articles were included. The most important predictors were the duration of caregiving and the patient's dependency level, in terms of both physical and mental dependency stemming from decreased cognitive capacity or behavioural problems. Some specific illnesses and role conflicts or captivity also increased caregiver burden, whereas social support lowered it. Being a female caregiver or having an adult-child relationship led to a higher burden. CONCLUSIONS: The most important predictors of caregiver burden are the duration of caregiving and the patient's dependency level. In addition, the patient's behavioural problems and cognitive capacity determine dependency level, and thus care burden. Interventions to relieve burden need to be adapted to the illness trajectory of specific diseases and corresponding needs for social support for both the recipient and the caregiver. Changing role expectations, leading to men being more involved, could reduce the disproportionately high burden for women.
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Cuidadores , Qualidade de Vida , Efeitos Psicossociais da Doença , Feminino , Custos de Cuidados de Saúde , Humanos , Masculino , Apoio SocialRESUMO
School violence is a significant public health concern that occurs in many forms. Physical aggression can cause serious bodily injury and long-term negative effects, and both teachers and students experience significant rates of physical aggression. There are few studies examining teachers' experiences of physical aggression. Studies that go beyond prevalence are limited, and we know little about the triggers and consequences that surround these incidents. This qualitative investigation used an antecedent-behavior-consequence (A-B-C) framework to understand how incidents of physical aggression directed toward teachers unfold. The sample included 193 elementary and secondary teachers who completed an anonymous, online survey and described events leading up to and following their experiences with physical aggression. Using conventional content analysis, we identified common antecedents, such as breaking up fights, discipline, and directives, and common consequences, such as student removal, school staff involvement, positive outcomes, and inaction. Further analyses revealed seven common A-B-C patterns among physical aggression incidents that are highlighted and discussed. Utility of the A-B-C framework for teacher-directed violence is described, along with implications for research, practice, and policy. Exploring the context surrounding incidents of physical aggression directed against teachers provides useful information for violence prevention and interventions.
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Agressão , Vítimas de Crime , Humanos , Professores Escolares/estatística & dados numéricos , Instituições Acadêmicas , EstudantesRESUMO
AIM: To understand what nursing education activities are missed in the daily life of nursing programmes, by also identifying antecedents and consequences of missed educational activities. DESIGN: A descriptive qualitative study according to the COnsolidated criteria for REporting Qualitative research guidelines. METHODS: A purposeful sample of 32 participants with different roles (nurse educators, clinical nurses, students, and administrative personnel) and working in different settings (university, administrative, healthcare service levels) were involved in three focus groups and nine face-to-face interviews from 2019-2020. Both focus groups and face-to-face interviews were audio-recorded and transcribed verbatim. The data that emerged were thematically categorized by induction. FINDINGS: Missed Nursing Education reflects those educational activities needed in the process of nursing education that are missed or delayed. Direct educational activities missed include clinical rotations, classroom teaching and students' overall learning experience. Indirect missed educational activities concern continuing professional development of nursing faculty members, nursing discipline development and the organizational processes of the nursing programme. As antecedents, missed nursing education is triggered by factors at the organizational, nursing faculty, and student levels. Consequences have been reported for students, nursing faculty, clinical nurses, and patients. CONCLUSIONS: Missed Nursing Education can be considered a multifaceted, multicausal phenomenon, with multitargeted consequences. IMPACT: To date, missed nursing care has only been investigated in clinical practice. However, care also permeates the relationship between nurse educators and students. Thus, at the point of 'educational care' delivery, aspects can also be omitted. Educational activities at risk of being missed or delayed affect the quality of nursing education and, in the short- and in the long- terms, also the quality of patient care. Some Missed Nursing Education antecedents can be modified by appropriate strategies that should be addressed by policy, health care and academic institutions.
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Bacharelado em Enfermagem , Educação em Enfermagem , Estudantes de Enfermagem , Atenção à Saúde , Docentes de Enfermagem , Grupos Focais , Humanos , Pesquisa QualitativaRESUMO
A large contemporary UK cohort study, the Avon Longitudinal Study of Parents and Children, was used to investigate gambling behavior and to explore the antecedents of regular gambling in the 17-24-year age group. Participants completed computer-administered gambling surveys in research clinics, on paper, and online. The sample sizes were 3566 at age 17 years, 3940 at 20 years, and 3841 at 24 years; only 1672 completed all three surveys. Participation in gambling in the last year was reported by 54% of 17-year-olds, rising to 68% at 20 years, and 66% at 24 years, with little overall variance. Regular (weekly) gambling showed a strong gender effect, increasing among young men from 13% at 17 years to 18% at 20 years, and 17% at 24 years. Although gambling frequency increased between the ages of 17 and 20 years, gambling behaviors showed little variance between 20 and 24 years, except online gambling and betting on horseraces. The commonest forms of gambling were playing scratchcards, playing the lottery, and private betting with friends. Gambling on activities via the internet increased markedly between 17 and 24 years, especially among males. In the fully adjusted model, individual antecedents of regular gambling were being male, and having a low IQ, an external locus of control, and high sensation seeking scores. Parental gambling behavior and maternal educational background were associated with regular gambling in both sexes. Regular gambling was associated with smoking cigarettes and frequent and harmful use of alcohol, but no associations with depression were found.
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Comportamento Aditivo/psicologia , Jogo de Azar/psicologia , Controle Interno-Externo , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Estudos de Coortes , Feminino , Amigos , Humanos , Estudos Longitudinais , Masculino , Pais/psicologia , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/complicações , Inquéritos e Questionários , Adulto JovemRESUMO
Since the dawn of breast implantation back in the sixties, five generations of breast implants have tried to provide the most natural-looking results while striving to eliminate the risk of unpleasant ruptures or capsular contractures. National Health regulators (i.e. the FDA in USA and ANSM in France) have had an "after the facts" reaction, which led to a so-called "dirty war" among producers in the form of a 1992 Silicone's Moratorium (after suspicions of associated cancer or immune-related disorders) all this under the rigid oversight of a FDA director, who seemed more sensible to media scandal than scientific data. After more than a decade of consistent scientific evidence, the interdiction was finally ended in France in 2001 and in the USA in 2006, however the scandals resurfaced again in 2011 after a proven fraud on the "PIP - affair" and most recently with "breast implant associated - anaplastic large cell lymphoma", an extremely serious and rare pathology, treated only by surgical means, until further research. We describe also a chronology on the way the FDA finally recognized this dramatic complication.