Midwives' occupational wellbeing and its determinants. A cross-sectional study among newly qualified and experienced Dutch midwives.

OBJECTIVE: Internationally, about 40 percent of midwives report symptoms of burnout, with young and inexperienced midwives being most vulnerable. There is a lack of recent research on burnout among Dutch midwives. The aim of this study was to examine the occupational wellbeing and its determinants of newly qualified and inexperienced midwives in the Netherlands. The majority of practicing Dutch midwives are aged under 40, which could lead to premature turnover. DESIGN: A cross-sectional study was conducted using an online questionnaire that consisted of validated scales measuring job demands, job and personal resources, burnout symptoms and work engagement. The Job Demands-Resources model was used as a theoretical model. SETTING AND PARTICIPANTS: We recruited Dutch midwives who were actually working in midwifery practice. A total of N=896 midwives participated in this study, representing 28 percent of practicing Dutch midwives. MEASUREMENTS AND FINDINGS: Data were analysed using regression analysis. Seven percent of Dutch midwives reported burnout symptoms and 19 percent scored high on exhaustion. Determinants of burnout were all measured job demands, except for experience level. Almost 40 percent of midwives showed high work engagement; newly qualified midwives had the highest odds of high work engagement. Master's or PhD-level qualifications and employment status were associated with high work engagement. All measured resources were associated with high work engagement. KEY CONCLUSIONS: A relatively small percentage of Dutch midwives reported burnout symptoms, the work engagement of Dutch midwives was very high. However, a relatively large number reported symptoms of exhaustion, which is concerning because of the risk of increasing cynicism levels leading to burnout. In contrast to previous international research findings, being young and having less working experience was not related to burnout symptoms of Dutch newly qualified midwives. IMPLICATIONS FOR PRACTICE: The recognition of job and personal resources for midwives' occupational wellbeing must be considered for a sustainable midwifery workforce. Midwifery Academies need to develop personal resources of their students that will help them in future practice.

The Demands of Surgery Residency: More Than Just Duty Hours?

INTRODUCTION: Efforts to improve surgical resident well-being could be accelerated with an improved understanding of resident job demands and resources. In this study, we sought to obtain a clearer picture of surgery resident job demands by assessing how residents distribute their time both inside and outside of the hospital. Furthermore, we aimed to elucidate residents' perceptions about current duty hour regulations. METHODS: A cross-sectional survey was sent to 1098 surgical residents at 27 US programs. Responses regarding work hours, demographics, well-being (utilizing the physician well-being index), and perceptions of duty hours in relation to education and rest, were collected. Data were evaluated using descriptive statistics and content analysis. RESULTS: A total of 163 residents (14.8% response rate) were included in the study. Residents reported a median total patient care hours per week of 78.0 h. Trainees spent 12.5 h on other professional activities. Greater than 40% of residents were "at risk" for depression and suicide based on physician well-being index scores. Four major themes associated with education and rest were identified: 1) duty hour definitions and reporting mechanisms do not completely reflect the amount of work residents perform, 2) quality patient care and educational opportunities do not fit neatly within the duty hour framework, 3) resident perceptions of duty hours are impacted the educational environment, and 4) long work hours and lack of adequate rest negatively affect well-being. CONCLUSIONS: The breadth and depth of trainee job demands are not accurately captured by current duty hour reporting mechanisms, and residents do not believe that their current work hours allow for adequate rest or even completion of other clinical or academic tasks outside of the hospital. Many residents are unwell. Duty hour policies and resident well-being may be improved with a more holistic accounting of resident job demands and greater attention to the resources that residents have to offset those demands.

Determining the role and responsibilities of the community epilepsy nurse in the management of epilepsy.

AIMS AND OBJECTIVES: The aim of this study is to enhance the understanding of the core elements and influencing factors on the community-based epilepsy nurse's role and responsibilities. BACKGROUND: Internationally, epilepsy nurse specialists play a key role in providing person-centred care and management of epilepsy but there is a gap in understanding of their role in the community. DESIGN: A national three-stage, mixed-method study was conducted. METHODS: One-on-one, in-depth semi-structured qualitative interviews were conducted online with 12 community-based epilepsy nurses (Stage 1); retrospective analysis of data collected from the National Epilepsy Line, a nurse-led community helpline (Stage 2); and focus group conducted with four epilepsy nurses, to delve further into emerging findings (Stage 3). A thematic analysis was conducted in Stages 1 and 3, and a descriptive statistical analysis of Stage 2 data. Consolidated Criteria for Reporting Qualitative studies checklist was followed for reporting. RESULTS: Three key themes emerged: (1) The epilepsy nurse career trajectory highlighted a lack of standardised qualifications, competencies, and career opportunities. (2) The key components of the epilepsy nurse role explored role diversity, responsibilities, and models of practice in the management of living with epilepsy, and experiences navigating complex fragmented systems and practices. (3) Shifting work practices detailed the adapting work practices, impacted by changing service demands, including COVID-19 pandemic experiences, role boundaries, funding, and resource availability. CONCLUSION: Community epilepsy nurses play a pivotal role in providing holistic, person-centred epilepsy management They contribute to identifying and addressing service gaps through innovating and implementing change in service design and delivery. RELEVANCE TO CLINICAL PRACTICE: Epilepsy nurses' person-centred approach to epilepsy management is influenced by the limited investment in epilepsy-specific integrated care initiatives, and their perceived value is impacted by the lack of national standardisation of their role and scope of practice. NO PATIENT OR PUBLIC CONTRIBUTION: Only epilepsy nurses' perspectives were sought.

Mindfulness Practice and Job Performance in Social Workers: Mediation Effect of Work Engagement.

Despite a rapid increase in the work force over the last decade, the social work labor force is still suffering through high amounts of stress and burnout that could negatively affect work engagement and job performance in China. A potential solution worth exploring, however, is the practice of mindfulness, a concept based on expanding one's awareness to target focus without judgement. Using 537 social workers from street-level social work service stations in Guangzhou, China, this paper examines the relation between mindfulness practice and job performance, and whether work engagement mediated the relation through the application of the job demand and resources theory. The findings indicate that that mindfulness practice directly increases work engagement (Beta = 0.33) and has an indirect effect on job performance (Beta = 0.21) through its effect on work engagement that fully mediated the relation between mindfulness practice and job performance. In contrast to formal mindful practices (Beta = 0.13), informal mindful practices (Beta = 0.22) encompass a broader impact on employee performance. The findings suggest that mindfulness practice can effectively be used in workspaces to enhance engagement and performance of social workers in China.

How does mindfulness help university employees cope with emotional exhaustion during the COVID-19 crisis? The mediating role of psychological hardiness and the moderating effect of workload.

The COVID-19 crisis has had severe adverse psychological effects on people globally. Although previous research has shown that mindfulness helps people cope with stressful situations, we do not know whether mindfulness can help people cope with the effects of the pandemic. This research examined the effect mindfulness has on emotional exhaustion on the part of employees who work at private international universities in Thailand that are affected by COVID-19. Grounded in the Conservation of Resources (COR) theory, this research proposed that the level of psychological hardiness mindful employees have mediates the effect of mindfulness in reducing emotional exhaustion. The Job Demands-Resource (JD-R) model was used as an additional theory to test the moderating effect of workload, which may reduce the benefit mindfulness has in alleviating emotional exhaustion. Questionnaire survey data were collected from 300 employees at two universities. Data analysis was conducted using partial least squares structural equation modeling, and the model showed that psychological hardiness mediated the effect mindfulness has on emotional exhaustion fully. Further, the analysis supported the moderating role workload plays in suppressing the effect of psychological hardiness on emotional exhaustion significantly. A simple slope analysis indicated as well that the negative association between psychological hardiness and emotional exhaustion was present only in employees with light workloads. By integrating the principle of COR theory with the JD-R model, this research extended previous research by showing that mindfulness may not help employees cope with stress during an organizational crisis like COVID-19 when they have to manage a heavy workload.

A conceptual model of risk and protective factors for autistic burnout.

Early qualitative research indicates that autistic burnout is commonly experienced by autistic people and is associated with significant, negative consequences for their mental health, wellbeing, and quality of life, including suicidality. Findings to date suggest that factors associated with being autistic and the widespread lack of autism awareness and acceptance within society contribute to the onset and recurrence of autistic burnout. Based on autistic adults' descriptions of their lived experiences, a Conceptual Model of Autistic Burnout (CMAB) is proposed, which describes a series of hypothesized relationships between identified risk and protective factors that may contribute to, or buffer against, autistic burnout. The theoretical framework for the CMAB is based on the Social-Relational model of disability and neurodiversity paradigm, and the Job Demands-Resources model of burnout, and Conservation of Resources theory. The CMAB offers a holistic perspective for understanding individual, social, and environmental factors that can influence autistic burnout via various direct and indirect pathways. Autistic burnout research is in its infancy and the CMAB provides a foundation for future investigations about this condition. LAY SUMMARY: Although many autistic people describe experiencing autistic burnout, there has been little research on this topic. Based on descriptions of autistic peoples' lived experiences, we developed a conceptual model to explore how various risk and protective factors may interact to contribute to, or prevent, autistic burnout.

Job Demands and Resources, Mindfulness, and Burnout Among Delivery Drivers in China.

The food and package delivery workforce in China has grown substantially in the past decade. However, delivery drivers face volatile and stressful work conditions, which can give rise to high turnover and burnout. Past research has indicated that job demands and resources (JD-R) significantly predict burnout. Scholars have also found evidence that mindfulness may be a protective factor against negative outcomes like burnout. Using data collected from 240 food and package delivery drivers in Beijing, China, we examined the effects of JD-R on burnout and whether these relations were moderated by mindfulness. Estimates produced by regression analyses indicated that job demands (JD) have significantly positive effects on burnout (ß = 0.33), while job resources (JR) have a significant negative effect on burnout (ß = -0.32). Mindfulness significantly moderated the effects of JD and JR on burnout (ß = -1.64 and - 1.30, respectively). Results suggest that mindfulness is a protective factor for delivery drivers. Practice and policy implications are discussed.

Experiences and views of nurses about unmet needs of older cancer patients receiving chemotherapy: A qualitative study.

OBJECTIVE: The aim is to understand the experiences and views of oncology nurses about the unmet care needs of older cancer patients receiving chemotherapy. Nurses play the key role in evaluating and determining the needs of this special group. METHOD: A phenomenological descriptive qualitative study with convenience sampling was used. Participants were referred by the Turkish Oncology Nursing Society. The study participants were 12 nurses aged 34-53 years, with oncology experience between 5 and 27 years. The data were collected using semi-structured face-to-face interviews. Interviews were transcribed verbatim with concurrent analyses and data collection. Thematic content analysis was used to determine common domains. RESULTS: The study data were categorized into 3 contexts, 12 themes, and 37 subthemes. The first context, "unmet needs", includes physical care, psychological care, and social care themes. The second context, "barriers to meeting those needs", comprises the theme of patient characteristics, attitude of family, attitude of the nurses/healthcare team, health system, and culture. The last context is "suggestions for meeting needs". Nurses play an important role in identifying and meeting unmet psychosocial needs. SIGNIFICANCE OF RESULTS: The study indicated that older cancer patients had problems in identifying, expressing, and making demands for their needs and that their culture contributed to this situation. Nurses serving in the outpatient chemotherapy units should conduct a holistic assessment of older cancer patients, be aware that these patients may not be able to express their needs, be more sensitive toward them, and ensure that the voice of the older patients is heard.

Job Demands, Resources, and Burnout in Social Workers in China: Mediation Effect of Mindfulness.

Internationally, human service professionals, including social workers, experience high burnout and turnover rates. Despite the recent and rapid development of contemporary social work in China, Chinese social workers similarly experience significant rates of burnout. Therefore, there is a need to investigate the factors that contribute to social work burnout. This study applied the job demands and resources (JD-R) model to examine the effects of JD-R on burnout in social workers (n = 897) from Chengdu, China, and whether these relations are mediated by state mindfulness. Structural equation modeling results supported the previously hypothesized dual process by which JD-R affect burnout, specifically in a sample of social workers in China. Job demands (JD) were positively associated with burnout, while job resources (JR) were negatively associated with burnout. These relations were partially mediated by state mindfulness. JR had a strong, positive direct effect on mindfulness (ß = 0.38), and its total effect on burnout was high (ß = -0.56). Meanwhile, JD had a slight negative direct effect on mindfulness (ß = -0.09), and its total effect on burnout was 0.42. The results suggest that the implementation of mindfulness-based interventions for social workers can potentially mitigate the effect of JD on burnout, as well as increase the effect of JR on burnout.

Centrality and compatibility of institutional logics when introducing value-based reimbursement.

PURPOSE: Using financial incentives has been criticised for putting too much focus on things that can be measured. Value-based reimbursement may better align professional values with financial incentives. However, professional values may differ between actor groups. In this article, the authors identify institutional logics within healthcare-providing organisations. Further, the authors analyse how the centrality and compatibility of the identified logics affect the institutionalisation of external demands. DESIGN/METHODOLOGY/APPROACH: 41 semi-structured interviews were conducted with representatives from healthcare providers within spine surgery in Sweden, where a value-based reimbursement programme was introduced. Data were analysed using thematic content analysis with an abductive approach, and a conceptual framework based on neo-institutional theory. FINDINGS: After the introduction of the value-based reimbursement programme, the centrality and compatibility of the institutional logics within healthcare-providing organisations changed. The logic of spine surgeons was dominating whereas physiotherapists struggled to motivate a higher cost for high quality physiotherapy. The institutional logic of nurses was aligned with spine surgeons, however as a peripheral logic facilitating spine surgery. To attain holistic and interdisciplinary healthcare, dominating institutional logics within healthcare-providing organisations need to allow peripheral institutional logics to attain a higher centrality for higher compatibility. Thus, allowing other occupations to take responsibility for quality and attain the feeling of professional pride. ORIGINALITY/VALUE: Interviewing spine surgeons, physiotherapists, nurses, managers and administrators allows us to deepen the understanding of micro-level behaviour as a reaction (or lack thereof) to macro-level decisions.

Testing a holistic conceptual framework for early childhood teacher well-being.

Using a holistic conceptualization of teacher well-being in concert with the Job Demands and Resources (JD-R) framework, our interdisciplinary study examined associations among various job demands and resources and whole teacher well-being (i.e., professional, psychological, and physical well-being) in early care and education settings. First, we investigated direct associations of job demands and resources with teachers' professional well-being. Second, we tested two models of potential mediation for the relationship of job demands and resources to well-being using structural equation modeling techniques: (a) that psychological and physical well-being mediate the relationship between demands, resources, and professional well-being; and (b) that professional well-being mediates the relationship between demands, resources, and psychological and physical well-being. Although our sample of early childhood teachers (n = 262) reported high levels of professional well-being (i.e., work commitment, self-efficacy), a substantial number of them experienced challenges in both psychological (e.g., perceived stress, depressive symptoms) and physical (e.g., ergonomic pain) well-being. As expected, teachers' work-related stressors and work resources (positive work climate, quality of the physical environment) were directly associated with teachers' professional well-being. Contrary to our expectations, however, instrumental resources (i.e, wages, health insurance) did not predict any aspects of teachers' professional well-being. Our data only supported the first of the two tested mediation hypotheses (i.e., that psychological and physical well-being mediated the associations between working conditions and professional well-being), but with one caveat: physical well-being preceded psychological well-being in mediating the associations. These results advance our understanding of the challenges present in the early childhood workforce and have implications for policies and programs to improve teacher working conditions and well-being.

What matters to patients? A mixed method study of the importance and consideration of oncology patient demands.

BACKGROUND: A patient-centred approach is increasingly the mandate for healthcare delivery, especially with the growing emergence of chronic conditions. A relevant but often overlooked obstacle to delivering person-centred care is the identification and consideration of all demands based on individual experience, not only disease-based requirements. Mindful of this approach, there is a need to explore how patient demands are expressed and considered in healthcare delivery systems. This study aims to: (i) understand how different types of demands expressed by patients are taken into account in the current delivery systems operated by Health Care Organisations (HCOs); (ii) explore the often overlooked content of specific non-clinical demands (i.e. demands related to interactions between disease treatments and everyday life). METHOD: We adopted a mixed method in two cancer centres, representing exemplary cases of organisational transformation: (i) circulation of a questionnaire to assess the importance that breast cancer patients attach to every clinical (C) and non-clinical (NC) demand identified in an exploratory inquiry, and the extent to which each demand has been taken into account based on individual experiences; (ii) a qualitative analysis based on semi-structured interviews exploring the content of specific NC demands. RESULTS: Further to the way in which the questionnaires were answered (573 answers/680 questionnaires printed) and the semi-structured interviews (36) with cancer patients, results show that NC demands are deemed by patients to be almost as important as C demands (C = 6.53/7 VS. NC = 6.13), but are perceived to be considered to a lesser extent in terms of pathway management (NC = 4.02 VS C = 5.65), with a significant variation depending on the type of non-clinical demands expressed. Five types of NC demands can be identified: demands relating to daily life, alternative medicine, structure of the treatment pathway, administrative and logistic assistance and demands relating to new technologies. CONCLUSIONS: This study shows that HCOs should be able to consider non-clinical demands in addition to those referring to clinical needs. These demands require revision of the healthcare professionals' mandate and transition from a supply-orientated system towards a demand-driven approach throughout the care pathway. Other sectors have developed hospitality management, mass customisation and personalisation to scale up approaches that could serve as inspiring examples.

Demanda espontânea e acesso no Sistema Único de Saúde: vivências de usuários da atenção primária / Demanda espontánea y acceso al Sistema Único de Salud: experiencias de usuarios de atención primaria / Spontaneous demand and access to the Unified Health System: The experience of primary care users

Objetivo: compreender as vivências cotidianas de usuários, em demanda espontânea, para o acesso e a acessibilidade no Sistema Único de Saúde na porta de entrada da Atenção Primária à Saúde. Materiais e métodos: estudo de casos múltiplos holístico-qualitativo, fundamentado na sociologia compreensiva do cotidiano, com 60 participantes de município de gran-de porte do estado de Minas Gerais, Brasil. Resultados:a demanda espontânea, no cotidiano, está voltada para o agendamento de consultas, para o aten-dimento médico e para o acesso aos exames, em uma assistência ao adoecimento. Os usuários apresentam dificuldades para o acesso e a acessibilidade às ações e aos serviços. Conclusões: o acesso aos serviços de saúde da Atenção Primária/Estratégia Saúde da Família continua desafiador, restritivo e burocrático, regulado pela demanda espontânea do usuário e pela agenda médica.

Objetivo: comprender las vivencias cotidianas de los usuarios en demanda espontánea en cuanto al acceso al Sistema Único de Salud en la puerta de entrada a la atención primaria en salud. Materiales y métodos: estudio de caso múltiple holístico-cualitativo, basado en la sociología integral de la vida cotidiana, con 60 participantes de un municipio en el estado de Minas Gerais, Brasil. Resultados: la demanda espontánea, en la vida diaria, está dirigida a programar citas, brindar atención médica y gestionar la realización de exámenes, brindado asistencia en caso de enfermedad. Se evidencia que los usuarios tienen dificultades de acceso y accesibilidad a servicios y procedimientos. Conclusiones: el acceso a los servicios de atención primaria en salud (Estrategia de Salud de la Familia) sigue siendo desafiador, restrictivo y burocrático, regulado por la demanda espontánea del usuario y la agenda médica.

Objective: To understand the daily experiences of spontaneous demand users regarding access and accessi-bility to the Unified Health System (Sistema Único de Saúde) through the gateway of primary health care. Materiales and methods: Holistic and qualitative multiple case study based on comprehensive sociology that addresses the every-day life of 60 participants in the state of Minas Gerais, Brazil. Results: Spontaneous demand, in real life, is aimed at scheduling patients appointments, medical care and exams, assisting them in case of illness. Findings show that users have difficulties in accessing services and procedures. Conclusions: Access to primary care services (Family Health Strategy) continues to be challenging, restrictive and bureaucratic, and is regulated by the spontaneous demand of users and the medical agenda

The routine of the street outreach office team: Procedures and care for the homeless.

This study aims to understand the routine of the street outreach office team regarding the attention paid to the homeless. It is a holistic qualitative multiple case study, based on Michel Maffesoli's Comprehensive and Quotidian Sociology. It was performed using two key informants and 20 professionals of the street outreach office of two capitals in the South of Brazil. For data analysis, we used the Thematic Content Analysis. The itinerancy, the unexpected and the immediacy of homeless people are part of the team's everyday life. The potentialities of the teams are their intra- and intersectoral networks; inter- and transdisciplinarity; and available material/diagnostic resources, whereas the limitations are their inequalities, vulnerabilities and social exclusion, in addition to the specificities of the homeless and the multiple problems that these people live with. Understanding the routine of the street outreach office reveals co-responsibility in unique actions aligned with the needs of the homeless, precisely signalling that health care needs to be integrated into a network so that these individuals can meet the complex challenges of living in unsafe street environments.

Universalidade do acesso e acessibilidade no quotidiano da atenção primária: vivências de usuários do sus / Universalidad del acceso y accesibilidad en el cotidiano de la atención primaria: vivencias de usuarios del sus / Universality of access and accessibility in the daily care of primary care: sus user experiences

Objetivo: Compreender o acesso e a acessibilidade à saúde na perspectiva de usuários, em atendimento à demanda espontânea em unidades de Atenção Primária à Saúde (APS). Métodos: Estudo de Casos Múltiplos Holístico-qualitativo, fundamentado na Sociologia Compreensiva do Quotidiano com 60 participantes, em município de grande porte de Minas Gerais. Resultados: Revelam a Saúde como uma questão de luta no quotidiano da APS, destacando as dificuldades enfrentadas pelos usuários do Sistema Único de Saúde (SUS), no que concerne o acesso aos serviços, ações, exames e medicamentos. Denotam a desorganização administrativa e morosidade do Sistema, a questão política, a judicialização. A situação contemporânea do SUS foi questionada: o que precisa no SUS? Conclusão: A realidade vivenciada pelos usuários indica que ainda não foi alcançada a idealização de um Sistema universal, equânime e integral. Ademais, a pesquisa possibilitou reflexões de todos os atores envolvidos, usuários, profissionais de saúde e gestores, sobre o exercício da participação social no SUS e a formação de sujeitos proativos na tomada de decisões políticas para o cumprimento e vigor das legislações que implementam o SUS (AU)

Objective: To understand the accessibility to health from the perspective of users in response to spontaneous demand in Primary Health Care (PHC) units. Methods: Holistic-qualitative Multiple Case Study based on Quotidian Comprehensive Sociology with 60 participants, in a large municipality of Minas Gerais. Results: They reveal Health as a matter of struggle in the daily life of PHC, highlighting the difficulties faced by users of the Brazilian Unified Health System (SUS) regarding access to services, actions, exams and medications. They denote the administrative disorganization and slowness of the System; political issues; and judicialization. The contemporary SUS situation was questioned: what do you need from SUS? Conclusion: The reality experienced by users indicates that the idealization of a universal, equitable and integral system has not yet been achieved. Furthermore, the research allowed reflections of all users, health professionals and managers on the exercise of social participation in SUS and the formation of proactive subjects in making political decisions for the compliance and vigor of the laws that implement SUS (AU)

Objetivo: Comprender el acceso y la accesibilidad a la salud en la perspectiva de los usuarios, en respuesta a la demanda espontânea en unidades de Atención Primaria a la Salud (APS). Métodos: Estudio de Casos Múltiples Holístico-cualitativo, fundamentado em la Sociología Comprensiva del Quotidiano con 60 participantes, en municipio de gran porte de Minas Gerais. Resultados: Revelan la Salud como una cuestión de lucha em el cotidiano de la APS, destacando lãs dificultades enfrentadas por los usuarios del Sistema Único de Salud (SUS) em lo que concierne al acceso a los servicios, acciones, exámenes y medicamentos. Denota la desorganización administrativa y la morosidad del sistema; la cuestión política; la judicialización. La situación contemporânea del SUS fue cuestionada: ¿qué necessita em el SUS? Conclusión: La realidad experimentada por los usuarios indica que la idealización de un sistema universal, equitativo e integral aún no se ha logrado. Además, la investigación permitió reflexionar sobre todos los actores involucrados, usuarios, profesionales de la salud y gerentes, sobre el ejercicio de la participación social en el SUS y la formación de sujetos proactivos en la toma de decisiones políticas para el cumplimiento y el vigor de las leyes que implementan el SUS.(AU)

How to foster nurses' well-being and performance in the face of work pressure? The role of mindfulness as personal resource.

AIM: The aim of this study was to study the simultaneous relationships of work pressure with the performance and well-being of nurses and to explore whether mindfulness moderates these relationships. DESIGN: A cross-sectional survey design. METHOD: We conducted a cross-sectional survey of 1,021 nurses from 103 Belgian care homes for older people, in 2017. Data were analysed using hierarchical multiple regression and simple slope analyses. RESULTS: Work pressure was positively associated with empathetic care, job performance and emotional exhaustion and negatively associated with work engagement. Mindfulness was positively related to empathetic care, job performance and work engagement and negatively related to emotional exhaustion. Regarding the moderations, mindfulness moderated the relationships between work pressure and both performance outcomes, as well as between work pressure and work engagement. Contrary to what we expected: (a) mindfulness showed no significant buffering effect of work pressure on emotional exhaustion; (b) the relationship between work pressure and both empathic care and job performance was stronger when mindfulness was low (vs. high); and (c) mindfulness strengthened instead of weakened the negative relationship between work pressure and work engagement. However, in high work pressure settings, more mindful individuals still had better job performance and work engagement outcomes than less mindful individuals. CONCLUSION: Our findings explain conflicting outcomes on the effects of work pressure by suggesting that work pressure can function both as a hindrance and a challenge job demand depending on the outcome. Furthermore, by exploring the role of mindfulness as a personal resource, we add to the literature on the role of personal resources in the job demands-resources (JD-R)-model which is particularly relevant in the context of increasing work pressure. IMPACT: Nurses are confronted with increasing work pressure. The present findings indicate that the implementation of mindfulness strategies can be beneficial for nurses dealing with work pressure, contributing to nursing practice and JD-R theory.

Does Acute Beetroot Juice Supplementation Improve Neuromuscular Performance and Match Activity in Young Basketball Players? A Randomized, Placebo-Controlled Study.

Whereas beetroot juice (BJ) supplementation is shown to increase physical performance in endurance activities, its benefits in team sports has been barely studied. In this randomized placebo-controlled study, we investigated the effects of BJ acute supplementation in improving neuromuscular performance and physical match activity in basketball. Ten young male competitive basketball players aged 15-16 years received 140 mL of BJ or placebo (PLA) on two separated days in a balanced cross-over design. Testing sessions comprised a neuromuscular test battery consisting of a countermovement jump (CMJ), isometric handgrip strength, 10-m/20-m sprint and agility T-test, followed by a 40-minute simulated basketball match. Physical match activity (distances, speeds, accelerations, and decelerations) was monitored using an inertial tracking system (Wimu ProTM) Results revealed no significant effects of BJ on CMJ (p = 0.304, ES = 0.13), isometric handgrip strength (p = 0.777, ES = 0.06), 10-m (p = 0.820, ES = 0.10), and 20-m sprint (p = 0.540, ES = 0.13), agility T-test (p = 0.979, ES ≤ 0.01) and any physical match demands (p > 0.151, ES = 0.13-0.48). Acute moderate doses of BJ (12.8 mmol of NO3-) was not effective in improving neuromuscular performance (jump height, isometric handgrip strength, sprint, and agility) or physical match requirements in young trained basketball players the day of the competition.

The Sacred and Stressed: Testing a Model of Clergy Health.

In many ways, clergy and religious leaders are an ignored, yet high-risk population. A clergy member unable to cope with challenges in his or her own life may be ineffective at helping church members to cope with their stress. In the present study, we developed and tested an operational model of clergy holistic health, including occupational demands, and personal and job-related resources. Data were collected from clergy (N = 418) and analyzed using correlational and regression-based techniques. Results from the present study provide support for the demands-control-support model (Johnson and Hall in Am J Public Health 78(10):1336-1342, 1988). Specifically, our findings suggest that clergy mental health may be improved by (a) an increase in the work-related social support needed to take advantage of job control followed by (b) an increase in job control. Furthermore, the present findings expand on previous research by identifying spiritual well-being as an important outcome that may be impacted by job-related demands. The present findings also underscore the value of contextualized or occupation-specific measures, given the stronger correlations that were observed between the occupation-specific measure of perceived job demands than the general measure of perceived job demands.

Demands for Development of Taurine-Containing Home Meal Replacement for Prevention of Dementia According to Age.

It has been reported that taurine intake in the past may have a positive effect on present cognitive function in the elderly. The purpose of this cross-sectional study was to investigate the need to develop an elderly-friendly home meal replacement (EF-HMR) containing taurine for the prevention of dementia in Korean adults aged 40-84 years. Study subjects included 481 adults 40-49 years group, 319 adults 50-64 years group, and 181 elderly group (65-84 years old) residing in Seoul and its metropolitan area, Korea. Data were collected from adults aged 40-64 years by self-administered questionnaires and from elderly through face-to-face interviews. Statistical analysis was performed using SPSS 18.0. The level of need for EF-HMR was significantly higher in 40-49 years and 50-64 years groups compared to the elderly group (p < 0.001). With regard to the preferred EF-HMR taste, the needs for less salty (p < 0.01) and less sweet (p < 0.001) foods were significantly higher in 40-49 years group compared to the elderly group. The main factors of consideration in the development of EF-HMR were nutrition, taste, and freshness. The level of need for EF-HMR containing taurine was significantly lower in those 40-49 years and 50-64 years groups compared to the elderly group (p < 0.01). If an EF-HMR containing taurine for prevention of dementia was developed, willingness to buy such a food was significantly higher in the elderly group than in those 40-49 years and 50-64 years groups (p < 0.01). Regarding cooked EF-HMR containing taurine, semi-prepared and ready-made meals were preferred in 71.1% and 25.4% in 40-49 years group, 69.6% and 22.6% in 50-64 years group, and 47.0% and 33.7% in the elderly group, respectively (p < 0.001). EF-HMR containing taurine sales unit sizes containing 3 servings or 1 serving was preferred by 37.2% and 26.3% of all subjects. The preferred places to purchase EF-HMR (in descending order of super-supermarket (mart), supermarket, and convenience store) were the same among the age groups. Therefore, it is necessary to understand the diversity present in the needs and purchasing characteristics of adults involved purchasing EF-HMR containing taurine, and there is a need to develop age-specific customized products for the elderly and for Korean adults 40-64 years old.

Is There a Preferred Mode of Exercise for Cognition Enhancement in Older Age?-A Narrative Review.

The aim of this review is to examine the moderating effect of the mode of exercise on the exercise-cognition relationship. Is one mode of exercise more efficient in enhancing cognition than the other? For example, is aerobic exercise preferable over balance training? Based on official guidelines for old age, exercise modes include aerobic activity, strength (resistance) training, flexibility, balance, and coordination. In relation to cognition, these exercise modes are further divided into two categories: physical training-aerobic and strength, and motor training-balance, coordination, and flexibility. The physical training activities are repetitive and automatic in nature, and require high metabolic energy and relatively low neuromuscular effort. The motor activities involve high neuromuscular demands and relatively low metabolic demands. In addition, there are specific movement skills that require more neuromuscular effort (e.g., Tai Chi), and sometimes also greater metabolic demands (e.g., tennis). Selected studies examining the effect of various modes of exercise on cognition contend that both training categories affect neuroplasticity, and consequently cognitive functioning. However, there are two main differences between them: (1) Physical training affects cognition via improvement in cardiovascular fitness, whereas motor training affects cognition directly; (2) Physical training affects neuroplasticity and cognition in a global manner, while motor training is task-specific in increasing brain neuroplasticity and in affecting cognition. Examining the underpinnings of these pathways reveals that there is a difference in the underlying forces behind the two training categories. In the physical training category, it is the intensity of training that enhances neuroplasticity and consequently improves cognition, while in the motor activities it is the task complexity that increases neuroplasticity, which improves cognition. Dual-task training, which includes cognitive demands in addition to physical or motor activity, has proven more effective in improving cognitive functioning than a single task. The implications are that if all training components traditionally recommended by official bodies-physical as well as motor training-are efficient in enhancing cognition, then we merely have to emphasize the inclusion of all exercise modes in our routine exercise regimen for physical as well as cognitive health in advanced age.