Caring for others without losing yourself: An adaptation of the Mindful Self-Compassion Program for Healthcare Communities.

OBJECTIVE: Two studies examined the efficacy of the Self-Compassion for Healthcare Communities (SCHC) program for enhancing wellbeing and reducing burnout among healthcare professionals. METHOD: Study 1 (N = 58) had a quasi-experimental design and compared wellbeing outcomes for the SCHC group compared to a waitlist control group. Study 2 (N = 23) did not include a control group and examined the effect of SCHC on burnout. RESULTS: Study 1 found that SCHC significantly increased self-compassion and wellbeing. All gains were maintained for three months. Study 2 found that in addition to enhancing wellbeing, SCHC significantly reduced secondary traumatic stress and burnout. Changes in self-compassion explained gains in other outcomes, and initial levels of self-compassion moderated outcomes so that those initially low in self-compassion benefitted more. CONCLUSIONS: Findings suggest that the SCHC program may be an effective way to increase self-compassion, enhance wellbeing, and reduce burnout for healthcare professionals.

Hematological malignancies in East Africa-Which cancers to expect and how to provide services.

BACKGROUND: Sub-Saharan Africa (SSA) has an increasing non-communicable disease burden. Tanzania has an incidence of more than 35,000 cancer cases per year with an 80% mortality rate. Hematological malignancies account for 10% of these cases. The numbers will double within the next 10 years due to demographic changes, better diagnostic capabilities and life style changes. Kilimanjaro Christian Medical Centre established a Cancer Care Centre (CCC) in December 2016 for a catchment area of 15 million people in Northern Tanzania. This article aims to display the hematological diagnosis and characteristics of the patients as well as to describe the advancements of hematologic services in a low resource setting. METHODS: A cross-sectional analysis of all hematological malignancies at CCC from December 2016 to May 2019 was performed and a narrative report provides information about diagnostic means, treatment and the use of synergies. RESULTS: A total of 209 cases have been documented, the most common malignancies were NHL and MM with 44% and 20%. 36% of NHL cases, 16% of MM cases and 63% of CML cases were seen in patients under the age of 45. When subcategorized, CLL/SLL cases had a median age was 56.5, 51 years for those with other entities of NHL. Sexes were almost equally balanced in all NHL groups while clear male predominance was found in HL and CML. DISCUSSION: Malignancies occur at a younger age and higher stages than in Western countries. It can be assumed that infections play a key role herein. Closing the gap of hematologic services in SSA can be achieved by adapting and reshaping existing infrastructure and partnering with international organizations.

[Job satisfaction and motivation in obstetric professionals of a Chilean hospital]. / Satisfacción laboral y motivación en profesionales obstetras en un hospital en Chile.

The main asset of an organization is its workers. Special attention must be paid to their motivation and satisfaction and also to how they relate to performance. Job satisfaction of health care professionals is directly related to the quality of care provided, hence the importance of its measurement. Dissatisfaction can negatively impact the quality of care. The purpose of this study is to determine the level of satisfaction and work motivation of the midwifery professionals of the Hospital of Puerto Montt (Chile). We used a quantitative, descriptive, and cross-sectional study. To measure motivation, we used the Job Diagnostic Survey, and to measure satisfaction, we used the SL-SPC scale. It was possible to determine that the professionals have medium-high levels of motivation in all the dimensions studied. Regarding satisfaction factors, the study showed a medium-low level, in most of the factors measured.

El principal activo de las organizaciones está constituido por sus trabajadores, por lo cual se debe prestar una especial atención a su motivación y satisfacción, y también a la relación con el desempeño. La satisfacción laboral de los profesionales del sistema de salud se relaciona directamente con la calidad de servicio ofrecido, de ahí la importancia de su medición. La insatisfacción puede repercutir negativamente en la calidad de atención. La presente investigación tiene por objetivo determinar el nivel de satisfacción y motivación laboral de los y las profesionales matronas del Hospital de Puerto Montt-Chile, para lo cual se realizó un estudio de carácter cuantitativo, descriptivo y transversal. Para medir la motivación se empleó el Job Diagnostic Survey y para la satisfacción se utilizó la escala de satisfacción laboral SL-SPC. Se logró determinar que los profesionales poseen niveles de motivación media-alta en todas las dimensiones estudiadas. Respecto a los factores de satisfacción, el estudio arrojó un nivel medio-bajo, en la mayoría de los factores medidos.

Traditional and complementary medicine in a nephrology department: practitioner knowledge and advice.

BACKGROUND: Knowledge of traditional and complementary medicine (TCM) and its use by patients are essential for patient safety. AIMS: To examine knowledge of TCM among practitioners in a nephrology unit and their advice to patients. METHODS: This was a descriptive, observational, cross-sectional study. Sociodemographic data were collected and an ad hoc closed response survey was used. FINDINGS: This study included 62 practitioners, of whom: 32.26% had been trained in TCM, with no significant differences between professional groups; 41.93% used TCM and 67.74% recommended TCM to patients, with no significant difference between personal use and training received. The majority (62.90%) approved of TCM being included in clinical practice, 77.42% were in favour of it being included in formal health teaching programmes, 27.42% said patients had requested information on TCM and 50% knew it could interact with conventional treatment. CONCLUSION: Although the majority of practitioners had not been trained in TCM, they were interested in including such treatments in clinical practice. They recommended TCM to patients, but neither training nor personal experience were significant factors in relation to these recommendations. Training in TCM is required to ensure advice is safe.

Perceptions of resuscitation care among in-hospital cardiac arrest responders: a qualitative analysis.

BACKGROUND: In-hospital cardiac arrests (IHCA) occur commonly and are associated with poor survival and variable outcomes. This study aimed to directly survey IHCA responders to understand their perceptions of resuscitation care. METHODS: As part of a quality improvement initiative, we surveyed participating providers of IHCAs at our institution from Jan 2014 to May 2016. The survey included unstructured free text feedback, which was the focus of this study. We systematically coded the free text and organized identifiable latent themes using thematic analysis. We used the natural timeline of an IHCA - pre-arrest, arrest, and post-arrest - for organization of the identifiable latent themes, and created a separate category for holistic remarks that arched across the timeline. RESULTS: We identified 172 IHCAs with a mean of 1.7 responses per arrest (range: 1-8 responses). The mean age of this patient population was 59 years at the time of arrest, and 107 (62%) were men. We identified several themes - [1] issues around code activation and code status characterized the pre-arrest period [2] ,team interactions and issues around supplies/equipment dominated the intra-arrest period, and [3] code cessation and transitions of care typified the post-arrest period. Holistic remarks focused on attentiveness paid by the arrest team to patient comfort and family. Some comments reflected positive experiences but most focused on areas of improvement consistent with the initiative's purpose. In certain cases, we identified a tension between the need to balance established resuscitation protocols with flexibility required by real-life circumstances. CONCLUSIONS: Directly surveying those who participated in IHCAs led to novel insights about their experiences. Our findings suggest that parsing through such qualitative feedback can help hospitals identify areas of improvement, modulate expectations, temper emotions, and refine protocols.

Maternity staff immunization coverage against pertussis and maternal vaccination practices: Results of a 2017 cross-sectional survey in five public maternity hospitals.

OBJECTIVES: To conduct an audit of vaccination practices against pertussis in maternity wards to assess immunization practices targeting women, knowledge and awareness among health professionals and their involvement in the vaccination process, and to estimate their vaccine coverage. MATERIALS AND METHODS: 2017 cross-sectional descriptive survey using a data collection sheet of immunization practices targeting women and an anonymous questionnaire for health professionals whose vaccine coverage had been documented by the occupational health service. RESULTS: Five public maternity wards participated: one had a vaccination policy for women; 426 of 822 health professionals completed the questionnaire, 76% (from 50% of all residents to 83% of nurses) declared their vaccination status as up to date. Staff files in occupational health services showed that 69% of 822 health professionals received at least one vaccine booster during adulthood (57% less than 10 years before the survey); documented vaccination coverage rates ranged from 75% for residents to 91% for senior physicians. Occupational physicians and family physicians respectively performed 41% and 34% of vaccinations. While knowledge regarding vaccines was good, only 47% of health professionals declared prescribing them and 18% declared administering the anti-pertussis vaccine "often" or "very often". CONCLUSIONS: Updated data is needed to confirm the reported increase as participating centers are not representative of all birth centers. The active role of health professionals in vaccination-based pertussis prevention needs to be reinforced.

Coping, mental health, and subjective well-being among mental health staff working in secure forensic psychiatric settings: Results from a workplace health assessment.

Given raised rates of patient suicide and violence in secure psychiatric facilities, staff in such settings are arguably at increased risk for burnout and reduced mental health. The present article responds to the recent U.K. National Institute for Health and Care Excellence (NICE) call to assess workforce well-being. This article held the following aims: (1) to quantify existing levels of mental health (i.e., depression, anxiety, distress, and posttraumatic stress) and subjective well-being (i.e., job satisfaction, life satisfaction, and four domains of burnout) and (2) to evaluate Coping Self-Efficacy (CSE) and Need for Affect (NFA) as factors associated with staff mental health and subjective well-being. We conducted a voluntary cross-sectional health needs assessment of forensic mental health staff (N = 170) between 2017 and 2018 from one National Health Service (NHS) Trust. Descriptive findings suggest staff possessed nonclinical average ranges of mental health symptoms. Subjective well-being findings showed burnout was relatively low, whereas job and life satisfaction were modest. Regression models demonstrated that (a) thought/emotion stopping beliefs were negatively associated with psychological exhaustion; (b) social support beliefs were positively associated with life satisfaction and job enthusiasm; (c) NFA Avoidance was linked with poor mental health and burnout, and; (d) NFA Approach was positively associated with two health subjective well-being indicators. Overall, assessment results suggest NHS forensic mental health staff reported relatively good health. Cognitive- and emotion-focused coping beliefs demonstrate promise as content for prevention programming. Using Emotional Labor Theory, we offer psychological services-based recommendations for future prevention programming and research. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Satisfacción laboral y motivación en profesionales obstetras en un hospital en Chile / Job satisfaction and motivation in obstetric professionals of a Chilean hospital

El principal activo de las organizaciones está constituido por sus trabajadores, por lo cual se debe prestar una especial atención a su motivación y satisfacción, y también a la relación con el desempeño. La satisfacción laboral de los profesionales del sistema de salud se relaciona directamente con la calidad de servicio ofrecido, de ahí la importancia de su medición. La insatisfacción puede repercutir negativamente en la calidad de atención. La presente investigación tiene por objetivo determinar el nivel de satisfacción y motivación laboral de los y las profesionales matronas del Hospital de Puerto Montt-Chile, para lo cual se realizó un estudio de carácter cuantitativo, descriptivo y transversal. Para medir la motivación se empleó el Job Diagnostic Survey y para la satisfacción se utilizó la escala de satisfacción laboral SL-SPC. Se logró determinar que los profesionales poseen niveles de motivación media-alta en todas las dimensiones estudiadas. Respecto a los factores de satisfacción, el estudio arrojó un nivel medio-bajo, en la mayoría de los factores medidos.

The main asset of an organization is its workers. Special attention must be paid to their motivation and satisfaction and also to how they relate to performance. Job satisfaction of health care professionals is directly related to the quality of care provided, hence the importance of its measurement. Dissatisfaction can negatively impact the quality of care. The purpose of this study is to determine the level of satisfaction and work motivation of the midwifery professionals of the Hospital of Puerto Montt (Chile). We used a quantitative, descriptive, and cross-sectional study. To measure motivation, we used the Job Diagnostic Survey, and to measure satisfaction, we used the SL-SPC scale. It was possible to determine that the professionals have medium-high levels of motivation in all the dimensions studied. Regarding satisfaction factors, the study showed a medium-low level, in most of the factors measured.

[Vitamin D Level in Employees of a Swiss University Geriatric Hospital]. / Vitamin-D-Status bei Mitarbeitenden eines universitären Schweizer Geriatriespitals.

Vitamin D Level in Employees of a Swiss University Geriatric Hospital Abstract. Vitamin D plays an important role in health. The aim of this study was to determine the vitamin D level in hospital employees from different age, sex and occupational groups. 281 employees took part in the investigation. Vitamin D (25-OH) was determined by serum sample analysis, the mean value was 59.5 nmol/l. 43.1 % of participants showed a vitamin D deficiency (<50 nmol/l). Low vitamin D levels significantly correlated with increased BMI. Women, physically active employees and those in occupations with medical content had significantly higher vitamin D levels. Sports activity and substitution were independent predictors of vitamin D level. The study illustrated that increased sun exposure and/or vitamin D supplementation are needed.

A Thematic Analysis of Health Care Workers' Adoption of Mindfulness Practices.

Mindfulness training, which teaches individuals to bring awareness and acceptance to the present moment, has been effective in improving the well-being of health care workers. Limited research examines the adoption of mindfulness practices using health behavior theories. The current study sought to conceptualize hospital health care workers' experiences in adopting mindfulness practices using the Health Belief Model (HBM), a theoretical framework used by health promotion practitioners to design and implement health behavior change interventions. Hospital health care workers in Colorado participated in an 8-week Mindfulness-Based Stress Reduction (MBSR) course. Participants ( n = 19) answered open-ended questions about their experiences adopting mindfulness practices. A theory-driven thematic analysis approach was used to analyze data with key constructs of the HBM acting as the framework for the analysis. Results showed that HBM constructs, including internal cues to action, perceived benefits and barriers, and self-efficacy, helped portray the participants' experiences and challenges in adopting and adhering to the mindfulness practices taught in the MBSR course.

Occupational exposure to electromagnetic fields from medical sources.

High exposures to electromagnetic fields (EMF) can occur near certain medical devices in the hospital environment. A systematic assessment of medical occupational EMF exposure could help to clarify where more attention to occupational safety may be needed. This paper seeks to identify sources of high exposure for hospital workers and compare the published exposure data to occupational limits in the European Union. A systematic search for peer-reviewed publications was conducted via PubMed and Scopus databases. Relevant grey literature was collected via a web search. For each publication, the highest measured magnetic flux density or internal electric field strength per device and main frequency component was extracted. For low frequency fields, high action levels may be exceeded for magnetic stimulation, MRI gradient fields and movement in MRI static fields. For radiofrequency fields, the action levels may be exceeded near devices for diathermy, electrosurgery and hyperthermia and in the radiofrequency field inside MRI scanners. The exposure limit values for internal electric field may be exceeded for MRI and magnetic stimulation. For MRI and magnetic stimulation, practical measures can limit worker exposure. For diathermy, electrosurgery and hyperthermia, additional calculations are necessary to determine if SAR limits may be exceeded in some scenarios.

"Phthisiophobia": the difficult recognition of transmission of tuberculosis to health care workers.

BACKGROUND: Even if the contagious nature of tuberculosis was universally accepted during the nineteenth century, its transmission to health care workers (HCWs) was initially denied by the scientific community. Working among TB patients was not considered dangerous for healthy adults, so the potential risks for HCWs were branded as unwarranted "phthisiophobia" (fear of contracting tuberculosis). OBJECTIVES: This study aims at analyzing the problem of tuberculosis transmission among health care workers from an historical perspective, particularly highlighting the contribution made by the Italian Occupational Medicine community. METHODS: Scientific literature and historical sources on different theories regarding tuberculosis transmission were investigated, specially focusing on the period at the turn of the 19th and 20th centuries. RESULTS: At the beginning of the twentieth century, Luigi Devoto (1864-1936), an Italian pioneer in the field of Occupational Medicine, was one of the first scientists to conduct research on the transmission of tuberculosis among nurses. Since the 1920s several studies, conducted mainly on medical and nursing students, confirmed the risk for HCWs. However an international consensus on this issue was only achieved during the 1950s, when the institution of mandatory chest radiographs on admission for all patients significantly decreased the cases of tuberculosis among HCWs. CONCLUSIONS: Devoto was one of the first scholars who postulated the transmission of tuberculosis to HCWs. He also theorized that hospital personnel with active disease could also be a source of contagion to patients. Nowadays, "third party risk" and latent tuberculosis infection pose a new challenge for occupational physicians in hospitals.

Work-related fatigue among medical personnel in Taiwan.

BACKGROUND/PURPOSE: Work-related fatigue among medical personnel is a major concern for patient safety, however heavy on-call duty is common in many hospitals. The purpose of this study was to investigate the prevalence of self-reported work-related fatigue and its associated factors. METHODS: A cross-sectional survey of 1833 participants was conducted in two hospitals in Taipei City, Taiwan, using a self-administered questionnaire. Participants reported their demographic characteristics, health-related behavior, health status and symptoms, and work-related fatigue during the past 3 months. RESULTS: The prevalence of work-related fatigue among the 1833 participants was 30.9%. Younger participants (20-29 years old) were more likely to report work-related fatigue than older participants (40-65 years old) [adjusted odds ratio (aOR) = 1.55, 95% confidence interval (CI) = 1.18-2.01]. Physicians, nurses, and medical technicians were more likely to report work-related fatigue symptoms than administrative personnel (aOR = 2.30, 95% CI = 1.57-2.79; aOR = 2.83, 95% CI = 1.87-3.99; and aOR = 2.01, 95% CI = 1.12-3.06, respectively). Those who drank coffee more than five times a week were more likely to report work-related fatigue than those who did not drink coffee at all (aOR = 2.53, 95% CI = 1.25-1.93). Participants with poor and very poor self-reported health were more likely to report work-related fatigue (aOR = 1.80, 95% CI = 1.26-2.38) than those who reported that their health was fair, good, or very good. CONCLUSION: We identified factors associated with work-related fatigue among hospital workers in Taipei City. These findings can be applied toward on-the-job training and the development of preventive measures for occupational safety in general hospitals.

[Training to management of violence in hospital setting]. / Formation à la gestion des situations violentes en contexte hospitalier.

OBJECTIVE: Evaluate the typology of violence in hospital setting, study the psychophysiological state of care givers dealing with the aggression and provide appropriate training. STUDY DESIGN: Single centre, observational. PATIENTS AND METHODS: A first anonymous questionnaire was given to a sample of emergency and intensive care providers in Narbonne Hospital. The parameters studied included: demographics data, the Trait Anxiety Inventory test, the typology of aggressions, and the psycho-physiological state of subjects dealing with the aggression. Robert Paturel, an instructor of French Special Forces (Recherche-Assistance-Intervention-Dissuasion [RAID]), has provided training for the management of violence. A second questionnaire assessed satisfaction for proposed formation. RESULTS: Forty-one questionnaires were returned. The rates of verbal and physical violence touching care givers were respectively 97 % and 41 % (median of 7years [1-36] experience on the job). Eighty-five percent of care givers wanted training in psychology of conflict and 93 % wanted a formation with a self-defense aspect. The first reason of violence was drugs and alcohol abuse. The "tunnel effect" during stress was identified in 34 % of care givers, and 20 % were unaware of its nature. Twenty-one percent of care givers spontaneously adopting a safe distance of more than 1m during a conflict had been physically assaulted versus 63 % for those staying less than 1m (P=0.03). The proposed formation, including psychology of conflict and self-defense, was satisfactory to all care givers who participated (median score 9/10 [7-10]). CONCLUSION: The verbal and physical violence affecting emergency departments is a common phenomenon warranting appropriate training. The proposed formation included the comprehension of the conflict causality, self-defense and self-control.

A process evaluation of a worksite vitality intervention among ageing hospital workers.

BACKGROUND: The process evaluation of the Vital@Work intervention was primary aimed at gaining insight into the context, dose delivered, fidelity, reach, dose received, and participants' attitude. Further, the differences between intervention locations were evaluated. METHODS: Eligible for this study were 730 workers, aged ≥ 45 years, from two academic hospitals. Workers randomised to the intervention group (n = 367) received a 6-months intervention consisting a Vitality Exercise Programme (VEP) combined with three visits to a Personal Vitality Coach (PVC), aimed at goal setting, feedback, and problem solving. The VEP consisted of a guided yoga session, a guided workout session, and aerobic exercising without direct face-to-face instruction, all once a week. Data were collected by means of a questionnaire after the intervention, attendance registration forms (i.e. attendance at guided VEP group sessions), and coaching registration forms (filled in by the PVCs). RESULTS: The dose delivered of the yoga and workout sessions were 72.3% and 96.3%. All PVC visits (100%) were offered. The reach for the yoga sessions, workout sessions and PVC visits was 70.6%, 63.8%, and 89.6%, respectively. When taken these three intervention components together, the reach was 52%. This differed between the two locations (59.2% versus 36.8%). The dose received was for the yoga 10.4 sessions/24 weeks and for the workout 11.1 sessions/24 weeks. The attendance rate, defined as the mean percentage of attended group sessions in relation to the total provided group sessions, for the yoga and workout sessions was 51.7% and 44.8%, respectively. For the yoga sessions this rate was different between the two locations (63.2% versus 46.5%). No differences were found between the locations regarding the workout sessions and PVC visits. Workers attended on average 2.7 PVC visits. Overall, workers were satisfied with the intervention components: 7.5 for yoga sessions, 7.8 for workout sessions, and 6.9 for PVC visits. CONCLUSIONS: The implementation of the intervention was accomplished as planned with respect to the dose delivered. Based on the reach, most workers were willing to attend the guided group sessions and the PVC visits, although there were differences between the locations and between intervention components. Overall, workers were positive about the intervention. TRIAL REGISTRATION: Trial registration NTR1240.

The role of hospital midwives in the Netherlands.

BACKGROUND: Most midwives in the Netherlands work in primary care where they are the lead professionals providing care to women with 'normal' or uncomplicated pregnancies, while some midwives work in hospitals ("clinical midwives"). The actual involvement of midwives in maternity care in hospitals is unknown, because in all statistics births in secondary care are registered as births assisted by gynaecologists. The aim of this study is to gain insight in the involvement of midwives with births in secondary care, under supervision of a gynaecologist. This is done using data from the PRN (The Netherlands Perinatal Registry), a voluntary registration of births in the Netherlands. The PRN covers 97% to 99% of all births taking place under responsibility of a gynaecologist. METHODS: All births registered in secondary care in the period 1998-2007 (1,102,676, on average 61% of all births) were selected. We analyzed trends in socio-demographic, obstetric and organisational characteristics, associated with the involvement of midwives, using frequency tables and uni- and multivariate logistic regression analyses. As main outcome measure the percentage of births in secondary care with a midwife 'catching' the baby was used. RESULTS: The proportion of births attended by a midwife in secondary care increased from 8.3% in 1998 to 26.06% in 2007, the largest increase involving spontaneous births of a second or later child, on weekdays during day shifts (8.00-20.00 hr) from younger mothers with a gestational age (almost) at term. After 2002, parallel to the growing numbers of midwives working in hospitals, the percentage of instrumental births decreased. CONCLUSIONS: In 2007 more midwives are assisting with more births in secondary care than in 1998. Hospital-based midwives are primarily involved with uncomplicated births of women with relatively low risk demographical and obstetrical characteristics. However, they are still only involved with half of the less complicated births, indicating that there may be room for more midwives in hospitals to care for women with relatively uncomplicated births. Whether an association exists between the growing involvement of midwives and the decreasing percentage of instrumental births needs further investigation.

Measuring and comparing safety climate in intensive care units.

BACKGROUND: Learning about the factors that influence safety climate and improving the methods for assessing relative performance among hospital or units would improve decision-making for clinical improvement. OBJECTIVES: To measure safety climate in intensive care units (ICU) owned by a large for-profit integrated health delivery systems; identify specific provider, ICU, and hospital factors that influence safety climate; and improve the reporting of safety climate data for comparison and benchmarking. RESEARCH DESIGN: We administered the Safety Attitudes Questionnaire (SAQ) to clinicians, staff, and administrators in 110 ICUs from 61 hospitals. SUBJECTS: A total of 1502 surveys (43% response) from physicians, nurses, respiratory therapists, pharmacists, mangers, and other ancillary providers. MEASURES: The survey measured safety climate across 6 domains: teamwork climate; safety climate; perceptions of management; job satisfaction; working conditions; and stress recognition. Percentage of positive scores, mean scores, unadjusted random effects, and covariate-adjusted random effect were used to rank ICU performance. RESULTS: The cohort was characterized by a positive safety climate. Respondents scored perceptions of management and working conditions significantly lower than the other domains of safety climate. Respondent job type was significantly associated with safety climate and domain scores. There was modest agreement between ranking methodologies using raw scores and random effects. CONCLUSIONS: The relative proportion of job type must be considered before comparing safety climate results across organizational units. Ranking methodologies based on raw scores and random effects are viable for feedback reports. The use of covariate-adjusted random effects is recommended for hospital decision-making.

[Prevalence of deficient and insufficient vitamin D levels in a young healthy population]. / Prevalencia de concentraciones deficientes e insuficientes de vitamina D en una población joven y sana.

BACKGROUND AND OBJECTIVES: Recent studies have shown a high frequency of insufficient serum vitamin D levels in the general population, especially in the elderly and in individuals with osteoporosis. Data from the young adult population are scarce, but also reveal a high prevalence of vitamin D insufficiency and deficiency in this age group. The main reasons for this high prevalence seem to be poor dietary vitamin D intake and low sun exposure. The aim of the present study was to determine the prevalence of vitamin D insufficiency and deficiency in a young healthy population and its association with concentrations of calcium and parathyroid hormone and sun exposure. METHODS: We performed an observational, descriptive study in 116 subjects (38 men and 78 women aged 26.56 +/- 3.32 years), during the late spring and early summer of 2007. Fasting blood samples were obtained and levels of 25-hydroxivitamin D, intact parathyroid hormone, calcium, albumin and creatinine were measured. A questionnaire designed to assess sun exposure and sunshine protection during the previous 12 months was administered. RESULTS: The mean value of 25-hydroxivitamin D obtained was 24.58 +/- 6.98 ng/ml. The subjects were divided into three groups according to 25-hydroxivitamin D levels: deficient: < 20 ng/ml (27.58%); insufficient: 20-30 ng/ml (56.03%); and sufficient: > or = 30 ng/ml (16.37%). No statistically significant differences were found between the groups or the studied variables except for age in relation to vitamin D levels. CONCLUSIONS: Our study shows a high prevalence of vitamin D insufficiency in a young healthy population with no clear relationship with sun exposure or sunscreen protection. The low intake of food rich in vitamin D and the lack of food fortification combined with scarce effective sun exposure could account for the low serum levels of vitamin D in this population.

Qigong stress reduction in hospital staff.

OBJECTIVE: The aim of this study was to investigate the effectiveness of a qigong training program in reducing stress in hospital staff. METHODS: Subjects were randomly assigned to a 6-week intervention of either qigong practice (n = 16) or a waiting list (n = 21). The primary measure of stress was the Perceived Stress Scale. Secondary measures included the Short Form 36 (SF-36) quality-of-life measure and a 100-mm analog pain scale. RESULTS: The qigong group demonstrated a statistically significant reduction of perceived stress compared to the control group (p = 0.02). On the Social Interaction subscale of the SF-36, the qigong group demonstrated greater improvement compared to controls (p = 0.04). Within-groups analyses demonstrated that the qigong group (p = 0.03), but not the control group, experienced a significant reduction of pain intensity. A regression analysis demonstrated an association between higher baseline stress levels and greater improvement within the qigong group (R(2) = 0.34; p = 0.02). CONCLUSIONS: These results suggest that short-term exposure to qigong was effective in reducing stress in hospital staff. Further studies are needed to evaluate the possible effectiveness of qigong in reducing pain and in improving quality of life.

Workplace violence and corporate policy for health care settings.

Incidents of workplace violence have been of significant concern to health care employers and the public at large. Many employers now find themselves confronted with sentinel events in the workplace, such as assault; property damage; racially, ethnically, or religiously motivated violence; sexual assault; employee suicide; or homicide. Regardless of a health care agency's size or mission, when employees are unexpectedly confronted with workplace violence, they are typically overwhelmed with shock and multiple questions surrounding how the event could have occurred in the safety of the workplace. It is difficult to imagine returning to work only minutes after hearing such news and, yet, in this modern era of corporate health care, this is what usually happens. Awareness of the dynamics and issues related to workplace violence can guide policy development and related interventions to promote safety, stability, and provide a platform for adapting to the devastation of such a disturbing event.