[Demands, resources, and work engagement of lower and middle level nurse managers: a cross-sectional study]. / Anforderungen, Ressourcen und Arbeitsengagement von Pflegemanager_innen der unteren und mittleren Ebene.

Demands, resources, and work engagement of lower and middle level nurse managers: a cross-sectional study Abstract. Background: Given their responsibilities, lower- and middle-level nurse managers hold a key role in the health care system. Their performance and health are affected by their work engagement, which according to the Job-Demands-Resources-Model depends on job-related demands and resources. To date, there is a lack of studies on the demands, resources, and work engagement of nurse managers in Germany. Objective: First, the study aimed to describe the job demands and resources as well as the work engagement of lower and mid-level nurse managers in hospitals and geriatric care facilities in Germany. Second, the aim was to explore potential differences in these areas between different groups, particularly regarding gender, age, and management level. Methods: The study used a cross-sectional design. Data were collected by an online survey. N = 408 cases could be evaluated. Results: Work overload is the most prominent demand, followed by emotional demands. In terms of resources, nurse managers can primarily draw on positive social relationships. The available professional resources are rated critically. Work engagement is moderate. Conclusions: The study indicates a clear need for action regarding an improvement in work engagement. In particular, work overload and professional resources need to be addressed by appropriate systemwide and organization-related measures.

Antecedents of Nurse Managers' Work Engagement: A Cross-Sectional Study.

The responsibilities of nurse managers are complex. Their actions are crucial to providing the best possible care to patients and to the success of health care organizations. Thus, nurse managers' work engagement is essential. However, understanding of the antecedents of nurse managers' work engagement is lacking. The job demands-resources theory posits that work engagement is contingent upon job resources and demands. Therefore, the aim of this study was to explore which job demands and resources exert a major influence on nurse managers' work engagement. Considering the literature, job resources and demands potentially relevant to nurse managers' work engagement were identified. To investigate the associations between these potential antecedents and nurse managers' work engagement, the study employed a cross-sectional survey. The dataset for analyses comprised 408 nurse managers in Germany and was analyzed by multiple linear regression. The study variables accounted for 26% of the variance in nurse managers' work engagement. Positive associations were detected between the job resource of empowering leadership and nurse managers' work engagement. Regarding job demands, lack of formal rewards and work-life interferences had negative effects on work engagement. The findings suggest that the job demands-resources theory can explain nurse managers' work engagement. However, not all job resources and demands considered were determined to be influential. In conclusion, empowering leadership should be promoted in the work environment of nurse managers. Nurse managers should be provided engaging financial and nonfinancial rewards. Work-life interferences should be systematically mitigated.

First Results of Peer Training for Medical Staff-Psychosocial Support through Peer Support in Health Care.

BACKGROUND: In view of the increasing strain on health workers, psychosocial support measures are becoming more important. The core of a sustainable concept is the establishment of peer support teams. Two aspects are central: first, target group-specific training content, and second, suitable staff members who are trained as peers. The goal of the study was to obtain a first look at what content can be taught in peer training for medical staff, how the training is evaluated by the target group, and which people are interested in training from peers. METHODS: During the period 2017-2022, Peer Training for medical staff was developed by a non-profit institution in Germany with state funding and the support of a medical professional association and evaluated during the project. Participants (N = 190) in the Peer Training course were interviewed in advance about their experiences and stresses at work using an anonymous questionnaire. After completing the training modules, the participants filled out an evaluation form. RESULTS: The participants of the Peer Training were predominantly female (70.5%) and middle-aged (between 31 and 50 years old). Most (80.3%) experienced stressful events themselves, mostly without any preparation (93.5%) or follow-up (86.8%) by the employer. The participants estimate their workload in the medium range. The proportion of stressed individuals among the participants was below that of various comparison groups as available reference values. The training module itself was evaluated very positively. CONCLUSIONS: The content and framework parameters of the training were rated very well. There is a high degree of fit with the requirements in the health sector. The participants in the Peer Training seem to represent a good cross-section of the target group medical staff, also regarding their own experiences, seem to have a good psychological constitution and are therefore very suitable to work as peers after the training.

Calling for Help-Peer-Based Psychosocial Support for Medical Staff by Telephone-A Best Practice Example from Germany.

BACKGROUND: A telephone support hotline (PSU-HELPLINE) was established at the beginning of the pandemic due to the burden on health professionals and the lack of support at the workplace. The aim of this study was to evaluate the telephone support service for health professionals in terms of its burden, benefits, and mechanisms of action. METHODS: Data collection was conducted during and after calls by PSU-HELPLINE counsellors. In addition to the socio-demographic data evaluation, burdens of the callers and the benefits of the calls were collected. The content-analytical evaluation of the stresses as well as the effect factors were based on Mayring's (2022). RESULTS: Most of the callers were highly to very highly stressed. The usefulness of the conversation was rated as strong to very strong by both callers and counsellors. The PSU-HELPLINE was used primarily for processing serious events and in phases of overload. The support work was carried out through the following aspects of so-called effect factors, among others: psychoeducation, change of perspective, resource activation, problem actualization, connectedness, information, problem solving, self-efficacy, and preservation of resources. CONCLUSIONS: The expansion of local peer support structures and the possibility of a telephone helpline are recommended. Further research is needed.

Observing many researchers using the same data and hypothesis reveals a hidden universe of uncertainty.

This study explores how researchers' analytical choices affect the reliability of scientific findings. Most discussions of reliability problems in science focus on systematic biases. We broaden the lens to emphasize the idiosyncrasy of conscious and unconscious decisions that researchers make during data analysis. We coordinated 161 researchers in 73 research teams and observed their research decisions as they used the same data to independently test the same prominent social science hypothesis: that greater immigration reduces support for social policies among the public. In this typical case of social science research, research teams reported both widely diverging numerical findings and substantive conclusions despite identical start conditions. Researchers' expertise, prior beliefs, and expectations barely predict the wide variation in research outcomes. More than 95% of the total variance in numerical results remains unexplained even after qualitative coding of all identifiable decisions in each team's workflow. This reveals a universe of uncertainty that remains hidden when considering a single study in isolation. The idiosyncratic nature of how researchers' results and conclusions varied is a previously underappreciated explanation for why many scientific hypotheses remain contested. These results call for greater epistemic humility and clarity in reporting scientific findings.

Anforderungen, Ressourcen und Arbeitsengagement Pflegender während der zweiten Welle der COVID-19-Pandemie.

Demands, resources, and work engagement of nurses during the second wave of the COVID-19 pandemic - A cross-sectional study Abstract. Background: Nurses are assigned a key role in managing the COVID-19 pandemic. Of particular importance is their work engagement, depending on job demands and resources. So far, there have only been scattered and first-wave related indications of nurses' job demands, resources and work engagement in Germany during the pandemic. Aim: To systematically assess key job demands, key job resources and work engagement of nursing staff for the second wave of the COVID-19 pandemic, also differentiating between various groups of nurses. Method: The study was realized in a cross-sectional design and included nurses in direct health care settings in Germany. Data was collected with an online questionnaire using valid and reliable measures during the second wave of the pandemic. The dataset for analyses comprised 1027 cases in total. Results: Regarding demands, work overload was even higher than before the pandemic, but work-life interferences were less pronounced. Nurses' resource architecture was not fundamentally changed by the pandemic, but interpersonal relationships and autonomy were rated more positively. Domiciliary care workers assessed demands and resources more positively than nurses in nursing homes or hospitals, whereas nurses caring for COVID-19 patients evaluated demands and resources more critically. Nurses' work engagement was higher during the second pandemic wave than in the first wave, but still low overall. Conclusions: Due to the importance of work engagement for nurses' health and performance and thus the quality of care, demands and resources must be further improved. Starting points are, e. g., fostering team cohesion, strengthening autonomy, and managing workload.

[How are key resources and key demands associated with nurses' work engagement during the COVID-19 pandemic? A cross-sectional study]. / Wie sind Schlüsselressourcen und -anforderungen mit dem Arbeitsengagement Pflegender während der COVID-19-Pandemie assoziiert? Eine Querschnittstudie.

INTRODUCTION: Nurses are assigned a key role in pandemic response, with work engagement considered to be pivotal. The job demands-resources theory assumes that work engagement depends on job resources and job demands. Key job resources and demands have already been proposed for nurses. However, there is no evidence on their importance under pandemic conditions. Hence, the aim of this study was to investigate their relevance to nurses' work engagement during the second wave of the COVID-19 pandemic. METHODS: The study was carried out in a cross-sectional design and addressed nurses in direct health care settings in Germany. Data was collected administering a quantitative online survey using valid and reliable measures during the second wave of the pandemic. A convenience sample was obtained, including the use of social media, randomly selected health care facilities, and all universities with nursing-related programs in Germany. The dataset for analyses comprised a total of 1,027 cases. The sample included nurses of various educational levels and from different sectors. Multiple linear regression analysis after multiple imputation was used to examine the relevance of key resources and demands for work engagement. RESULTS: Key resources and demands explained 36% of the variance in nurses' work engagement during the COVID-19 pandemic. Positive associations were found between the key resources of autonomy (߯SP=0.072, 95% CI [0.011; 0.133]), professional resources (߯SP=0.204, 95% CI [0.124; 0.285]), and interpersonal relationships (߯SP=0.178, 95% CI [0.117; 0.240]) and nurses' work engagement. On the demands side, lack of formal rewards negatively (߯SP=-0.312, 95% CI [-0.380; -0.245]) affected work engagement, whereas work overload (߯SP=0.063, 95% CI [0.001; 0.126]) was positively associated with work engagement. DISCUSSION: The job demands-resources theory is suitable for explaining nurses' work engagement even in times of crisis. Taken together, key resources and demands have a significant influence on nurses' work engagement under pandemic conditions. However, not all so-called key resources and demands actually have a key status in a pandemic. CONCLUSION: Any lack of formal rewards should be countered, professional resources should be sustainably secured, and the autonomy of nurses and their interpersonal relationships should be strengthened. Nursing management decisions should be made not only with the current pandemic but also the post-pandemic period in mind.

The adaptation of educational expectations in response to ability tracking: Variations by migration background.

In various educational systems, students are sorted into separate secondary schools on the basis of their academic ability. Research suggests that this type of tracking impacts students' educational expectations, as expectations generally align with students' ability track. However, most research is cross-sectional and students with lower expectations are possibly also sorted into lower tracks. Moreover, the extent to which track placement influences expectations may vary across students. In this paper, we address the following research question: how does ability tracking impact the development of student expectations and how does this vary by students' migration background. Based on the literature on the immigrant aspiration-achievement paradox, we expect that students with a migration background are less likely to adapt expectations downwardly, and more likely to adapt expectations upward in response to track placement. Using German panel data, we examine the educational expectations of students with and without a migration background, before and after track placement. Moreover, we use variations in tracking procedures across German states to study how students who get tracked compare with students who do not get tracked in the development of their educational expectations. We show that students are more likely to upwardly adjust their expectations when their track placement exceeds their expectations and to downwardly adjust their expectations when their track placement is below their expectations. We find little support for the hypothesized variations by student migration background. Students whose parent(s) hold (a) Bachelor degree(s) are more likely to upwardly adjust their expectations when their track placement exceeds their expectations than students whose parent(s) maximally hold an upper secondary or vocational degree(s).

Vocational education and employment over the life course using a new measure of occupational specificity.

Vocational education is seen as beneficial for the labor market allocation of young people. However, recent studies point to disadvantages later in the life course, where the specific skills that are obtained from vocational education decrease employability. This paper re-evaluates this hypothesis for the Netherlands with an improved measure for the vocational specificity of educational programs, utilizing both vertical (level) and horizontal (field) information on education. More specifically, we use a gradual measure for the linkage strength between education and occupation to predict employment over the life course. Using data from the national Dutch labor force surveys, we show that there is considerable heterogeneity in occupational specificity within the categories of vocational and general educational programs that is masked when using a dichotomous classification of general versus vocational education. In the life course analyses we find that the large early benefits of having vocational education disappear later in the career and turn into a small disadvantage before retirement.

Increased invasive potential and up-regulation of MMP-2 in MDA-MB-231 breast cancer cells expressing the beta3 integrin subunit.

Integrins are a family of transmembrane adhesion receptors that might transduce signals from the extracellular matrix into the inside of cells after ligand binding. In order to investigate whether beta3 integrins expressed in tumor cells might mediate such outside-in signaling, human MDA-MB-231 breast cancer cells that were stably transfected with either beta3 integrin or mock-transfected were investigated in a matrigel degradation assay and a grafting experiment was performed on the developing chicken chorioallantoic membrane (CAM). After cultivation on matrigel for time periods between one and five days, more matrigel was digested in the wells in which beta3 integrin expressing cells were incubated than in wells of mock-transfected cells. Furthermore, extracts of beta3 integrin expressing cells contained higher levels of MMP-2 protein as determined by immunoblotting and more MMP-2 associated gelatinase activity as detected by zymography than extracts of mock-transfected cells. Matrigel degradation and gelatinase activity as well as MMP-2 expression were elevated when beta3 integrin expressing cells were incubated in the presence of the RGD peptide (mimicking an integrin ligand). After grafting on 10 day-old embryonic chicken CAM for three to five days, beta3 integrin expressing cells assembled in spheroids showed higher rates of spreading on the CAM surface and CAM invasion as well as a significant MMP-2 up-regulation compared to mock-transfected cells. The results from the in vivo and in vitro experiments allow the conclusion that the presence of beta3 integrin in MDA-MB-231 breast cancer cells induced an increased MMP-2 expression and activity that might contribute to the enhanced invasive potential observed.

Breast cancer and human papillomavirus (HPV) infection: no evidence of a viral etiology in a group of Swiss women.

There are controversial data on the meaning of viral induction of breast cancer. The aim of this study was to investigate the presence of human papillomavirus (HPV) DNA in patients with breast carcinoma and the correlation of viral infection with disease outcome. Paraffin-embedded sections from 81 patients with breast cancer were analyzed for HPV DNA by polymerase chain reaction (PCR) using the SPF1/2 primers covering about 40 different low-, intermediate- and high-risk types. We found all samples were negative for HPV DNA. Our analysis could not support a role of HPV in breast carcinoma. Controversial published data indicate a need for further, larger epidemiologic studies.

Sites of failure in breast cancer patients with extracapsular invasion of axillary lymph node metastases. No need for axillary irradiation?!

BACKGROUND AND PURPOSE: Extracapsular spread (ECS) is frequent, but the specific sites of relapse are seldom given in the literature. In this study it was evaluated, if ECS might be an indicator for axillary irradiation. PATIENTS AND METHODS: After a retrospective review of pathology reports, the information about ECS was available in 254 lymph node-positive patients: ECS was absent in 34% (ECS-negative; n = 87) and present in 66% (ECS-positive; n = 167). All patients were irradiated locally, 78 patients got periclavicular and 74 axillary irradiation (median total dose: 50.4 Gy). 240/254 patients (94.5%) received systemic treatment/s. Mean follow-up was 46 months. RESULTS: The regional relapse rate was 4.6% without ECS versus 9.6% with ECS. The 5-year axillary relapse-free survival was 100% in ECS-negative and 90% in ECS-positive patients (p = 0.01), whereas corresponding values for periclavicular relapse-free survival (with ECS: 91% +/- 4%; without ECS: 94% +/- 3%; p = 0.77) and local relapse-free survival (with ECS: 86% +/- 4%; without ECS: 91% +/- 3%; p = 0.69) were not significantly different. chi(2)-tests revealed a high correlation of ECS with T-stage, number of positive lymph nodes and progesterone receptor status, comparisons with estrogen receptor, grade, or age were not significant. In multivariate analysis number of positive lymph nodes was solely significant for regional failure. Dividing the patients into those with one to three and those with four or more positive lymph nodes, ECS lost its significance for axillary failure. CONCLUSION: ECS was accompanied by an enhanced axillary failure rate in univariate analysis, which was no longer true after adjusting for the number of positive lymph nodes.

Square Planar (SP-4) and Octahedral (OC-6) Complexes of Platinum(II) and -(IV) with Predetermined Chirality at the Metal Center.

cis-Bis-homoleptic platinum(II) complexes, with predetermined helical chirality at the metal center, can be obtained by using strongly sterically interacting ligands. With this aim, two new ligands, (8R,10R)-2-(2'-thienyl)-4,5-pinenopyridine, th4,5ppy (2), and (8R,10R)-2-(2'-thienyl)-5,6-pinenopyridine, th5,6ppy (4), were synthesized and coordinated to platinum. The structures of the resulting complexes, Pt(th4,5ppy)(2) (5) and Pt(th5,6ppy)(2) (6), were determined by X-ray diffraction, and it was found that they both crystallize with a Delta-cis configuration. Thermal oxidative additions (TOA) of alkyl halides were performed with both complexes leading, in the case of 5, to a mixture of isomers and, in the case of 6, to isomerically pure products. The predetermination of chirality at the metal center is therefore preserved in the octahedral (OC-6) platinum(IV) complexes. Crystals of Pt(th4,5ppy)(2) (5) are orthorhombic, of space group P2(1)2(1)2(1), with a = 12.973(1) Å, b = 13.619(2) Å, c = 17.665(2) Å, alpha = beta = gamma = 90 degrees, and Z = 4. Final R = 0.0268 and R(w) = 0.0424 for 3101 observed reflections. Crystals of Pt(th5,6ppy)(2) (6) are hexagonal, of space group P6(1), with a = 11.5465(4) Å, b = 11.5465(4) Å, c = 35.356(3) Å, alpha = beta = 90 degrees, gamma = 120 degrees, and Z = 6. Final R = 0.0424 and R(w) = 0.0845 for 2660 observed reflections. Neither molecule possesses a crystallographic C(2) symmetry.