Strain and serenity: exploring the interplay of stress, burnout, and well-being among healthcare professionals.

Introduction: Stress and burnout can negatively affect performance, mental health, and the overall well-being of healthcare workers. The study aims to examine the prevalence of stress and burnout, and investigate links between stress, burnout, mental state, and well-being among healthcare workers in the Czech Republic. Methods: A cross-sectional survey was conducted in the Czech Republic, focusing on healthcare professionals working in various healthcare settings. A total of 1,064 healthcare workers participated in the study. A standardized questionnaire battery was used, consisting of the Maslach Burnout Inventory (MBI), Perceived Stress Scale (PSS) and Supso-7 measuring mental state. Separate correlation and multiple regression analyses were conducted. Results: 46.24% of the healthcare workers reported high levels of emotional exhaustion, 25.56% reported high levels of depersonalization, 24.15% reported low levels of personal accomplishment, while 11.18% reported high levels of perceived stress. The findings revealed that emotional exhaustion, a core component of burnout, was associated with increased feelings of anxiety and depression. Perceived stress was also linked to anxiety and depression, while personal accomplishment appeared to mitigate depression and support positive psychological well-being. Conclusion: The study provides promising evidence suggesting that addressing stress and emotional exhaustion, while fostering a sense of personal achievement, could lead to improvements in the mental health and work performance of healthcare workers. These findings highlight the importance of addressing burnout and stress management strategies to support the overall well-being of healthcare professionals.

Unmasking impostor phenomenon: a study of nurses in specialist roles.

This cross-sectional study aimed to explore the incidence of impostor phenomenon among 79 nurses in specialist roles in a single NHS trust in England, using an online anonymous questionnaire that included the Clance Imposter Phenomenon Scale and free-text responses. Results indicated a high prevalence of impostor phenomenon, with no specific variables predicting its occurrence. Four main themes emerged: self-doubt, role expectations, fear of exposure as an impostor, and factors leading to burnout. The study highlights the need for targeted support and training for this cohort, particularly as impostor phenomenon was found to be prevalent during career transitions and was not limited by gender. The findings have implications for nursing management and education, offering the opportunity to develop specific support mechanisms to alleviate impostor phenomenon and potentially reduce attrition rates in specialist nursing roles.

Validity of simplified self-report methods versus standard use method for pain assessment in preschool-aged children.

PURPOSE: Children experience painful invasive procedures very intensely. The aim of health professionals is to help children minimize this traumatic experience. The Simplified Faces Pain Scale (S-FPS) and Simplified Concrete Ordinal Pain Scale (S-COS) tools offer children the possibility of self-assessing their pain. This can then be the basis for tailoring pain relief to the child's individual need. The aim of this study is to present the validation procedure of the S-FPC, S-COS methods. DESIGN AND METHODS: 135 children aged 3-6 years assessed their pain using the self-reported S-FPS and S-COS methods at three consecutive times, and their results were compared with the commonly used Face, Legs, Activity, Cry, Consolability assessment scale. Intra-class correlations (ICC) were used to assess inter-rater agreement. Convergent validity was verified using Spearman's correlation coefficient. RESULTS: This study demonstrated good validity for both the S FPS and S-COS assessment tools. The ICC coefficient showed good inter-rater correlation. Spearman's correlation coefficient showed a strong correlation between the scales. PRACTICE IMPLICATIONS: It is not possible to clearly select a best method of pain assessment in preschool children. To choose the most appropriate method, it is necessary to take into account the child's cognitive development and preferences.

COVID-19-The impact of variable and "low normal" pulse oximetry scores on Oximetry@Home services and clinical pathways: Confounding variables?

COVID-19 Oximetry@Home services have been commissioned nationally. This allows higher-risk patients with mild COVID-19 symptoms to remain at home, being supplied with a Pulse Oximeter to measure their oxygen saturation (SpO2 ) two to three times daily for two weeks. Patients record their readings manually or electronically which are monitored by a clinical team. Clinical decisions, using an algorithm, are based on SpO2 readings in a narrow range with 1-2 point changes potentially affecting care. In this article, we discussed the problem that multiple factors affect SpO2 readings, and that some "normal" individuals will have "low-normal" scores at the threshold of clinical management, without any known respiratory problem. We discuss the potential magnitude of this problem based on the associated literature and consider how this will have an impact on the use of the Oximetry@home services, potentially partially confounding their purpose; to reduce face-to-face medical care.

A study to introduce National Early Warning Scores (NEWS) in care homes: Influence on decision-making and referral processes.

AIM: Early warning scores are commonly used in hospital settings, but little is known about their use in care homes. This study aimed to evaluate the impacts of National Early Warning Scores alongside other measures in this setting. DESIGN: Convergent parallel design. METHODS: Quantitative data from 276 care home residents from four care homes were used to analyse the relationship between National Early Warning Scores score, resident outcome and functional daily living (Barthel ADL (Barthel Index for Activities of Daily Living)) and Rockwood (frailty). Interviews with care home staff (N = 13) and care practitioners (N = 4) were used to provide qualitative data. RESULTS: A statistically significant link between National Early Warning Scores (p = .000) and Barthel ADL (p = .013) score and hospital admissions was found, while links with Rockwood were insignificant (p = .551). Care home staff reported many benefits of National Early Warning Scores, including improved communication, improved decision-making and role empowerment. Although useful, due to the complexity of the resident population's existing health conditions, National Early Warning Scores alone could not act as a diagnostic tool.

Phosphine on Venus Cannot Be Explained by Conventional Processes.

The recent candidate detection of ∼1 ppb of phosphine in the middle atmosphere of Venus is so unexpected that it requires an exhaustive search for explanations of its origin. Phosphorus-containing species have not been modeled for Venus' atmosphere before, and our work represents the first attempt to model phosphorus species in the venusian atmosphere. We thoroughly explore the potential pathways of formation of phosphine in a venusian environment, including in the planet's atmosphere, cloud and haze layers, surface, and subsurface. We investigate gas reactions, geochemical reactions, photochemistry, and other nonequilibrium processes. None of these potential phosphine production pathways is sufficient to explain the presence of ppb phosphine levels on Venus. If PH3's presence in Venus' atmosphere is confirmed, it therefore is highly likely to be the result of a process not previously considered plausible for venusian conditions. The process could be unknown geochemistry, photochemistry, or even aerial microbial life, given that on Earth phosphine is exclusively associated with anthropogenic and biological sources. The detection of phosphine adds to the complexity of chemical processes in the venusian environment and motivates in situ follow-up sampling missions to Venus. Our analysis provides a template for investigation of phosphine as a biosignature on other worlds.

The Venusian Lower Atmosphere Haze as a Depot for Desiccated Microbial Life: A Proposed Life Cycle for Persistence of the Venusian Aerial Biosphere.

We revisit the hypothesis that there is life in the venusian clouds to propose a life cycle that resolves the conundrum of how life can persist aloft for hundreds of millions to billions of years. Most discussions of an aerial biosphere in the venusian atmosphere temperate layers never address whether the life-small microbial-type particles-is free floating or confined to the liquid environment inside cloud droplets. We argue that life must reside inside liquid droplets such that it will be protected from a fatal net loss of liquid to the atmosphere, an unavoidable problem for any free-floating microbial life forms. However, the droplet habitat poses a lifetime limitation: Droplets inexorably grow (over a few months) to large enough sizes that are forced by gravity to settle downward to hotter, uninhabitable layers of the venusian atmosphere. (Droplet fragmentation-which would reduce particle size-does not occur in venusian atmosphere conditions.) We propose for the first time that the only way life can survive indefinitely is with a life cycle that involves microbial life drying out as liquid droplets evaporate during settling, with the small desiccated "spores" halting at, and partially populating, the venusian atmosphere stagnant lower haze layer (33-48 km altitude). We, thus, call the venusian lower haze layer a "depot" for desiccated microbial life. The spores eventually return to the cloud layer by upward diffusion caused by mixing induced by gravity waves, act as cloud condensation nuclei, and rehydrate for a continued life cycle. We also review the challenges for life in the extremely harsh conditions of the venusian atmosphere, refuting the notion that the "habitable" cloud layer has an analogy in any terrestrial environment.

Resisting decline? Narratives of independence among aging limbless veterans.

'Maintaining independence' is a core project for many older people; a project which has received critical attention within aging studies. In this paper, we extend the critique by exploring how aging intersects with disability and militarism as additional critical subjectivities. The empirical focus of the paper is the narratives of older military veterans who had lost a limb either during or post-service. Data reveal the long legacy of military experience in the lives of these veterans; a legacy which is manifested in both negative and positive outcomes. A dominant narrative of 'struggling against decline' is identified, while 'minimization', 'victimhood', and 'life-as-normal' emerged as further narrative types through which veterans articulated their experiences of aging with limb loss. Findings from this study highlight both resilience and vulnerability as features of older veterans' experiences of aging with limb loss. Building on previous critiques, we add further nuance to understandings of how older people might respond to the narrative of decline, and illustrate multiple possible meanings of claims to 'normality'. By sharing the stories of older limbless veterans, we aim to contribute to - and connect - several fields of study including aging studies, critical disability studies, and critical military studies. Findings are discussed in light of current trends in each of these fields.

Nursing workloads and activity in critical care: A review of the evidence.

OBJECTIVES: To review current methods for informing nurse workforce decisions in critical care. Many clinical outcomes are worse if staffing is inadequate. Workforce planning is usually according to guidelines developed from the opinions of expert groups. Objective systems for planning and distributing staff have been developed but their value is unclear. DESIGN: A rapid review methodology was employed. REVIEW METHODS: The search included research studies, guidelines and surveys within and outside United Kingdom since 1995. FINDINGS: Thirty-two studies met eligibility criteria. Studies originated worldwide, with considerable work undertaken in the United Kingdom and Brazil. Two were large multicentre studies. Tools examined fell into three groups: those focused on the condition and needs of the patient, those focused on the number and time for nursing activities and those that also took account of psycho-social factors. Many tools were not used beyond their country of origin. CONCLUSION: There is limited experience of using tools to determine nurse staffing. No one tool is likely to suit every application. More information is needed to clarify the practicalities of using the tools.

Spiral density waves in a young protoplanetary disk.

Gravitational forces are expected to excite spiral density waves in protoplanetary disks, disks of gas and dust orbiting young stars. However, previous observations that showed spiral structure were not able to probe disk midplanes, where most of the mass is concentrated and where planet formation takes place. Using the Atacama Large Millimeter/submillimeter Array, we detected a pair of trailing symmetric spiral arms in the protoplanetary disk surrounding the young star Elias 2-27. The arms extend to the disk outer regions and can be traced down to the midplane. These millimeter-wave observations also reveal an emission gap closer to the star than the spiral arms. We argue that the observed spirals trace shocks of spiral density waves in the midplane of this young disk.

In search of future earths: assessing the possibility of finding Earth analogues in the later stages of their habitable lifetimes.

Earth will become uninhabitable within 2-3 Gyr as a result of the increasing luminosity of the Sun changing the boundaries of the habitable zone (HZ). Predictions about the future of habitable conditions on Earth include declining species diversity and habitat extent, ocean loss, and changes to geochemical cycles. Testing these predictions is difficult, but the discovery of a planet that is an analogue to future Earth could provide the means to test them. This planet would need to have an Earth-like biosphere history and to be approaching the inner edge of the HZ at present. Here, we assess the possibility of finding such a planet and discuss the benefits of analyzing older Earths. Finding an old-Earth analogue in nearby star systems would be ideal, because this would allow for atmospheric characterization. Hence, as an illustrative example, G stars within 10 pc of the Sun are assessed as potential old-Earth-analog hosts. Six of these represent good potential hosts. For each system, a hypothetical Earth analogue is placed at locations within the continuously habitable zone (CHZ) that would allow enough time for Earth-like biosphere development. Surface temperature evolution over the host star's main sequence lifetime (assessed by using a simple climate model) is used to determine whether the planet would be in the right stage of its late-habitable lifetime to exhibit detectable biosignatures. The best candidate, in terms of the chances of planet formation in the CHZ and of biosignature detection, is 61 Virginis. However, planet formation studies suggest that only a small fraction (0.36%) of G stars in the solar neighborhood could host an old-Earth analogue. If the development of Earth-like biospheres is rare, requiring a sequence of low-probability events to occur, biosphere evolution models suggest they are rarer still, with only thousands being present in the Galaxy as a whole.

Interferometric identification of a pre-brown dwarf.

It is not known whether brown dwarfs [stellar-like objects with masses less than the hydrogen-burning limit, 0.075 solar mass (M)[symbol:see text]] are formed in the same way as solar-type stars or by some other process. Here we report the clear-cut identification of a self-gravitating condensation of gas and dust with a mass in the brown-dwarf regime, made through millimeter interferometric observations. The level of thermal millimeter continuum emission detected from this object indicates a mass ~0.02 to 0.03 M[symbol:see text], whereas the small radius, <460 astronomical units, and narrow spectral lines imply a dynamical mass of 0.015 to 0.02 M[symbol:see text]. The identification of such a pre-brown dwarf core supports models according to which brown dwarfs are formed in the same manner as hydrogen-burning stars.

Disks around stars and the growth of planetary systems.

Circumstellar disks play a vital evolutionary role, providing a way to move gas inward and onto a young star. The outward transfer of angular momentum allows the star to contract without breaking up, and the remnant disk of gas and particles is the reservoir for forming planets. High-resolution spectroscopy is uncovering planetary dynamics and motion within the remnant disk, and imaging at infrared to millimeter wavelengths resolves disk structure over billions of years of evolution. Most stars are born with a disk, and models of planet formation need to form such bodies from the disk material within the disk's 10-million-year life-span.