The Relationship Between Rest Breaks and Professional Burnout Among Nurses.

BACKGROUND: Professional burnout is a well-studied phenomenon marked by feelings of depersonalization, emotional exhaustion, and decreased accomplishment. Affecting nearly half of all nurses, burnout presents a threat to health outcomes of the nurse, patient, organization, and society. Despite a growing literature on professional burnout, specific interventions that address key contributing factors have not been well described. OBJECTIVE: The primary aim of this integrative literature review was to evaluate the relationship between rest breaks and professional burnout among registered nurses. METHODS: A literature search was performed in the APA (American Psychological Association) PsycInfo, CINAHL (Cumulative Index of Nursing and Allied Health Literature), Cochrane Library, Embase, and PubMed databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses as a reporting guideline. RESULTS: Five articles were selected for final synthesis; 1 was of "high" quality and 4 were of "good" quality. The literature showed that rest breaks were protective against professional burnout among registered nurses, especially when integrated with nursing management support, staffing support, and complementary strategies. Several threats to validity were identified as limitations among the articles selected for final synthesis. CONCLUSIONS: Rest breaks are effective in decreasing professional burnout among registered nurses, especially when combined with management support, staffing support, and complementary strategies. Future research should focus on a deeper evaluation of staffing support models, as well as identifying how nursing leaders can integrate complementary strategies across health care settings to reduce burnout.

Reasons for Moral-Based Opposition to Pornography in a U.S. Nationally Representative Sample.

Pornography use is a common-but-controversial activity that many people object to or morally disapprove of. Despite this, there is a limited understanding of the reasons for such moral opposition. Although some prior research has assessed characteristics that influence moral opposition to pornography, most research has done so using various forced-choice methods. The present study aimed to better understand the reasoning behind moral-based opposition to pornography by using open-ended questioning and exploring the relationship between these reasons and pornography use habits. To achieve these aims, we analyzed data from a nationally representative U.S. sample, specifically studying individuals who reported moral beliefs opposing pornography (N = 1,020). Results revealed 14 general themes (e.g., religion/spirituality; concerns about abuse; disgust) in the reasons participants reported for their moral disapproval of pornography, many of which were related to individual difference variables such as gender, age, religiousness, and political preferences. Implications, limitations, and directions for future research are also discussed.

Predicting College Women's Self-esteem Based on Verbal Coercion Experience and Verbal Tactic Items on the Revised Sexual Experiences Survey.

Verbal coercion experience is common among college women and has sometimes been associated with lower self-esteem. The current study examined self-esteem based on the two verbal coercion items included in the latest version of the most popular measure of sexual victimization experience, the Sexual Experiences Survey-Short Form Victimization (SES-SFV; Koss et al., 2007). One item includes verbal tactics categorized as "threat" and the other item includes verbal tactics categorized as "criticism." Undergraduate women (n = 479) completed the Rosenberg Self-Esteem Scale and the SES-SFV. Results showed that women who experienced criticism reported lower self-esteem than those who did not experience criticism. However, threat experience was not significantly related to women's self-esteem. Findings support Koss et al.'s suggestion that criticism tactics are more negative than threat tactics, and imply that self-esteem may be negatively associated with some sexually coercive verbal tactics but not associated with others. Future researchers should pay careful attention to operational definitions of verbal coercion.

Racial/ethnic disparities in treatment pattern and time to treatment for adults with glioblastoma in the US.

PURPOSE: Race/ethnicity have been previously shown to significantly affect survival after diagnosis with glioblastoma, but the cause of this survival difference is not known. The aim of this study was to examine variation in treatment pattern and time to treatment by race/ethnicity, and the extent to which this affects survival. METHODS: Data were obtained from the National Cancer Database (NCDB) for adults ≥ 40 with glioblastoma from 2004 to 2016 (N = 68,979). Treatment patterns and time to treatment by race/ethnicity were compared using univariable and multivariable logistic and linear regression models, respectively, and adjusted for known prognostic factors and factors potentially affecting health care access. RESULTS: Black non-Hispanics (BNH) and Hispanics were less likely to receive radiation and less likely to receive chemotherapy as compared to White non-Hispanics (WNH). Time to radiation initiation was ~ 2 days longer and time to chemotherapy initiation was ~ 4 days longer in both groups in comparison to WNH. CONCLUSION: Both race/ethnicity and treatment timing significantly affected survival time, and this association remained after adjustment for known prognostic factors. Additional research is necessary to disentangle the specific causal factors, and the mechanism with which they affect survival.

Human platelet antigen allele frequencies in different Algerian populations.

The frequencies of human platelet antigens (HPAs) vary between different populations and are a major determinant for the prevalence of HPA alloimmunization and its clinically associated entities. No report on HPA prevalence has previously been published for the Algerian populations which are ethnically diverse. The aim of this study was to determine the HPA allele frequencies in Algerian populations and to identify situations of incompatibility possibly leading to alloimmunization. A total of 485 healthy volunteer Algerian blood donors from different regions and representing different ethnic groups were included. HPA genotyping was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and/or polymerase chain reaction-sequence specific primer (PCR-SSP). The HPA-1 allele frequencies were close to the frequencies found in Caucasian populations. The presence of the molecule human leukocyte antigen (HLA)-DRB3*0101 (17.9%) increases the risk of alloimmunization. We observed an increase in the frequency of homozygous HPA-5b, particularly in the population of Annaba (7.61%) and the Mzab population (5.13%). The allele frequency HPA-2b (0.193-0.147) was similar to that seen in Sub-Saharan African populations. The high frequency of homozygotic HPA-2b (Kabyle 5%; Mzab 2.44% and Annaba 2.19%) could increase the risk of alloimmunization. GPIIb A(k) mutation (2614C>A) was found in these populations. This study is the first to report on HPA allele frequencies in Algerian populations. High allele frequencies were observed for HPA-1b (0.209-0.112), HPA-3b (0.411-0.312) and HPA-5b (0.217-0.087), leading to a high risk of alloimmunization in this population, especially the Mzab and the population of Annaba. Our results could have some impact in the diagnosis, prevention and treatment of alloimmune thrombocytopenia.

New mutations on platelet GPIIb in Sub-Saharan African populations revealed by genotyping discrepancies.

BACKGROUND: Previous studies of platelet allele frequencies in Sub-Saharan African populations enabled us to identify discrepancies in HPA-3 typing, suggesting the presence of new mutations and of a greater polymorphism than so far described in other populations. OBJECTIVES: To analyze these discrepancies and to assess the factors leading to potential alloimmunization in these populations. SAMPLES: Maternal samples from a Beninese woman following in utero death and panels of blood donors from Benin, Cameroon, Congo, and Pygmies from Central Africa. TECHNIQUES: Genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), PCR-sequence specific primers (PCR-SSP) and sequencing techniques. RESULTS: Three new mutations were found on GPIIb gene: exon 26 a) 2614C>A situated between HPA-3 and HPA-9w, b) 2645C>T downstream of HPA-3, c) intron 26 IVS26+89G>A. These mutations may lead to discrepant DNA typing results, due either to a localization in the complementary sequence recognized by the primer or to the appearance of a new enzyme restriction site. Furthermore, a bilateral linkage << deletion (Delta9 bp) intron 21 and the HPA-3b allele (exon 26) >> found in Caucasian, Asian, and Oceanian populations is not found in African populations, suggesting that its appearance was prior to HPA-3. CONCLUSION: Three new mutations have been identified, two of them potentially immunogenic through their position. Furthermore, the polymorphism found on intron 26, localized in the complementary sequence of the PCR primer, may lead to a false typing assignation. It is therefore important to diversify techniques, both genomic (PCR-RFLP and PCR-SSP), and proteomic monoclonal antibody-specific immobilization of platelets antigen (MAIPA) to ensure accurate HPA antigenic system typing.

HPA polymorphism in sub-Saharan African populations: Beninese, Cameroonians, Congolese, and Pygmies.

The frequency of human platelet antigen-1 (HPA-1) to HPA-11w (excluding HPA-8w) and HPA-15 systems was studied in four sub-Saharan populations: Beninese, Congolese (Democratic Republic of Congo Kinshasa), Cameroonians, and Aka pygmies (Central African Republic). No report of HPA prevalence has previously been published concerning these populations which are characterized by the highest HPA-2b gene frequencies of any reported to date (Aka 0.393, Benin 0.292, Cameroon 0.237, and Congo 0.224) and at lesser degree HPA-5b (Aka 0.405, Congo 0.268, Cameroon 0.254, and Benin 0.182). This study is of great importance (i) particularly in the context of the diversity caused by the population migrations, we may observe today in our hospitals (ii) to confirm that the Pygmy population with distinctive frequencies (absence of the HPA-1b, HPA-2b, and HPA-5b highest frequencies) is an isolated population.

L'incompatiblite foeto-maternelle anti-plaquettaire: a propos de 238 gestantes a Cotonou

En Afrique l'incompatibilite foeto-maternelle est le plus souvent percue sous l'angle des incompatibili-tes erythrocytaires. Cette incompatibilite peut aussi se manifester par une destruction des plaquettes sensibilisees par les anticorps (Ac) d'une mere soit auto immunisee; soit allo-immunisee contre des antigenes (Ag) plaquettaires fotaux transmis par le pere mais absents chez la mere.Sur une periode de 8 mois; 238 gestantes de moins de 7 mois de grossesse ont ete suivies : 109 parmi elles sont phenotypees pour les Ag plaquettaires specifiques et toutes ont subi des tests de depistage et d'identification d'anticorps anti-plaquettaires par la technique du MAIPA. Durant cette periode; les enfants nes de meres immunisees ont ete examines a la recherche d'une thrombopenie et de signes cliniques de spoliation sanguine.Les genotypes les plus frequemment rencontres sont : HPA-1a/1a (81;65) ; HPA-5a/5a (62;39) ; HPA-3a/3b (52;3) ; HPA-3a/3a (41;28) et HPA-5a/5b (35;78)79;2des gestantes ont developpe des auto-Ac contre le complexe glycoproteique IIb IIIa. La fre-quence de l'auto-immunisation semble inversement proportionnelle a la gestite. Chez quatre gestan-tes (1;7) dont 3 primigestes; des allo-Ac sont detectes contre l'Ag HPA-5b.Des 4 enfants nes de meres immunisees dans la periode de suivi; aucun n'a pose de probleme clini-que. Par contre 2 ont ete thrombopeniques des la naissance (109 et 9 G/L) mais leurs nombres de plaquettes se sont spontanement normalises au 3eme jour de naissance

Eleven human platelet systems studied in the Vietnamese and Ma'ohis Polynesian populations.

The frequencies of human platelet antigens (HPA) are variable among different ethnic groups. Platelet phenotyping and genotyping in different populations are important to the clinical implications of antiplatelet alloimmunization. No report on HPA prevalence has been published concerning the Vietnamese Kinh and Ma'ohis Polynesian populations. Recent anthropological and genetic marker studies suggest that these two groups have a common origin in East Asia, so we have conducted a combined study concerning the frequency of HPA-1 to HPA-11w systems (excluding HPA-8w) and Gov in these two populations. The results demonstrate a similar pattern of prevalence between Ma'ohis and most of the Asian populations. However, it should be noted that the frequency of HPA-2 is closer to northern Caucasian frequencies than to Asian frequencies. The population of Kinh shows an HPA distribution that is closer to the Chinese population than to the northeastern Thais except for HPA-3, closer to the Indonesian population. Given HPA-3 gene frequency distribution fetomaternal incompatibility could occur more frequently with the risk of alloantibody production.

HLA class II polymorphism in Aka Pygmies and Bantu Congolese and a reassessment of HLA-DRB1 African diversity.

HLA-DRB1, -DQB1 and -DPB1 polymorphisms were investigated in two African populations, the Basse Lobaye Aka Pygmies of the Central African Republic, and a Bantu-speaking group from the Democratic Republic of Congo Kinshasa. Allelic and haplotypic frequency distributions reveal marked differences between the two populations in spite of their geographical proximity: the Aka exhibit high frequencies for several alleles, especially at the DPB1 locus (0.695 for DPB1*0402), probably due to rapid genetic drift, while the Bantu distributions are more even. Genetic distances computed from DRB1 allelic frequencies among 21 populations from North and sub-Saharan Africa were applied to a multidimensional scaling analysis. African populations genetic structure is significantly shaped by linguistic differentiation, as confirmed by an analysis of molecular variance. However, selective neutrality tests indicate that many African populations exhibit an excess of heterozygotes for DRB1, which is likely to explain the genetic similarity observed between some North African and Bantu populations. Overall, this study shows that natural selection must be taken into account when interpreting the patterns of HLA diversity, but that this effect is probably minor in relation to the stochastic events of human population differentiations.

Gene frequencies of human platelet antigens in the Tunisian population.

Gene frequencies for the human platelet antigens HPA-1, -3 and -5 in the Tunisian population were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) on 93 volunteer blood donors (78 were tested for HPA-1, 90 for HPA-3 and 93 for HPA-5). This study shows the highest frequencies of the HPA-1b (0.25) and HPA-5b (0.22) yet recorded. These antigens are considered as markers of a high risk of platelet alloimmunisation in other populations, and for this reason particular attention should be paid in the case of pregnancy or blood transfusion in this population. The 9 base pair deletion located in intron 21 of the GPIIb gene associated with HPA-3b determinant is present in this population. No individual showed the polymorphism associated with HPA-1b (T-->G at codon 40 of the GPIIIa).

[Platelet alloantigenic systems]. / Les systèmes alloantigéniques plaquettaires.

Platelet-specific alloantigen systems are located on glycoproteins expressed at the surface of platelet membrane. These di-allelic systems are due to an amino acid substitution. An official nomenclature was adopted in 1990 by the Working Party on Platelet Serology ICST/ISBT which defined the following rules: (1) platelet-specific antigen systems are called HPA for "Human Platelet Antigens"; (2) they are numbered chronologically according to the date of publication; (3) the most frequent allele is designated by the letter a and the less frequent by the letter b (i.e., HPA-1a 1b). Since the introduction of molecular biology techniques, the nomenclature has become insufficiently precise and an adjustment will probably be required in a near future.

Low frequency of HLA-B27 and scarcity of ankylosing spondylitis in a Zairean Bantu population.

Ankylosing spondylitis (AS) is an inflammatory rheumatic disease which is thought to be rarely seen in African Blacks. Its genetic predisposition has been stressed in Caucasians where the HLA-B27 antigen is firmly linked to the disease. In the present study, HLA-B27 antigen was determined in 146 individuals of Bantu root. Only one of these subjects was found to possess HLA-B27 antigen. This study correlates the low frequency of HLA-B27 with the observed scarcity of AS in patients attending a clinic in Kinshasa for osteoarticular diseases.

HLA-DR gene frequencies in a Zaïrean population with particular reference to rheumatic diseases.

Epidemiological studies have shown that rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus are uncommon in black Africans, and in this population the prevalence and the clinical features of these rheumatic diseases are variable. Environmental and genetic factors have been pointed out to explain this variability. In the present study, HLA-DR genes have been determined in a Zaïrean population in order to compare our results with those found elsewhere in other black populations of the same Bantu origin. Our results show that the frequency of HLA-DR1 is higher than in Nigerians, Zimbabweans and Xhosas, the decrease in Xhosas being statistically significant (p < 0.006). The HLA-DR3 frequency is higher in Zaïreans than in Nigerians but not significantly, while it is lower than in Xhosas (p < 0.003) and in Zimbabweans (not significant). The HLA-DR4 frequency is higher in Zaïreans than in Nigerians but it is lower than in Xhosas and Zimbabweans; the differences are not statistically significant. The HLA-DR8 frequency is lower in Zaïreans than in Nigerians while it is higher than in Xhosas (p < 0.002) and in Zimbabweans (not significant). These data suggest that genetic factors partly explain the clinical and epidemiological variability of rheumatic diseases in black Africans.

HLA phenotype polymorphism in the Lebanese population.

The HLA-A, -B, -DR and DQ phenotypes have been defined in a panel of 217 Lebanese. These subjects were all unrelated, belonged to different religious communities and originated from the various provinces of Lebanon. All the broad class I specificities tested, except splits A25(10), B54(22) and B56(22), were present in this panel. When HLA-A and -B antigen frequencies were compared with data on the Caucasoids, Negroids and Orientals, several similarities in antigen frequencies could be found between some frequencies observed in the Lebanese and those observed in the Negroids and/or Orientals. There were no frequencies equivalent to those particular to the Caucasoids. In addition, two groups of class I antigens could be distinguished: a first group (A32, B14, B18, B35, B38, B39, B41 and B50) showing higher frequencies, and a second group (A31, B27, B60 and B62) showing lower frequencies than those observed in the Caucasoids, Negroids and Orientals. However, when analysed separately, several mediterranean ethnic groups, notably the Greeks and Italians, have a frequency profile equivalent to that of the Lebanese, with the exception of the B41 specificity, which is particularly high in the Lebanese (14.2%). The data concerning the class II antigens are the most interesting. All the specificities were present in the panel. The HLA-DR5 is the highest frequency of DR antigens in the present panel (58.9%) and nearly all DR5 positive individuals are DR11. The DR11 allele accounts for 33.1% of the total DR gene frequency. The highest DQ antigen frequency is that of DQ3 (76.4%), the majority of which is DQ7 (66.4%). We observed a high DR11-DQ7 haplotype frequency (29.4%) with a significant delta value for linkage disequilibrium. There is no linkage disequilibrium between B41 and DR11. The commonly observed linkage disequilibrium between the DQ5 allele, and the DR1, DR2, DR10 and DR14 alleles are not significant in this Lebanese panel.

Relationship of HLA to schizophrenia not supported in multiplex families.

The role of the human histocompatibility complex (HLA) in the pathogenesis of schizophrenia has been suggested in previous reports. We conducted a genetic study in 33 new families. Our linkage analysis, which used the affected sib-pair method, did not provide evidence for nonrandom assortment. Moreover, the results of an association study using the "haplotype relative risk" method failed to confirm the positive association between HLA A9 and schizophrenia. Taken together, our data did not support any relationship of HLA type to schizophrenia.

Y chromosome DNA polymorphisms in two African populations.

Y chromosome-specific DNA polymorphisms were detected using probe p49f after restriction with TaqI enzyme on samples coming from two African populations: Bantus and Pygmies. All the main TaqI alleles at five Y loci already found in Caucasians are also found in these two populations; 12 of the 16 Caucasian haplotypes were found in these two African populations, and two new haplotypes are Pygmy specific. A proposed phylogeny of the various haplotypes that was derived by using the parsimony criterion established that haplotypes XIII and XVIII, respectively the most frequent one and only one present in Pygmies, are probably ancestral.