Prevalence of High-Risk HPV Subtypes and Efficacy of the HPV Vaccine in Preventing Cervical Epithelial Lesions: Survey and Insights from a German Study.

BACKGROUND: Historically, cervical cytology has been the standard method for detecting dysplastic cervical changes. However, extensive research has established that human papillomavirus (HPV) infection is a primary cause of these changes, necessitating a shift in screening and preventive strategies towards the molecular detection of high-risk HPV subtypes. To combat HPV infection, prophylactic vaccines have been developed, including the nonavalent, quadrivalent, and bivalent vaccines. An essential criterion for an effective HPV vaccine is to provide comprehensive coverage against the most prevalent high-risk HPV types associated with cervical cancer, ensuring optimal efficacy in preventing cervical lesions. Long-term protection against these types is crucial for effective prevention strategies; Material and Methods: A cohort of 210,510 women's samples was included in the analysis conducted within one year of implementing a screening program in Germany. The screening program involved the molecular detection of high-risk HPV subtypes, targeting specific age groups. The cohort comprised 63,710 women below 35 years of age and 146,800 women aged 35 years and above. The selection of high-risk HPV subtypes followed the guidelines provided by Becton-Dickinson. This study focused exclusively on cases with a documented history of vaccination, which were categorized into two main groups: Group I consisted of vaccinated individuals under 35 years old (12,765 cases), while Group II comprised vaccinated individuals aged 35 years and above (296 cases); Results: The HPV types HPV56/59/66 were found to be widely distributed across all age groups, with certain age groups exhibiting a higher incidence compared to HPV16 and HPV18. Similarly, HPV35/39/69, along with HPV31 and HPV45, were also observed to have a broad distribution among women. The incidence of high-grade squamous intraepithelial lesions (HSIL), including both CIN2 and CIN3, varied between 0.076% and 0.5% across all age groups, regardless of the individuals' vaccination status; Aim of the study: Our study provides valuable insights into the distribution, incidence, and prevalence of various high-risk HPV subtypes, including HPV56/59/66, HPV33/58, HPV35/39/68, and HPV45, in relation to precancerous cervical lesions. These subtypes are not adequately covered by the currently available HPV vaccines. Addressing the discrepancies between the prevalent HPV subtypes and existing vaccines is crucial in developing an ideal HPV vaccine that offers comprehensive protection. Tailoring screening programs and vaccination strategies to the local distribution of HPV subtypes is essential for effective prevention. By raising awareness and implementing targeted preventive measures, including vaccination, we can significantly reduce the incidence of precancerous and cancerous cervical lesions.

Distribution and incidence of atypical glandular lesions in cervical cytology focusing on the association with high-risk human papillomavirus subtypes.

Adenocarcinoma in situ (AIS) is considered a precursor of adenocarcinoma. Cervical adenocarcinoma has been associated with human papillomavirus (HPV), while other subtypes of AIS and endocervical adenocarcinoma have no precursor lesions and are not associated with HPV. Cervical cytology and HPV genotyping are important in the detection of these different subtypes. Notably, endometrial lesions and infiltration with secondary adenocarcinoma may lead to misdiagnosis of endocervical lesions. The aim of the present study was to avoid misdiagnosis of squamous cell changes and endometrial lesions as endocervical lesions in cervical screening. A total of 210,510 female cytological samples were analyzed between the beginning of January 2020 and the beginning of January 2021. The samples were processed for conventional cytological techniques, and for molecular detection and subtyping of high-risk HPV (HPV-HR) according to the advice and measurements of BD Biosciences (117,765 samples) and the PapilloCheck® HPV test (5,579 samples). The present study was carried out in Germany using the Munich classification III. II-g (Bethesda classification: atypical glandular cells not otherwise specified) was detected in 0.12% of cases under the age of 35 years. Another peak was noticed within the 41-60-years age group (0.11%). In the 41-50-years age group, a peak for II-e (Bethesda classification: Endometrial cells) (1.5%) was identified. An association was revealed between HPV16, HPV18 and HPV45 with cervical intraepithelial neoplasia III, AIS, endocervical adenocarcinoma and squamous cell carcinoma, in addition to other HPV-HR subtypes, such as HPV33/58, as well as 52, 56/59/66 in the different age groups. In patients aged <35 years, 0.03% of cases were vaccinated cases against HPV. In the 35-40-years age group, there was only one vaccinated case (0.0045%); in the 41-50-years age group, there were 11 vaccinated cases (0.031%); and in the 51-60-years age group, there was one vaccinated case (0.002%). No patients aged >60 years were vaccinated against HPV in the analyzed cohort. In conclusion, most cases of HPV-associated glandular dysplastic changes and neoplasia occurred in sexually active women aged between 35 and 60 years. In addition, endocervical adenocarcinoma may occur at any age with or without an HPV infection.

Walking the tightrope between work and home: the role of job/home resources in the relation between job/home demands and employee health and well-being.

The present study investigated the role of job/home resources in the relation between job/home demands and exhaustion, job satisfaction, work-home interference, and home-work interference during the COVID-19 pandemic. We explored the prevalence of job/home demands and resources during the COVID-19 pandemic, and examined whether working at different locations (i.e., working from home or at the office) affects how both job/home demands and resources are associated with employees' health and well-being. An online cross-sectional survey study using self-report questionnaires was carried out among the networks of the International Commission on Occupational Health (ICOH) association (N=153). The findings of this study illustrated that (1) cognitive job demands/resources and emotional home demands/resources were crucial in predicting employee health and well-being; (2) a conceptual match was detected between corresponding demands and resources; (3) subgroup analysis showed that employees were not heavily affected by the different working locations during the pandemic. In conclusion, this study confirms the positive role of job/home resources. We suggest that cultivating specific job/home resources and establishing an appropriate match between specific job/home resources and corresponding job/home demands is necessary to ensure employees' health and well-being in times of a pandemic.

HPV-genotyping versus conventional cervical cytology as a screening method to detect dysplastic cervical epithelial changes.

The world health organization (WHO) called for coordinated global action in 2018 to eliminate cervical cancer, ensuring that every woman is screened and treated for precancerous lesions (World Health Organization. Cervical cancer: an NCD we can overcome. Geneva, 2018. http://www.who.int/director-general/speeches/detail/cervical-cancer-an-ncd-we-can-overcome.tegy ). Cytology-based screening has been for decades the conventional method of screening. Ancillary techniques have been added like immunocytochemistry with P16/Ki67 and L1-Capsid, but these methods require maintenance of complex infrastructure and highly trained personnel as well as relatively short screening intervals. HPV-based screening method to detect high-risk groups is a faster and automated method, which does not need morphologically highly qualified personal with high social costs. In the study, we have focused on the distribution of cervical lesions in the age groups with concordance of detection HPV high-risk subtypes (HPV-HR) and on the safety of the screening method. In the Institute for Pathology and Cytology-Schuettorf-Leer-Germany 146.800 samples of women from the age of and above 35 years were analyzed between the beginnings of 2020 until the beginning of 2021. 63.710 cases under 35 years old were analyzed. The samples were processed for both conventional cytological techniques and for molecular detection and subtyping of HPV-HR according to the advice and measurements of BD-manufacture. In this study, we have studied the histopathological results (Table 2) after colposcopy according to the age subgroups. The histopathological results were subdivided into no dysplasia, cervical intraepithelial neoplasia I (CIN I), cervical intraepithelial neoplasia II (CIN II), cervical intraepithelial neoplasia III (CIN III), squamous cell carcinoma (Sq.c.c), adenocarcinoma in situ (AIS), endometrial carcinoma, endocervical adenocarcinoma and cases without biopsy during the colposcopy (COB). We have used the muenchener classification III (Table 3) as a subgrading system for the cytological specimens. The frequency of detecting HPV56/59/66 is higher as detecting HPV-16 and HPV18 in age groups under 35 years old, 41-50 years old and 51-60 years old. HPV16 is detected higher in age groups 35-40 years old and above 60 years. The incidence of high squamous intraepithelial lesions (CIN II and III) is 0.92% in age group 35-40 years, 0.54% in age under 35 years, 0.59% in age group 41-50 years old, 0.35% in age group 51-60 years old and 0.15% in age group above 60 years old. There is no significance (p value = 0.4060). Low grade cervical lesions (CIN I) were 0.13% (< 35 Ys), 0.35% (35-40 Ys), 0.36% (41-50 Ys), 0.25% (51-60 Ys) and 0.098% (> 60Y s), which was statistically significant (p value = 0.04,0.60). Without dysplasia 0.19% (< 35 Ys), 0.5% (35-40 Ys), 0.56% (41-50 Ys), 0.51 (51-60 Ys) and 0.26% (> 60 Ys). There is no significance between occurrence of cervical dysplasia and without dysplasia despite of detection of HPV-HR subtypes (p value = 0.1754). The only use of HPV-subtyping is not a secure method and a protective way for women. There are worldwide many HPV-positive cases, which have been psychologically impaired with higher costs, although they have no cervical epithelial changes during the HPV-infection. There are many HPV-negative cases, in some studies up to 13% of cases, which develop cervical cancer. We have the opinion and are convinced that the screening should be both morphologically via cytological examination and may be with adding immunocytochemistry to detect the really dysplastic cervical lesions. HPV-subtyping may be added every three years to detect the concomitant subtype.

Evaluation of P16/Ki67 (CINtecPlus) and L1-capsid compared with HPV-genotyping in cervical cytology in women ≥35 years old focusing on patients with atypical squamous cells of undetermined significance.

Cervical cancer is the third most common cancer in women worldwide. Conventional cytological examination as a screening method with Papanicolaou has been established to reduce the incidence of dysplasia and cervical cancer for years. In addition to the conventional screening, the introduction of immunocytochemical examinations, including CINtecPlus and L1-capsid, has been demonstrated to have a positive impact on screening results. In addition to morphological screening methods, human papillomavirus (HPV)-testing has also been demonstrated to possess an enormous potential in the cervical screening process. Additionally, different screening models ranging from conventional cytological screening to primary HPV-testing do exist in different countries. At the beginning of the year 2020, a combination of cytological screening and HPV-testing was introduced in Germany for women ≥35 years. The aim of the present study was to evaluate the role of morphological screening, including immunocytochemistry, and to compare it with HPV-genotyping. Immunocytochemistry was added to confirm the diagnosis but needs established infrastructure and well-trained personnel. Furthermore, there was a need to establish the HPV-screening method. In the Institute for Pathology and Cytology (Schuettorf, Leer, Germany), 146,800 samples of women (>35 years old) were examined between January 2020 and January 2021. The present study retrospectively analyzed 146,800 samples. Each sample was examined using a conventional cytological technique and HPV-high risk-Test (HPV-HR-Test) with Viper-BD. Immunocytochemistry with CINtecPlus and L1-capsid was added in some cases. A total of 555 cases were cytological diagnosed as atypical squamous cells of undetermined significance (ASC-US; IIp). After performing immunocytochemistry, 79% of cases were suspected to be positive and 1.48% of cases were definitely positive. The HPV-HR-Test was positive in 26.4% of cases. Among cases of ASC-US and HPV-HR-negativity, 33.7% were suspicious of immunocytochemical positivity and 0.5% were definitely positive. Among patients with HPV-16-negativity, 13.6% were patients with highly squamous intraepithelial lesion (HSIL) and 22.7% were patients with low-grade squamous intraepithelial lesion (LSIL) and HSIL. Among patients with HPV-18-negativity, 14.3% were patients with HSIL and 19.5% were patients with LSIL and HSIL. There were 107 cases in this group of cases with negativity of both HPV-16 and HPV-18. After performing the colposcopy and biopsy, there were 6.5% with cervical intra-epithelial neoplasia (CIN) I, 8.4% with CIN II and 5.6% with CIN III. In conclusion, there is still a need for conventional cytological examination and maybe the addition of immunocytochemistry to confirm the diagnosis and to exclude dysplasia of cervical epithelium. The HPV-HR-Test is not enough as a screening method and may be misleading.

Employee Sustainable Performance (E-SuPer): Theoretical Conceptualization, Scale Development, and Psychometric Properties.

Although the concept of employee sustainable performance has received considerable attention in the practitioner literature, academic research still lacks a clear conceptualization and empirical operationalization of this concept. Defining employee sustainable performance as a regulatory process in which an individual worker enduringly and efficiently achieves particular desired work goals while maintaining a satisfactory level of well-being, this paper describes a corresponding instrument called E-SuPer, and examines its psychometric properties. The E-SuPer instrument was tested and cross-validated using two cross-sectional survey studies (n = 153 and n = 160), focusing on factorial validity, internal consistency, and discriminant and concurrent validity. Psychometric findings across the two samples revealed that the E-SuPer instrument consists of one general factor of ten items with good internal consistency. Discriminant validity and concurrent validity with other relevant constructs (task performance, counterproductive work behavior, and employee vitality) were also confirmed, showing promising results. Finally, theoretical and practical implications, as well as suggestions for future research, are outlined.

Does Match Really Matter? The Moderating Role of Resources in the Relation between Demands, Vigor and Fatigue in Academic Life.

The goal of the present study is to examine the moderating role of resources at work or study in the relation between demands, vigor, and fatigue in academic life. Trying to replicate scarce research on both academic and student stress simultaneously, we tested the so-called triple-match principle in an academic context to study whether or not match between specific resources, demands and well-being/health outcomes does really matter. A cross-sectional survey study using online self-completion questionnaires was carried out among 96 academics and 221 engineering students from a technological university (n = 317 in total). Findings showed a moderating, matching, role of resources in the association between demands, vigor, and particularly fatigue. Specifically, high cognitive resources strengthened the positive relation between cognitive demands and cognitive liveliness. In addition, high emotional resources buffered the positive association between emotional demands and successively emotional, cognitive and physical fatigue. This study reveals that matching resources are important in academic life. Therefore, it seems essential to create an appropriate equilibrium between specific resources and corresponding demands to promote academic well-being and health.

Mental Recovery and Running-Related Injuries in Recreational Runners: The Moderating Role of Passion for Running.

This pilot study investigates the moderating role of passion for running in the relation between mental recovery from running and running-related injuries (RRIs). We predict that the relation between recovery and injuries is dependent on the level of passion. A cross-sectional survey study was conducted among 246 Dutch recreational runners. Multivariate logistic regression analyses revealed that the negative association between mental recovery after running and RRIs is moderated (i.e., strengthened) by harmonious passion. Put differently, runners who are able to mentally recover well after running were less likely to report RRIs in the case of harmonious passion. Additionally, findings demonstrated that obsessively passionate runners were more likely to report RRIs. Passionate runners may benefit from education programs to help them integrate running more harmoniously with other aspects of life, and to prevent injuries. In addition, they should be educated about the crucial role of appropriate mental recovery from running. Considering mental aspects in running such as mental recovery from running and passion for running seems to be worthwhile to gain a better understanding of the incidence and/or prevalence of RRIs. Future (quasi-experimental) studies should investigate the issues raised here more profoundly.

What makes a good work break? Off-job and on-job recovery as predictors of employee health.

Recovery from work today seems to be crucial for health care employees' health, so it is important to uncover ways how to facilitate and improve adequate recovery from work. Focusing on the recovery concept of detachment from work, this study investigated associations between detachment after work and during work breaks and individual health among health care employees from a general hospital in the Netherlands. An online cross-sectional survey study was conducted comprising a sample of 368 health care employees of different departments. Controlling for demographics in hierarchical regression analyses, results showed that when health care employees experienced more cognitive detachment after work, they reported less concentration problems. Second, when employees experienced more emotional detachment after work, they reported less feelings of emotional exhaustion, less depressive feelings, and less sleep problems. Finally, in case employees experienced more physical detachment after work, they reported less concentration problems, less feelings of emotional exhaustion, less sleep problems and less physical health problems. No significant associations were found for detachment during work breaks. In conclusion, findings add to current recovery research showing that detachment after work is an important predictor for health care employees' health.

Feeling Vital or Fatigued? Relations with Demands and Resources in a University Context.

This study examines whether specific (matching) combinations of demands and resources exist in the prediction of both positive and negative outcomes (i.e., vitality and fatigue) in a university context. In addition, we test the Demand-Induced Strain Compensation (DISC) Model's key principles in this context to study its relevance, validity, and generalizability. A cross-sectional survey study was conducted among 397 employees and 497 students at a Dutch university. Hierarchical multiple regression analyses among both employees and students showed matching combinations of demands and resources in the prediction of vitality and fatigue. Specifically, an increase in cognitive demands was particularly associated with more student cognitive vitality when cognitive resources were high. Furthermore, results showed that an increase in cognitive demands was related to less cognitive fatigue in both employees and students when cognitive resources were high. Findings partly confirm our hypotheses in showing the important role of matching resources in the relation between demands and vitality and fatigue in university staff and students. Our study reveals that a sustainable work environment is about maintaining a healthy balance between sufficient, matching resources and demands at work or study.

The Vital Worker: Towards Sustainable Performance at Work.

Vitality at work is an important factor for organizations to build a healthier, more engaged, sustainable, and productive workforce. The organizational and societal relevance of vitality at work is high, particularly with regard to an aging and more diverse workforce. This Special Issue focusses on what might be called sustainable performance at work: Maximizing work performance as well as worker health and well-being through employee vitality. Currently, there are still many gaps of knowledge with regard to the relationship between employee vitality and sustainable performance at work. Examples of knowledge gaps are concerned with potential determinants of vitality at work for different occupational groups (such as older workers, ethnic minority workers, and handicapped workers), pathways linking vitality to sustainable performance, or health effects of interventions targeting employee vitality and/or sustainable performance at work. With this Special Issue, we hope to provide readers with solid new findings extending the current state of knowledge about employee vitality and sustainable work performance.

Physical recovery, mental detachment and sleep as predictors of injury and mental energy.

Although sports activities are generally considered beneficial to people's health and well-being, they can cause injuries and increased fatigue. Guided by the Demand-Induced Strain Compensation Recovery Model, this study hypothesized that physical recovery and mental detachment from sport-related activities would prevent injury and enhance mental energy. A cross-sectional survey study was conducted among 161 recreational athletes. Structural equation modelling analyses showed that mental detachment was negatively associated with injury and positively associated with mental energy. Sleep deprivation partially mediated the relation between mental detachment and mental energy. These findings imply an important role for mental detachment in maintaining people's health and well-being.

"Leave It All Behind": The Role of Mental Demands and Mental Detachment in Relation to Dance Students' Health and Well-Being.

AIMS: Adequate physical and mental (i.e., cognitive and emotional) recovery is essential for dancers' health and well-being. However, studies investigating the role of mental demands and recovery in dance are scarce. A potentially effective mental recovery strategy is detachment from dance, which refers to the absence of performance-related thoughts, emotions, and feelings during time away from dance. The first aim of this study was to investigate the relation between 1) cognitive and emotional demands in dance and 2) health and well-being of dance students. The second aim was to examine whether the recovery strategy of mental detachment moderated the relation between cognitive and emotional demands and dancers' health and well-being. METHODS: A cross-sectional survey study was conducted among 80 full-time dance students enrolled in a bachelor's degree in either dance (n=45) or dance teacher (n=35). Dependent variables were health problems, concentration difficulties, and positive affect. RESULTS: Hierarchical regression analyses showed that cognitive demands and cognitive detachment were not associated with dance students' health and well-being. In contrast, emotional demands were negatively related to positive affect and positively related to concentration difficulties. Emotional detachment was positively related to positive affect and negatively related to health problems. Moreover, emotional detachment moderated (i.e., buffered) the negative relation between emotional demands and positive affect. CONCLUSIONS: These findings highlight the importance of considering emotional aspects of effort and recovery in dance. It is recommended that dance students consider ways to emotionally distance themselves from negative dance-related emotions and feelings during their free time.

'Take a Mental Break!' study: Role of mental aspects in running-related injuries using a randomised controlled trial.

BACKGROUND: Running-related injuries (RRIs) can be considered the primary enemy of runners. Most literature on injury prediction and prevention overlooks the mental aspects of overtraining and under-recovery, despite their potential role in injury prediction and prevention. Consequently, knowledge on the role of mental aspects in RRIs is lacking. OBJECTIVE: To investigate mental aspects of overtraining and under-recovery by means of an online injury prevention programme. METHODS AND ANALYSIS: The 'Take a Mental Break!' study is a randomised controlled trial with a 12 month follow-up. After completing a web-based baseline survey, half and full marathon runners were randomly assigned to the intervention group or the control group. Participants of the intervention group obtained access to an online injury prevention programme, consisting of a running-related smartphone application. This app provided the participants of the intervention group with information on how to prevent overtraining and RRIs with special attention to mental aspects. The primary outcome measure is any self-reported RRI over the past 12 months. Secondary outcome measures include vigour, fatigue, sleep and perceived running performance. Regression analysis will be conducted to investigate whether the injury prevention programme has led to a lower prevalence of RRIs, better health and improved perceived running performance. ETHICS AND DISSEMINATION: The Medical Ethics Committee of the University Medical Center Utrecht, the Netherlands, has exempted the current study from ethical approval (reference number: NL64342.041.17). Results of the study will be communicated through scientific articles in peer-reviewed journals, scientific reports and presentations on scientific conferences.

Short-Term and Long-Term Effects of Off-Job Activities on Recovery and Sleep: A Two-Wave Panel Study among Health Care Employees.

This study examined whether particular recovery activities after work have a positive or negative effect on employee recovery from work (i.e., cognitive, emotional, and physical detachment) and sleep quality. We used a two-wave panel study of 230 health care employees which enabled looking at both short-term and long-term effects (i.e., two-year time interval). Gender, age, marital status, children at home, education level, management position, and working hours were used as control variables. Hierarchical multiple regression analyses showed that work-related off-job activities were negatively associated with cognitive and emotional detachment in both the short and long run, whereas low-effort off-job activities were positively related to cognitive detachment in the short run. Moreover, household/care off-job activities were positively related to sleep quality in the long run, whereas physical off-job activities were negatively associated with sleep quality in the long run. The long-term findings existed beyond the strong effects of baseline detachment and sleep quality. This study highlights the importance of off-job recovery activities for health care employees' detachment from work and sleep quality. Practical implications and avenues for further research are discussed.

Balancing Demands and Resources in Sport: Adaptation and Validation of the Demand-Induced Strain Compensation Questionnaire for Use in Sport.

Too high demands, combined with a lack of resources, are often detrimental to athletic health and well-being. However, a valid and reliable instrument to investigate different dimensions of demands and resources in sport is currently unavailable. Therefore, the present study examines the psychometric properties of an existing and well-validated survey instrument on demands and resources at task-level that was adapted to sport. This instrument, the Demand-Induced Strain Compensation Questionnaire for Sport (DISQ-SPORT), was empirically tested among 1,101 athletes (416 females and 685 males) from a variety of sports and in different languages. Results supported the proposed six-factor structure of the instrument, consisting of physical, cognitive, and emotional demands and resources. Internal consistencies of all subscales were satisfactory and the instrument was invariant across type of sport, competitive level and language. Continued evaluation of the psychometric properties of the DISQ-SPORT, especially in terms of content validity and test-retest stability, is nevertheless warranted. Theoretical and practical implications as well as areas for future research are discussed.

Work Stress Interventions in Hospital Care: Effectiveness of the DISCovery Method.

Effective interventions to prevent work stress and to improve health, well-being, and performance of employees are of the utmost importance. This quasi-experimental intervention study presents a specific method for diagnosis of psychosocial risk factors at work and subsequent development and implementation of tailored work stress interventions, the so-called DISCovery method. This method aims at improving employee health, well-being, and performance by optimizing the balance between job demands, job resources, and recovery from work. The aim of the study is to quantitatively assess the effectiveness of the DISCovery method in hospital care. Specifically, we used a three-wave longitudinal, quasi-experimental multiple-case study approach with intervention and comparison groups in health care work. Positive changes were found for members of the intervention groups, relative to members of the corresponding comparison groups, with respect to targeted work-related characteristics and targeted health, well-being, and performance outcomes. Overall, results lend support for the effectiveness of the DISCovery method in hospital care.

Is an unhealthy work environment in nursing home care for people with dementia associated with the prescription of psychotropic drugs and physical restraints?

BACKGROUND: Research showed that long-term care facilities differ widely in the use of psychotropic drugs and physical restraints. The aim of this study is to investigate whether characteristics of an unhealthy work environment in facilities for people with dementia are associated with more prescription of psychotropic drugs and physical restraints. METHODS: Data were derived from the first wave (2008-2009) of a national monitoring study in the Netherlands. This paper used data on prescription of psychotropic drugs and physical restraints from 111 long-term care facilities, residing 4,796 residents. Survey data of a sample of 996 staff and 1,138 residents were considered. The number of residents with prescribed benzodiazepines and anti-psychotic drugs, and physical restraints were registered. Work environment was assessed using the Leiden Quality of Work Questionnaire (LQWQ). RESULTS: Logistic regression analyses showed that more supervisor support was associated with less prescription of benzodiazepines. Coworker support was found to be related to less prescription of deep chairs. Job demands and decision authority were not found to be predictors of psychotropic drugs and physical restraints. CONCLUSIONS: Staff's job characteristics were scarcely related to the prescription of psychotropic drugs and physical restraints. This finding indicates that in facilities with an unhealthy work environment for nursing staff, one is not more likely to prescribe drugs or restraints. Further longitudinal research is needed with special attention for multidisciplinary decision making - especially role of physician, staff's knowledge, philosophy of care and institutional policy to gain further insight into factors influencing the use of psychotropic drugs and restraints.

The Demand-Induced Strain Compensation Questionnaire: A Cross-national Validation Study.

The demand-induced strain compensation model is a theoretical job stress model that has been tested in different kinds of empirical study in several countries. To measure key concepts in the model (job demands and job resources), the demand-induced strain compensation questionnaire (DISQ) was developed and has been used in many empirical studies. However, most studies neither focused on the psychometric properties of the DISQ nor tested it cross-nationally. In this study, we examined the psychometric properties of the DISQ tested on Italian (n = 422) and Dutch (n = 1629) employees. Results indicated that the six-factor model, consisting of cognitive, emotional and physical job demands as well as cognitive, emotional and physical job resources, provided a better fit to the data than an alternative two-factor model (demands and resources only). Findings were invariant across Italian and Dutch samples. Internal consistencies were satisfactory. Additionally, the six dimensions of DISQ were found to be meaningfully related to employee active learning behaviour, emotional exhaustion and musculoskeletal disorders. Results suggest the DISQ questionnaire is a valid and reliable instrument to measure the proposed dimensions of job demands and job resources in both Italian and Dutch work contexts.

Staff's person-centredness in dementia care in relation to job characteristics and job-related well-being: a cross-sectional survey in nursing homes.

AIM: To explore the role of nursing staff's person-centredness caring for people with dementia in relation to their work environment and job-related well-being. BACKGROUND: Given the development towards person-centred care and labour force issues, research has recently focused on the effect of person-centredness on nursing staff's well-being. Findings from occupational stress research suggest that employees' personal characteristics, such as person-centredness, can moderate the impact particular job characteristics have on their job-related well-being. DESIGN: Cross-sectional survey. METHODS: A national survey was conducted among healthcare staff (n = 1147) in 136 living arrangements for people with dementia in the Netherlands (2008-2009). Hierarchical regression analyses were used. RESULTS: Person-centredness moderates the relationship between coworker support and three outcomes of job-related well-being and between supervisor support and two of these outcomes. For highly person-centred nursing staff, coworker support was found to have a weaker impact and supervisor support to have a stronger impact on their job-related well-being. In addition, direct effects showed that person-centredness was weakly associated with more job satisfaction, more emotional exhaustion and more strongly with more personal accomplishment. CONCLUSION: Nursing staff's person-centredness does play a modest role in relation to job characteristics and job-related well-being. Findings indicate that person-centredness is not only beneficial to residents with dementia as found earlier, but also for nursing staff themselves; specifically, in case nursing staff members feel supported by their supervisor. Since a more person-centred workforce feels more competent, further implementation of person-centred care might have a positive impact on the attractiveness of the profession.