A palpable sense of frustration with NHS patient safety culture development.

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses two recent reports on NHS patient safety.

Frustration can Limit the Adaptation of Promiscuous Enzymes Through Gene Duplication and Specialisation.

Virtually all enzymes catalyse more than one reaction, a phenomenon known as enzyme promiscuity. It is unclear whether promiscuous enzymes are more often generalists that catalyse multiple reactions at similar rates or specialists that catalyse one reaction much more efficiently than other reactions. In addition, the factors that shape whether an enzyme evolves to be a generalist or a specialist are poorly understood. To address these questions, we follow a three-pronged approach. First, we examine the distribution of promiscuity in empirical enzymes reported in the BRENDA database. We find that the promiscuity distribution of empirical enzymes is bimodal. In other words, a large fraction of promiscuous enzymes are either generalists or specialists, with few intermediates. Second, we demonstrate that enzyme biophysics is not sufficient to explain this bimodal distribution. Third, we devise a constraint-based model of promiscuous enzymes undergoing duplication and facing selection pressures favouring subfunctionalization. The model posits the existence of constraints between the catalytic efficiencies of an enzyme for different reactions and is inspired by empirical case studies. The promiscuity distribution predicted by our constraint-based model is consistent with the empirical bimodal distribution. Our results suggest that subfunctionalization is possible and beneficial only in certain enzymes. Furthermore, the model predicts that conflicting constraints and selection pressures can cause promiscuous enzymes to enter a 'frustrated' state, in which competing interactions limit the specialisation of enzymes. We find that frustration can be both a driver and an inhibitor of enzyme evolution by duplication and subfunctionalization. In addition, our model predicts that frustration becomes more likely as enzymes catalyse more reactions, implying that natural selection may prefer catalytically simple enzymes. In sum, our results suggest that frustration may play an important role in enzyme evolution.

Fear of movement and competence frustration mediate the relationship between pain catastrophising and physical function in people living with axSpA: an online cross-sectional survey.

The objective of this study is to examine the contribution of pain catastrophising to Axial Spondyloarthritis (axSpA) patient's physical function and to test the mediating role of fear of movement, and uniquely, the contribution of competence frustration to the fear-avoidance model. Participants (N = 98, 70% female, M age = 45.62, SD 12.16) completed an online survey (December 2020-May 2021) distributed in the United Kingdom via the National Axial Spondyloarthritis Society (n ≈ 3500; NASS, 2019). The PROCESS SPSS macro was used to test three mediation models using percentile bootstrap 95% confidence intervals (PBCI). A significant indirect effect on the relationship between pain and physical function via fear of movement (ß = 0.10, 95% PBCI = 0.030-0.183) was observed (Model 1). Model 2 showed the relationship between pain catastrophising and physical function to be significantly mediated by fear of movement (ß = 0.16, 95% PBCI = 0.005-0.322). Finally, Model 3 showed a significant indirect effect on the relationship between pain catastrophising and physical function via competence frustration (ß = 0.15, 95% PBCI = 0.014-0.309) but not through fear of movement (ß = 0.062, 95% PBCI = - 0.134 to 0.248). To our knowledge, this is the first study to examine and demonstrate the unique contribution of competence need frustration to the Fear-avoidance model in people that live with axSpA. Identifying modifiable factors that contribute to disease outcomes such as physical function can improve the care and quality of life for people living with a disease currently without a cure.

Factors Influencing Abortion Decision-Making of Adolescents and Young Women: A Narrative Scoping Review.

INTRODUCTION: Globally, about half of all induced abortions have been estimated to be unsafe, which results in 13% of maternal deaths yearly. Of these induced abortions, 41% of unsafe abortions have been reported in young women who are dependent on their parents for their livelihood. They are often left in a vulnerable position and may have difficulty in making a decision regarding abortion. This study aimed to (1) characterize and map factors that influence abortion decision-making of adolescents and young women, and (2) identify the care and support that they need in their decision-making process. METHODS: We conducted a scoping review following the JBI method and PRISMA-ScR checklist. We comprehensively searched MEDLINE (PubMed), Embase, Cochrane Library, CINAHL, and PsycInfo, and hand searched publications in the Google Scholar database between November 2021 and October 2023. The search included all English language qualitative and mixed methods research articles published on the database up to October 2023 that included participants aged 10-24 years. The CASP checklist was used as a guide for the qualitative analysis. NVivo was used to synthesize the findings. RESULTS: There were 18 studies from 14 countries (N = 1543 young women) that met the inclusion criteria. Three domains and eleven categories were included as follows: personal (desire for self-realization and unwanted pregnancy), interpersonal (parental impact, reaction of partner, roles of peers and friends, existence of own child, and lack of support), and social circumstances (sexual crime, financial problem, limitation of choice, and underutilized healthcare services). Decision-making factors regarding abortions were also found across all three domains. CONCLUSION: The abortion decision-making of young women is influenced by various external factors regardless of country. Parents are especially influential and tend to force their daughters to make a decision. Young women experienced suffering, frustration, and lack of autonomy in making decisions based on their preference. This emphasizes the importance of autonomous decision-making. In this regard, healthcare services should be used. However, there are barriers to accessing these services. To improve such access, the following are required: staff training to provide adolescent and youth-friendly health services, counseling based on women's needs, counseling including the parents or guardians that is confidential and ethical, promotion of decision aids, and affordable accessible care.

Daily Dynamics of Awareness of Aging and Basic Psychological Need Satisfaction and Frustration in Middle and Older Adulthood.

OBJECTIVES: This daily diary study examined associations between awareness of age-related change (AARC) and satisfaction/frustration of basic psychological needs of autonomy, competence, and relatedness in a sample of midlife and older adults. We expected that greater satisfaction and lower frustration of needs would be associated with higher AARC-gains and lower AARC-losses. We also examined whether within-person associations of need satisfaction/frustration with AARC were moderated by age. METHODS: Participants (N = 152; aged 53+) completed measures of AARC and basic psychological need satisfaction and frustration on their smartphones for 10 consecutive days. Data were analyzed using multilevel models, with time-varying basic need satisfaction/frustration variables disaggregated into between-person and within-person components. RESULTS: On days participants reported higher than usual overall satisfaction of needs, and lower than usual frustration of needs, AARC-gains was higher, and AARC-losses was lower. Analysis of individual needs showed that autonomy and competence were more consistently related to higher AARC-gains and lower AARC-losses than relatedness. Within-person autonomy satisfaction was more strongly (negatively) associated with AARC-losses at older ages. DISCUSSION: Findings suggest that daily experiences related to satisfaction and frustration of goals related to autonomy and competence in particular may be proximal antecedents of short-term variation in AARC.

Longitudinal relationship between harsh parenting and adolescent non-suicidal self-injury: The roles of basic psychological needs frustration and self-concept clarity.

BACKGROUND: Harsh parenting has been shown to be associated with adolescents' non-suicidal self-injury (NSSI) behavior. However, less is known about the mechanism underlying the association. OBJECTIVE: The aim of this study was to use a one-year longitudinal design to investigate the mediating role of basic psychological needs frustration and the moderating role of self-concept clarity in the association between harsh parenting and NSSI. METHODS: Three waves of data (called T1, T2 and T3) were collected 6 months apart, between April 2021 and 2022, in a sample of 786 Chinese adolescents (52.0 % girls; Mage at Wave 1 = 13.27 years). Structural equation model was used to test a longitudinal moderated mediation model, with gender, age and baseline NSSI as covariates. RESULTS: The results showed process of mediation in which T1 harsh parenting was longitudinally and positively associated with T3 NSSI through T2 basic psychological needs frustration. Furthermore, moderated mediation analyses revealed that T2 self-concept clarity buffered the adverse impact of T2 needs frustration on T3 NSSI, thereby mitigating the mediation process. CONCLUSIONS: The findings support the self-determination theory, and suggest that fostering adolescents' self-concept clarity and satisfying their psychological needs may be useful in programs designed to lower the risk of NSSI.

Femcel Discussions of Sex, Frustration, Power, and Revenge.

Although male incels have received a great deal of scholarly attention in recent years, there has been almost no research on femcels (involuntarily celibate women). After collecting data from more than 24,000 femcel posts, we drew from a recently developed sexual frustration theory and conducted qualitative analyses of approximately 1200. Overall, our findings suggest that (1) femcels struggled with multiple types of sexual frustration; (2) they frequently discussed the gender dynamics of both sex and power; (3) they were more interested in their own frustrations than men's frustrations; and (4) despite some notable exceptions, they exhibited less support for aggression, violence, and crime than what has been reported about male incels. Although some femcels referenced their anger, hatred, or desires for revenge, this antipathy may have been rooted in their concerns about how to find a suitable intimate partner while avoiding the threat women often face from violent men. Despite this challenge, most femcels who wanted to enhance their situation or increase their power sought to do so through legal means (e.g., self-improvement, group mobilization, or challenging the patriarchy) and did not express violent intent. Further research on femcels, and the evidence-based strategies that could help them, would be a significant contribution to society.

An Ego-Involving Motivational Climate Can Trigger Inflammation, a Threat Appraisal, and Basic Psychological Need Frustration in an Achievement Context.

In this experimental investigation, male college students (N = 56; Mage = 19.95 years) who did not yet know how to juggle were randomly assigned to a 30-min instructional juggling session with either a caring, task-involving climate or an ego-involving climate. An inflammatory response to psychosocial stress was assessed via salivary interleukin-6 prior to (t = 0) and following (t = +30, +45, +60 min) the session. Surveys were utilized to examine positive and negative affect prior to the session and affect, psychological needs, challenge and threat appraisals, and perceived ability to juggle following the session. This is the first investigation to show that ego-involving climates can trigger inflammation, along with maladaptive psychological responses. Participants in the caring, task-involving climate responded with greater psychological need satisfaction, resource evaluations, positive affect, and perceived juggling ability. This research suggests there may be important physiological consequences to ego-involving climates, in addition to concerning cognitive, affective, and behavioral responses.

The Boomerang Effect of Suppression of Emotional Expression: Relationship Power, Affectivity and Adolescent and Youth Male-To-Female Dating Violence.

Scarce research has been performed on the role of power, affectivity, and suppression of emotional expression in the use of dating violence by adolescents and young men. This study aims to analyze a model of the associations between perceived power (control and dominance), affectivity (positive and negative affect), suppression of emotional expression and the frequency of use of male-to female dating violence. Participants in this cross-sectional and correlational study were 786 Spanish students aged between 13 and 25 years (M = 18.80; SD = 2.93) divided in two groups: 13-18 (316 adolescents, M = 15.58; SD = 1.02) and 18-25 (462 young men, M = 20.79; SD = 1.98) with 8 participants not stating their age. Different sequential mediation models confirmed that, only in young men, affectivity (negative and positive affect) and suppression of emotional expression mediate the relationship between power and the use of dating violence. Fostering equal relationships, associating them with positive emotional states, avoiding the frustration derived from low power perception, and providing young men with strategies for appropriately expressing their emotions may help decrease the use of dating violence.

Effects of polygenes, parent-child relationship and frustration on junior high school students' aggressive behaviors.

The effects of the interaction between polygenes and the parent-child relationship on junior high school students' aggressive behaviors were explored through the frameworks of gene-endophenotype-behavior and neurophysiological basis. A total of 892 junior high school students participated in this study. They were asked to complete self-reported questionnaires, and saliva samples were collected. Results showed that 5-HTTLPR, MAOA-uVNTR, COMT (rs4680), and Taq1 (rs1800497) of the DRD2 gene affected students' aggressive behaviors in an accumulative way. The polygenic risk score explained 3.4% of boys' aggression and 1.1% of girls' aggression. The interactions between polygenic risk score and parent-child conflict significantly affected the aggressive behaviors of male students, but did not show any significant effect on those of female students. The interactional effect of polygenic risk score and parent-child conflict on junior high school students' aggressive behaviors was completely mediated by frustration. However, the interaction effect of polygenic risk score and parent-child affinity on aggression was not affected by frustration. This study helps us better understand junior high school students' aggressive behaviors and promotes the prevention and correction of adolescents' problem behaviors.

Delay frustration in children who do and do not stutter: A preliminary study.

PURPOSE: Frustration is an emotion often clinically reported by persons who stutter. So far, mainly questionnaire-based studies have reported findings related to increased frustration or decreased frustration tolerance. The aim of this preliminary study was to determine possible group differences between children who stutter (CWS) and children who do not stutter (CWNS) using a behavioral experimental task, as well as to evaluate possible associations with the frequency, duration, and physical concomitants of stuttering disfluencies. METHOD: Participants were 13 CWS (mean age = 6;05 years) and 13 CWNS (mean age = 6;06 years), matched on age (±4 months) and gender. Frustration tolerance was assessed by the Delay Frustration task. This task includes normal delay, short delay, and long delay trials. Responses during long delay trials provide an indication of frustration tolerance and were recorded across time intervals during the response window. RESULTS: CWS, compared to CWNS, responded more frequently during the long delay trials, which is indicative of higher delay frustration. The variation in responding across time within intervals was similar for both groups. Decreased frustration tolerance was associated with increased duration of stuttered disfluencies and of physical concomitants. CONCLUSIONS: In general, the current findings seem to provide support for earlier theoretical conceptualizations about the role of emotional reactivity in the development of stuttering.

Bar press durations as a reliable and robust measure of frustration-related operant behavior: Sensitivity to incentive downshift and dose-response paradigms.

In humans, frustrating experiences are known to trigger relapse events and individuals with higher frustration intolerance show increased risk of developing substance use disorders (SUDs). Despite this clear relationship, frustration-related behavior is seldom studied concurrently with self-administration behavior in rodent models. A major obstacle has been the lack of robust, quantitative assays of frustration-related operant behavior thus far. In previous work, we identified increased bar press (BP) durations in response to frustrating conditions in rats self-administering natural or drug rewards. Here, to propose BP durations as a measure of frustration-related behavior, we conducted an operant successive negative contrast (oSNC) study and found that increases in BP durations are observed in the absence of increased effort, providing evidence that this is a psychological phenomenon. Moreover, we assess the viability of widespread use of BP duration measurements as a behavioral tool by quantifying performance as it pertains to sensitivity, robustness, replicability, and sex differences. We conclude that increases in BP durations are a highly sensitive psychological response to frustrating conditions and that this measure is robust, replicable, and applicable to both sexes.

Fascination, frustration and a passion for tech meant only one career: veterinary IT.

A mischievous mind at school steered Jack Peploe's career journey towards an inevitable conclusion: at 16 he was running his own IT firm, which evolved into specialist company Veterinary IT Services.

Are reactions to frustrative nonreward in other animals a model for human anger? Neurobehavioral implications and therapeutic applications.

Anger is a powerful and mostly deleterious emotion that can impair an individual's health and social relationships and that imposes considerable costs on society at large. It is a constituent of multiple psychopathologies, most notably intermittent explosive disorder. Excessive anger can drive injurious and even lethal reactive aggression. To understand its biobehavioral origins and develop appropriate therapeutic interventions, an animal model of human anger would be quite useful. The phenomena of aggression provoked by frustrative nonreward (FNR) in other animals, including species of fish, birds, and mammals, resemble those in people in whom it elicits subjectively experienced anger. The brief history presented here traces the original, overgeneralized frustration-aggression hypothesis for humans through to the discovery of operant schedule-induced attack in birds, rodents, and ourselves to the current status of FNR as a cross-species, transdiagnostic construct within the National Institute of Health Research Domain Criteria. Brain circuitry that is activated by frustration, generates felt anger and motivates reactive aggression includes discomfort reactions likely instantiated in the insula and cingulate gyrus of the salience network and reward expectancy/prediction error mediated by the ventral striatum and other structures. Caveats in establishing a paradigm for other animals that most closely matches FNR-induced anger in people include avoiding confounds with other aggression-provoking stimuli and situations, providing evidence for aggressive motivation, as well as behavior, and demonstrating activation of homologous brain structures. With appropriate regard for these caveats, developing such paradigms appears to be the best route to advancing psychopharmacological and deep brain stimulation treatments for excessive anger. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Torture survivors' experiences of receiving surgical treatment indicating re- traumatization.

Due to the invasive nature of surgical procedures and the involvement of medical personnel, torture survivors may experience re-traumatization during surgical treatment. This study aimed to explore torture survivors' experiences of re-traumatization during surgical treatment as well as the process by which trauma-related emotions and responses are evoked during surgical treatment for torture survivors. Eight men, aged 45 to 72, from four different countries, who have lived in Norway for 6-40 years, were recruited. We assessed torture and surgical care experiences through in-depth interviews, and the data were analyzed using thematic analysis, resulting in five themes: (1) Interactions with healthcare providers, (2) Reactions during treatment, (3) Triggers causing re-experiences, (4) Avoidance, and (5) Suggestions to healthcare providers. In this study, survivors reported challenges receiving surgical treatment, indicating re-traumatization and difficulty returning to daily life following treatment. Participants reported little collaboration in care-related decision-making processes, lack of recognition of torture by healthcare providers involved in surgical care and experiencing healthcare professionals' attitudes as a source of perplexity, frustration, and despair. Exacerbation of torture memories throughout treatment and re-experiencing of trauma symptoms aggravated these difficulties. Our findings suggest that surgical treatment can remind torture survivors of the traumatic aspects of torture, eliciting strong reactions and feelings like those experienced during torture.

Maternal invalidation and child RSA reactivity to frustration interact to predict teacher-reported aggression among at-risk preschoolers.

BACKGROUND: Aggression is a transdiagnostic indicator of risk and represents one of the most common reasons children are referred for mental health treatment. Theory and research highlight the impact of maternal invalidation on child aggression and suggest that its influence may vary based on differences in child physiological reactivity. Moreover, the interaction between these risk factors may be particularly pronounced among children of mothers with emotion regulation (ER) difficulties. The current study examined the independent and interactive effects of maternal invalidation and child physiological reactivity to frustration on teacher-reported aggression in an at-risk sample of preschool children. METHOD: Participants included 77 mothers (Mage = 33.17 years, s.d. = 4.83; 35% racial/ethnic minority) and their children (Mage = 42.48 months; s.d. = 3.78; 56% female; 47% racial/ethnic minority). Groups of mothers with and without clinician-rated ER difficulties reported on maternal invalidation, and child respiratory sinus arrhythmia (RSA) was assessed continuously during a frustration task as an indicator of physiological reactivity. Teachers or daycare providers reported on child aggression. RESULTS: Results demonstrated positive associations between maternal ER difficulties and both maternal invalidation and child RSA reactivity to frustration. As expected, the interaction between maternal invalidation and child RSA reactivity was significant, such that higher maternal invalidation and greater child RSA reactivity to frustration predicted more aggression in a daycare or preschool setting. Importantly, this effect was demonstrated while controlling for demographic covariates and baseline RSA. CONCLUSIONS: Findings are in line with diathesis-stress and biosocial models of risk and point to multiple targets for prevention and early intervention.

Introducing the Basic Psychological Needs Frustration in Second Language Scale (BPNF-L2): Examining its factor structure and effect on L2 motivation and achievement.

Research on the satisfaction of the basic psychological needs for autonomy, competence, and relatedness is well-established in second language (L2) research. However, little is known about the frustration of these basic psychological needs and how they can undermine intrinsic motivation and L2 achievement. Importantly, there is no valid scale of the frustration of the basic psychological needs in the L2 context. Accordingly, the present study introduces a new scale called the Basic Psychological Needs Frustration in Second Language (BPNF-L2) and assesses its factor structure and criterion-related validity through the application of bifactor exploratory structural equation modeling (bifactor ESEM). Our results showed that scores obtained on the BPNF-L2 scale are reliable and valid. Moreover, our results support the criterion-related validity of this factor structure by showing that the general factor of BPNF-L2 negatively explains intrinsic motivation and L2 achievement while the BPNF-L2 specific factors (i.e., autonomy, competence, and relatedness frustration) explain the outcomes differently. The results indicate that feeling frustrated because basic psychological needs are not met may hinder the enjoyment and acquisition of the L2. Educational implications, methodological advancements, and directions for future research are provided.