Drinking on an empty stomach: a scoping review of the evidence on how consuming food with alcohol affects short-term outcomes.

BACKGROUND: Alcohol is a leading risk factor for death worldwide. Governments issue official guidelines on reducing the short-term risks associated with alcohol as do alcohol industry-funded organizations. Both sources frequently recommend consuming food with alcohol, however, it is unclear what evidence these recommendations are based on. The aim of this scoping review was to map and summarize evidence on the short-term effects of consuming food and alcohol. METHODS: A scoping review, following PRISMA Extension for Scoping Reviews, searched CINAHL, Cochrane Library, Embase, Medline, PsychINFO and NICE Evidence Search (published inception to June 2021). Studies in English, investigating co-consumption of food and alcohol and reporting short-term health outcomes or acute effects, were included. RESULTS: Of the 15 246 studies identified, 10 met the inclusion criteria. There was little evidence on the effects of food co-consumption on most short-term alcohol-related outcomes. Included studies were low in quality and inconsistent in their reported outcomes. CONCLUSIONS: Despite a weak and inconsistent evidence base, food co-consumption is often recommended by both official guidance and alcohol industry-funded sources. Food co-consumption as a harm reduction measure, while plausible, requires a stronger evidence base and more nuanced messaging due to the risk of encouraging heavier, sustained drinking.

Mycobacterial Cord Factor Reprograms the Macrophage Response to IFN-γ towards Enhanced Inflammation yet Impaired Antigen Presentation and Expression of GBP1.

Mycobacteria survive in macrophages despite triggering pattern recognition receptors and T cell-derived IFN-γ production. Mycobacterial cord factor trehalose-6,6-dimycolate (TDM) binds the C-type lectin receptor MINCLE and induces inflammatory gene expression. However, the impact of TDM on IFN-γ-induced macrophage activation is not known. In this study, we have investigated the cross-regulation of the mouse macrophage transcriptome by IFN-γ and by TDM or its synthetic analogue trehalose-6,6-dibehenate (TDB). As expected, IFN-γ induced genes involved in Ag presentation and antimicrobial defense. Transcriptional programs induced by TDM and TDB were highly similar but clearly distinct from the response to IFN-γ. The glycolipids enhanced expression of a subset of IFN-γ-induced genes associated with inflammation. In contrast, TDM/TDB exerted delayed inhibition of IFN-γ-induced genes, including pattern recognition receptors, MHC class II genes, and IFN-γ-induced GTPases, with antimicrobial function. TDM downregulated MHC class II cell surface expression and impaired T cell activation by peptide-pulsed macrophages. Inhibition of the IFN-γ-induced GTPase GBP1 occurred at the level of transcription by a partially MINCLE-dependent mechanism that may target IRF1 activity. Although activation of STAT1 was unaltered, deletion of Socs1 relieved inhibition of GBP1 expression by TDM. Nonnuclear Socs1 was sufficient for inhibition, suggesting a noncanonical, cytoplasmic mechanism. Taken together, unbiased analysis of transcriptional reprogramming revealed a significant degree of negative regulation of IFN-γ-induced Ag presentation and antimicrobial gene expression by the mycobacterial cord factor that may contribute to mycobacterial persistence.

Validation of the German HeartQoL: a short health-related quality of life questionnaire for cardiac patients.

PURPOSE: The aim of this study was to evaluate psychometric properties of the core disease-specific 14-item German HeartQoL questionnaire. METHODS: As an extension of the international HeartQol Project, cross-sectional and longitudinal health-related quality of life (HRQL) data were collected from 305 patients with angina (N = 101), myocardial infarction (N = 123), or ischemic heart failure (N = 81) in Austria and Switzerland using German versions of the HeartQoL, the Short Form-36 Health Survey (SF-36), and the Hospital Anxiety and Depression Scale. The underlying factor structure was examined with Mokken Scaling analysis; then convergent, divergent, and discriminative validity, internal consistency reliability, and responsiveness were assessed. RESULTS: The highest HRQL scores were reported by patients with myocardial infarction followed by ischemic heart failure and then angina. The two-factor structure was confirmed with strong physical, emotional, and global scale H coefficients (> .50). Divergent and convergent validity (from r = .04 to .78) were shown for each diagnosis; discriminative validity was verified as well (partially: age, sex, and disease severity; largely: SF-36 health status/transition; totally: anxiety and depression). Internal consistency reliability was excellent (Cronbach's alpha = .91). In terms of responsiveness, physical and global scale scores improved significantly after percutaneous coronary intervention (p < .01) while after cardiac rehabilitation all scale scores improved significantly (p < .001). CONCLUSIONS: The German HeartQoL questionnaire is a valid and reliable HRQL instrument with these data supporting its potential use in clinical practice and research to assess and compare HRQL in German-speaking patients with ischemic heart disease. The shortness of the tool may prove to be helpful particularly in clinical practice.

Differential control of Mincle-dependent cord factor recognition and macrophage responses by the transcription factors C/EBPß and HIF1α.

Trehalose-6,6-dimycolate (TDM), the mycobacterial cord factor, and its synthetic analog Trehalose-6,6-dibehenate (TDB) bind to the C-type lectin receptors macrophage-inducible C-type lectin (Mincle) and Mcl to activate macrophages. Genetically, the transcriptional response to TDB/TDM has been defined to require FcRγ-Syk-Card9 signaling. However, TDB/TDM-triggered kinase activation has not been studied well, and it is largely unknown which transcriptional regulators bring about inflammatory gene expression. In this article, we report that TDB/TDM caused only weak Syk-phosphorylation in resting macrophages, consistent with low basal Mincle expression. However, LPS-priming caused MYD88-dependent upregulation of Mincle, resulting in enhanced TDB/TDM-induced kinase activation and more rapid inflammatory gene expression. TLR-induced Mincle expression partially circumvented the requirement for Mcl in the response to TDB/TDM. To dissect transcriptional responses to TDB/TDM, we mined microarray data and identified early growth response (Egr) family transcription factors as direct Mincle target genes, whereas upregulation of Cebpb and Hif1a required new protein synthesis. Macrophages and dendritic cells lacking C/EBPß showed nearly complete abrogation of TDB/TDM responsiveness, but also failed to upregulate Mincle. Retroviral rescue of Mincle expression in Cebpb-deficient cells restored induction of Egr1, but not of G-CSF. This pattern of C/EBPß dependence was also observed after stimulation with the Dectin-1 ligand Curdlan. Inducible expression of hypoxia-inducible factor 1α (HIF1α) also required C/EBPß. In turn, HIF1α was not required for Mincle expression, kinase activation, and Egr1 or Csf3 expression, but critically contributed to NO production. Taken together, we identify C/EBPß as central hub in Mincle expression and inflammatory gene induction, whereas HIF1α controls Nos2 expression. C/EBPß also connects TLR signals to cord factor responsiveness through MYD88-dependent upregulation of Mincle.

International SF-36 reference values in patients with ischemic heart disease.

PURPOSE: International reference data for the SF-36 health survey (version 1) are presented based on a sample of 5508 adult patients with ischemic heart disease. METHODS: Patients with angina, myocardial infarction and ischemic heart failure completed the SF-36. Data were analyzed by diagnosis, gender, age, region and country within region and presented as mean ± standard deviation (SD), minimum, maximum, 25th, 50th and 75th percentile of the physical (PCS) and mental component summary (MCS) measures. RESULTS: Mean PCS scores were reported as being more than one SD below the normal range (standardized mean of 50 ± 10) by more than half of the patient subgroups (59 %) with all of the mean MCS scores falling within the normal range. Patients with angina and patients with ischemic heart failure reported the poorest mean PCS scores with both diagnoses reporting scores more than one SD below the standardized mean. Females, older patients (especially >70 years) and patients from Eastern Europe reported significantly worse mean PCS scores than male, younger and non-Eastern European patients. The cardiac diagnosis had no effect on the mean MCS scores; however, females, younger patients (especially <51 years) and patients from Eastern Europe reported significantly worse mean MCS scores than male, older and non-Eastern European patients. CONCLUSIONS: These international reference SF-36 values for patients with IHD are useful for clinicians, researchers and health-policy makers when developing improved health services.

THC (Δ9-Tetrahydrocannabinol) Exerts Neuroprotective Effect in Glutamate-affected Murine Primary Mesencephalic Cultures Through Restoring Mitochondrial Membrane Potential and Anti-apoptosis Involving CB1 Receptor-dependent Mechanism.

Aging-related neurodegenerative diseases, such as Parkinson's disease (PD) or related disorders, are an increasing societal and economic burden worldwide. Δ9-Tetrahydrocannabinol (THC) is discussed as a neuroprotective agent in several in vitro and in vivo models of brain injury. However, the mechanisms by which THC exhibits neuroprotective properties are not completely understood. In the present study, we investigated neuroprotective mechanisms of THC in glutamate-induced neurotoxicity in primary murine mesencephalic cultures, as a culture model for PD. Glutamate was administered for 48 h with or without concomitant THC treatment. Immunocytochemistry staining and resazurin assay were used to evaluate cell viability. Furthermore, superoxide levels, caspase-3 activity, and mitochondrial membrane potential were determined to explore the mode of action of this compound. THC protected dopaminergic neurons and other cell types of primary dissociated cultures from glutamate-induced neurotoxicity. Moreover, THC significantly counteracted the glutamate-induced mitochondrial membrane depolarization and apoptosis. SR141716A, a CB1 receptor antagonist, concentration-dependently blocked the protective effect of THC in primary mesencephalic cultures. In conclusion, THC exerts anti-apoptotic and restores mitochondrial membrane potential via a mechanism dependent on CB1 receptor. It strengthens the fact that THC has a benefit on degenerative cellular processes occurring, among others, in PD and other neurodegenerative diseases by slowing down the progression of neuronal cell death. Copyright © 2016 John Wiley & Sons, Ltd.

Does the implementation of hardware need software? A longitudinal study on fluoride-removal filter use in Ethiopia.

Evidence suggests that the effectiveness of technology designed to provide safe and healthy water is dependent on the degree of its use. In addition to providing safe water "hardware" (i.e., new infrastructure or equipment) to populations at risk, it might be necessary to also provide suitable "software" programs (behavior change strategies) to support use. A longitudinal survey was conducted in rural Ethiopia following the distribution of fluoride-removal household filters. Three intervention groups were evaluated. Group 1 only received the hardware, i.e., the fluoride-removal filter. Groups 2 and 3 also received software in the form of two evidence-based psychological interventions: a planning and social prompts intervention and an educational workshop with pledging. Group 2 received both software interventions, and Group 3 only received the educational workshop. The effects of the hardware and software on behavior and thus filter use were analyzed along with specific psychological factors. The results showed that the provision of the hardware alone (the fluoride-removal filter) was not enough to ensure sufficient use of the equipment. The addition of a software component in the form of psychological interventions increased filter use up to 80%. An increase in filter use was measured following each intervention resulting in the health-risk being minimized. We conclude that it is necessary that the implementation of hardware of this nature is accompanied by evidence-based intervention software.

Determining behavioral factors for interventions to increase safe water consumption: a cross-sectional field study in rural Ethiopia.

In developing countries, the lack of safe water options leads to many health risks. In the Ethiopian Rift Valley, most water sources are contaminated with an excess of fluoride. The consumption of fluoride-contaminated water leads to dental and skeletal fluorosis. The article presents an approach to designing community interventions based on evidence from quantitative data. After installing a community filter, a baseline study was conducted in 211 households to survey the acceptance and usage of the filter. To identify important psychological factors that lead to health behavior change, the Risk, Attitude, Norm, Ability, Self-regulation (RANAS) model was taken into account. Descriptive statistics were calculated for behavioral determinants, and their influence on consumption was analyzed with a linear regression. For every behavioral factor, an intervention potential (IP) was calculated. It was found that perceived distance, factual knowledge, commitment, and taste strongly influenced participants' consumption behavior and therefore should be tackled for interventions.

[Patterns of dysfunctional parenting styles and psychological disturbances in offspring]. / Muster dysfunktionaler Erziehungsstile und psychische Storungen im Erwachsenenalter.

OBJECTIVES: Dysfunctional parenting styles represent a risk factor for the development of psychological disturbances. The present study investigated the differential validity of the German language Fragebogen zur Erfassung dysfunktionaler Erziehungsstile (FDEB; Measurement of Parental Styles, MOPS) and determined whether different forms of psychological disorders are associated with specific patterns of parenting styles. METHODS: 145 inpatients, 108 outpatients and a control group of 633 representative individuals from the general population were investigated by adapting the FDEB. RESULTS: A comparison of dysfunctional parenting styles showed different distress levels within the diagnostic groups: Patients suffering from depression reported high levels of maternal indifference and over protectiveness together with an abusive rearing behavior on the part of both parents. Patients with anxiety disorders reported having overprotective mothers. Bulimic patients as well as those with personality disorders significantly exhibited stress in almost all areas. However, anorexic patients did not differ significantly from the control group, which appeared to be the least affected of all. CONCLUSION: The FDEB showed a satisfactory differential validity. There was evidence that specific patterns of dysfunctional parenting styles were associated with different diagnostic groups.

Well-Being, Mental Health, and Study Characteristics of Medical Students before and during the Pandemic.

Medical students report high demands, stressors, pressure to perform, and a lack of resources, and are therefore at a higher risk for mental strain and burnout. Due to the COVID-19 pandemic, study conditions have changed, and new challenges have emerged. Thus, this study aimed to examine medical students' well-being, mental health, and study characteristics before and during the pandemic. Data from 988 Austrian medical students were included into the cross-sectional comparisons, and 63 students were included into the longitudinal analyses (variance analyses/t-tests or appropriate non-parametric tests). Well-being before and during the pandemic did not differ significantly but the peri-pandemic cohort reported higher study satisfaction, more social support from lecturers, and less emotional exhaustion, cognitive demands, and stressors (information problems, organizational stressors, work overload). Longitudinally, work overload was also perceived to be higher before the pandemic; however, study satisfaction was lower. During the pandemic, approximately every seventh student exceeded the cut-off value for generalized anxiety disorder, and approximately every tenth student exceeded the cut-off value for major depression. These unexpected peri-pandemic results concerning constant high well-being, study satisfaction, and the perception of conditions may be based on response shift effects that require further exploration. The scores exceeding the reasonable cut-point for identifying probable cases of generalized anxiety disorder and depression may reflect medical students' needs, calling for an in-depth analysis if further health promotion is necessary.

Spectroscopic characterization of coumarin-stained beads: quantification of the number of fluorophores per particle with solid-state 19F-NMR and measurement of absolute fluorescence quantum yields.

The rational design of nano- and micrometer-sized particles with tailor-made optical properties for biological, diagnostic, and photonic applications requires tools to characterize the signal-relevant properties of these typically scattering bead suspensions. This includes methods for the preferably nondestructive quantification of the number of fluorophores per particle and the measurement of absolute fluorescence quantum yields and absorption coefficients of suspensions of fluorescent beads for material performance optimization and comparison. Here, as a first proof-of-concept, we present the first time determination of the number of dye molecules per bead using nondestructive quantitative ((19)F) NMR spectroscopy and 1000 nm-sized carboxylated polystyrene particles loaded with varying concentrations of the laser dye coumarin 153 containing a CF(3) group. Additionally, the signal-relevant optical properties of these dye-loaded particles were determined in aqueous suspension in comparison to the free dye in solvents of different polarity with a custom-built integrating sphere setup that enables spectrally resolved measurements of emission, transmission, and reflectance as well absolute fluorescence quantum yields. These measurements present an important step toward absolute brightness values and quantitative fluorescence analysis with particle systems that can be exploited, for example, for optical imaging techniques and different fluorescence assays as well as for the metrological traceability of fluorescence methods.

Reality Meets Belief: A Mixed Methods Study on Character Strengths and Well-Being of Hospital Physicians.

Positive psychology deals with factors that make life most worth living and focuses on enhancing individual potentials. Particularly, character strengths can positively contribute to well-being and work-related health, bearing a promising potential for professions, such as physicians, who are at risk for burnout or mental illnesses. This study aims to identify beneficial character strengths by examining the quantitative and qualitative data. In a cross-sectional multi-method study, 218 hospital physicians completed an online survey assessing their character strengths and their general and work-related well-being, comprising thriving, work engagement, and burnout dimensions (outcome variables). Quantitative data were analyzed for the total sample and by tertiary split. Additionally, interview-gathered opinions of four resident physicians and four medical specialist educators were collected to expand the perspective on which character strengths might be beneficial for the well-being of the resident physicians. The highest significant correlations between character strengths and outcome variables were found for hope and thriving (r = 0.67), zest, and work engagement (r = 0.67) as well as emotional exhaustion (r = -0.47), perseverance/leadership and depersonalization (r = -0.27), bravery, and reduced personal accomplishment (r = -0.39). Tertiary splits revealed that some correlations were not consistent across the entire scale continuum, for example, creativity was only significantly correlated with comparatively high levels of thriving (r = 0.28) or forgiveness with comparatively high levels of depersonalization (r = -0.34). Humility, social intelligence, and teamwork showed predominantly low correlations with all outcome variables (r = -0.17 - 0.34), although humility was stated by all interviewed medical specialist educators to be the most relevant for the well-being at work, and the latter two by three resident physicians, respectively. Different perspectives resulting from quantitative and qualitative data in terms of beneficial character strengths for work-related well-being may be driven by different work experiences, professional understandings, generational beliefs, or social expectations. Some significant correlations between character strengths and well-being outcomes varied depending on low, medium, or high outcomes. This raises questions about suitable work-related well-being interventions, as simple single intervention approaches (one intervention fits all) may not work for the respective outcome levels. These new findings warrant further research on how to foster the well-being of resident physicians at work.

Do More of What Makes You Happy? The Applicability of Signature Character Strengths and Future Physicians' Well-Being and Health Over Time.

Research on applying signature character strengths demonstrated positive effects on well-being, health and work behavior. Future health care professionals represent a group at risk for impaired well-being due to high study demands. This study investigates potential long-term protective effects on well-being. In total, 504 medical students participated in a longitudinal online study, with at least 96 providing complete data at all three time points (time lag: 1 year). Data on individual signature character strengths and their applicability, thriving (subjective and psychological well-being), work engagement, burnout, mental and physical health were collected. Longitudinal relations of signature character strengths' applicability and well-being, mental and physical health were tested with cross-lagged panel analyses. Moreover, indirect longitudinal mediation effects via work engagement and emotional exhaustion were considered. Cross-lagged panel analyses demonstrated significant positive effects of thriving on signature character strengths' applicability at later time points (ß = 0.20 to 0.27) indicating that higher levels of well-being might be mandatory first to have access to one's own signature character strengths in a naturalistic setting. Disentangling thriving, the effect was only significant for psychological well-being (t1-t2: ß = 0.23; t2-t3: ß = 0.27). Across all three time points, significant indirect effects via work engagement on the relation of the applicability of signature character strengths and well-being were identified (r = 0.15), whereas significant indirect effects on mental and physical health were only evident at t2 (both: r = 0.06) and t3 (mental health: r = 0.11). A longitudinal mediation analysis via work engagement revealed a significant indirect effect (a∗b = 0.13). These results call for further research as previous studies showed that the applicability of signature character strengths affected well-being, not vice versa. The 'broaden-and-build' theory (positive emotions broaden one's consciousness and hereupon individuals build new enduring resources and skills) and the assumption of well-being in a "top-down" model (trait-like predisposition to interpret life experiences in positive ways coloring one's evaluation of satisfaction in various domains accordingly) could possibly explain these novel results.

Communicative and social competence in the medical curriculum of the Medical University of Innsbruck: learning objectives, content, and teaching methods.

Aim: The Austrian Competence Level Catalogue for Medical Skills clearly states the importance of teaching communicative and social competence in the different subject areas of undergraduate medical and dental education. This paper aims to present an overview of the academic courses at the Medical University of Innsbruck that explicitly address the promotion of communication and social skills in medical students. Method: This paper focuses on educators' descriptions of how communicating with patients is taught. The Medical University's longitudinal curriculum on medical interviewing is presented in detail. The courses on ethical principles in the dissection course, palliative medicine, and gender medicine are also outlined as examples. In addition, lecturers (n=536) participated in an online survey to determine the teaching and testing content regarding patient communication and to measure the value attached to the associated teaching and learning methods. Results: The examples given by educators to illustrate learning objectives, educational content, and the teaching methods used to impart communicative and social competence provide an overview of the courses which focus on this topic or intentionally address it during the course. The results of the online survey offer a broad overview of the awareness of the topic at the university. Different testing formats are used to assess the skills being taught. Conclusion: Familiarity with the various teaching methods used in the different courses is important for developing communicative and social competence in medical education. Active networking is necessary to anchor communicative and social competency as a major thread throughout an entire medical curriculum.

Predictors of COVID-19 epidemics in countries of the World Health Organization African Region.

Countries of the World Health Organization (WHO) African Region have experienced a wide range of coronavirus disease 2019 (COVID-19) epidemics. This study aimed to identify predictors of the timing of the first COVID-19 case and the per capita mortality in WHO African Region countries during the first and second pandemic waves and to test for associations with the preparedness of health systems and government pandemic responses. Using a region-wide, country-based observational study, we found that the first case was detected earlier in countries with more urban populations, higher international connectivity and greater COVID-19 test capacity but later in island nations. Predictors of a high first wave per capita mortality rate included a more urban population, higher pre-pandemic international connectivity and a higher prevalence of HIV. Countries rated as better prepared and having more resilient health systems were worst affected by the disease, the imposition of restrictions or both, making any benefit of more stringent countermeasures difficult to detect. Predictors for the second wave were similar to the first. Second wave per capita mortality could be predicted from that of the first wave. The COVID-19 pandemic highlights unanticipated vulnerabilities to infectious disease in Africa that should be taken into account in future pandemic preparedness planning.

A little is better than none: the biggest gain of physical activity in patients with ischemic heart disease.

BACKGROUND: There is a relationship between physical activity and health-related quality of life (HRQL) in healthy people and in patients with ischemic heart disease (IHD). The purpose of this study was to determine whether this relationship between sports or recreational physical activity levels and HRQL has a dose-response gradient in patients with IHD. METHODS: Using one generic and three IHD-specific HRQL questionnaires, differences in HRQL scores (adjusted for confounders) were determined for physically a) inactive vs. active patients and b) inactive vs. patients being active 1-2, 3-5, or >5 times per week. RESULTS: Data were provided by 6143 IHD-patients (angina: N = 2033; myocardial infarction: N = 2266; ischemic heart failure: N = 1844). Regardless of diagnosis or instrument used, when patients were dichotomized as either inactive or active, the latter reported throughout higher physical and emotional HRQL (all p < 0.001; d = 0.25-0.70). When categorized by physical activity levels, there was a positive HRQL dose-response gradient by increasing levels of physical activity that was most marked between inactive patients and those being active 1-2 times per week (63 82%). CONCLUSIONS: Using generic and IHD-specific HRQL questionnaires, there seems to be an overall dose-dependent gradient betweenincreasing levels of sports or recreational physical activity and higher HRQL in patients with angina, myocardial infarction, and ischemic heart failure. The greatest bang for the public health buck still lies on putting all the effort in changing sedentary lifestyle to at least a moderate active one (1-2 times per week), in particular in cardiac rehabilitation settings.

Character Strengths Profiles in Medical Professionals and Their Impact on Well-Being.

Character strengths profiles in the specific setting of medical professionals are widely unchartered territory. This paper focused on an overview of character strengths profiles of medical professionals (medical students and physicians) based on literature research and available empirical data illustrating their impact on well-being and work engagement. A literature research was conducted and the majority of peer-reviewed considered articles dealt with theoretical or conceptually driven 'virtues' associated with medical specialties or questions of ethics in patient care (e.g., professionalism, or what makes a good physician). The virtues of compassion, courage, altruism, and benevolence were described most often. Only a limited number of papers addressed character strengths of medical students or physicians according to the VIA-classification. Those articles showed that the VIA-character strengths fairness, honesty, kindness, and teamwork were considered most often by respondents to be particularly important for the medical profession. Available cross-sectional (time span: six years) and longitudinal (time span: three years) data regarding VIA-character strengths profiles of medical professionals were analyzed (N = 584 medical students, 274 physicians). These profiles were quite homogenous among both groups. The character strengths fairness, honesty, judgment, kindness, and love had the highest means in both samples. Noteworthy differences appeared when comparing medical specialties, in particular concerning general surgeons and psychiatrists, with the former reporting clearly higher levels of e.g., honesty (d = 1.02) or prudence (d = 1.19). Long-term results revealed significant positive effects of character strengths on well-being and work engagement (e.g., perseverance on physicians' work engagement) but also significant negative effects (e.g., appreciation of beauty and excellence on students' well-being). Further, hope was significantly associated both positively with physicians' well-being and negatively with students' work engagement, possibly indicating specific issues concerning medical education or hospital working conditions. According to the modern-day physician's pledge, medical professionals should pay attention to their own well-being and health. Therefore, promoting self-awareness and character building among medical professionals could be a beneficial strategy.

Perceived Socio-moral Climate and the Applicability of Signature Character Strengths at Work: a Study among Hospital Physicians.

Previous research demonstrated that the applicability of signature character strengths at work is associated with employee well-being. However, there is a lack of research on possible antecedents of the applicability of signature character strengths in the occupational domain. In this study we examined whether the perceived socio-moral climate of medical departments has a positive impact on the applicability of hospital physicians' signature character strengths and whether it relates to work engagement, hedonic subjective well-being (SWB) and eudaimonic psychological well-being (PWB). Based on cross-sectional data of N = 165 hospital physicians in Austria, we tested mediation models with perceived socio-moral climate as predictor, applicability of signature character strengths as mediator, and work engagement, SWB and PWB as outcomes. Additionally, we collected longitudinal data (time-lag T1-T2: 6 months) from a sub-sample (n = 69) for testing the relationship between the perceived socio-moral climate and the applicability of signature character strengths over time. The cross-sectional results showed indirect effects of the perceived socio-moral climate on work engagement and eudaimonic well-being via the applicability of signature character strengths at work. Results from a cross-lagged panel analysis suggested an impact of socio-moral climate at T1 on the applicability of signature character strengths 6 months later (T2), but also an even stronger reversed effect of the applicability of signature character strengths at T1 on perceived socio-moral climate at T2.

Development of Cynicism in Medical Students: Exploring the Role of Signature Character Strengths and Well-Being.

Reports of medical students experiencing burnout-related symptoms (e.g., cynicism) have increased in recent years. Little is known about the developmental process of this phenomenon and its relations with signature character strengths and well-being. The aim of this longitudinal analysis was to explore changes in the level of cynicism of medical students while in preclinical education. We further examined how the applicability of signature character strengths and well-being are related to this developmental process. Medical students (N = 99) participated in three online surveys over 3 years during medical school. Latent growth modeling, latent class growth modeling, general mixed modeling was conducted, and post hoc mixed ANOVA, Friedman test and Welch test analyses were examined. The results showed an increase in cynicism among medical students from first to last measurement. Two groups with distinct developmental trajectory patterns of cynicism were identified. Students with high levels of cynicism (high-level group) and students with changing levels of cynicism (increasing group) perceived higher applicability of signature character strengths in private life compared to the study context. Moreover, the high-level group experienced significantly lower psychological well-being (in particular mastery, optimism, and relationship) in their first year of medical education. This explorative study offers a comprehensive understanding of cynicism development in medical students during medical school and its relations to the applicability of signature character strengths and well-being. Prospective replication studies are needed to replicate the results obtained in this study.

Identifying thriving Workplaces in Hospitals: Work Characteristics and the Applicability of Character Strengths at Work.

In most of their work settings, the health and well-being of hospital physicians are at risk. Trends of work intensification and changing laws in the European Union and beyond have heightened the call for taking a closer look at the workplace and training conditions of hospital physicians. This study aims to identify specific work characteristics (such as autonomy, social support, cognitive demands, and skill adequacy), in order to determine conditions for the applicability of individual character strengths at work and in turn for increased work engagement and well-being. We examined our hypotheses based on cross-sectional (N = 173) and longitudinal self-report data (N = 72) of hospital physicians in Austria. The results identified significant indirect effects of skill adequacy, cognitive demands, autonomy, and social support at work - via the applicability of individual character strengths at work - on work engagement and general well-being. Longitudinal analyses additionally confirmed autonomy as a thriving work characteristic for promoting the applicability of individual character strengths over time (time lag: 6 months). This study revealed the value of enabling and preserving the applicability of character strengths in a hospital work setting and focused - for the first time - on its predicting work characteristics. Furthermore, it emphasizes the importance of securing skill adequacy early in the training of young physicians and encouraging, as well as, sustaining autonomy in their daily work life.