Does parental exposure to nanoplastics modulate the response of Hediste diversicolor to other contaminants: A case study with arsenic.

Plastic pollution is a serious problem in aquatic systems throughout the world. Despite the increasing number of studies addressing the impact of macro- and microplastics on biota, there is still a significant knowledge gap regarding the effects of nanoplastics alone and in combination with other contaminants. Among the aquatic contaminants that may interact with nanoplastics is arsenic (As), a metalloid found in estuarine and coastal ecosystems, pernicious to benthic organisms. This study aimed to understand how a parental pre-exposure to 100 nm polystyrene nanoplastics (PS NPs) would influence the response of Hediste diversicolor to exposure to arsenic in terms of behaviour, neurotransmission, antioxidant defences and oxidative damage, and energy metabolism. The obtained data revealed an increase in burrowing time and a significant inhibition in cholinesterase activity in all polychaetes exposed to As, regardless of the pre-exposure to PS NPs. Oxidative status was altered particularly in parentally exposed organisms, with damage detected in terms of lipid peroxidation at 50 µg/L and protein carbonylation at 50 and 250 µg As/L exposed organisms when compared to control. Overall, data shows that parental pre-exposure to plastics influences the response of aquatic organisms, increasing their susceptibility to other contaminants. Thus, more studies should be performed with other environmental contaminants, to better understand the potential increased risk associated with the presence of nanoplastics to aquatic ecosystems.

The Dynamics of Patient Visits to a Public Hospital Pediatric Emergency Department: A Time-Series Model.

BACKGROUND: The overcrowding of emergency departments (EDs) is an increasingly relevant public health problem. The main aims of this study were to identify and analyze temporal periodicities of a self-referred pediatric ED (PED), correlate them with meteorological and calendar variables and build a robust forecasting model. METHODS: An 8-year administrative data set (2010-2017) of the daily number of admissions to the PED of a public hospital in Lisbon, Portugal, was used (n = 670,379). A time-series model of the daily number of visits was built, including temporal periodicities, the Portuguese school calendar, and a meteorological comfort index (humidex). RESULTS: Several temporal cycles were identified: 1 year (peak in January/February related to respiratory infections in younger children and infants), 6 months (peaks in May and October with an increase in the admissions of older children and adolescents with trauma, gastrointestinal infections and atopic symptoms), 4 months (related to annual school vacations), 1 week (lower admission values on Saturday), and half a week (low from Friday to Monday morning). School calendar and humidex were significantly correlated with daily admissions. The model yielded a mean absolute percentage error of 10.7% ± 1.10% when cross-validation was performed for the full data set. CONCLUSION: Although PED visits are multifactorial, they may be predicted and explained by a relatively small number of variables. Such a model may be easily reproduced in different settings and represents a relevant tool to improve quality in EDs through correctly adapting human resources to ED demand.

Social support and job satisfaction in nursing staff: Understanding the link through role ambiguity.

AIM: This study aimed to analyse the mediator effect of role ambiguity between social support from supervisor and colleagues and job satisfaction in Portuguese nursing staff. BACKGROUND: Few studies have analysed the processes through which social support increases job satisfaction in the nursing context. DESIGN: A cross-sectional design using questionnaires. METHOD: A total of 124 registered nurses and 130 certified nursing assistants participated in the study. Mediation analysis was performed by calculating percentile confidence intervals (10,000 resamples). RESULTS: Mediation analysis revealed a partial mediation between social support and job satisfaction through role ambiguity. The direct effect was greater in the case of supervisor support. CONCLUSIONS: Social support is a crucial resource in the nursing work context with a beneficial effect on well-being (e.g. reducing role stress) and job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: Managers of hospitals and health units can establish the organizational bases to facilitate this process, considering the importance of the role of the supervisors and colleagues in the provision of high levels of instrumental and socio-emotional support.

Macrobrachium amazonicum (Crustacea, Decapoda) Used to Biomonitor Mercury Contamination in Rivers.

Open-air landfill's may be are considered as a potential source of human environmental exposure to chemical substances such as, polycyclic aromatic hydrocarbons and toxic metals. Due to possible availability of mercury in the environment caused by open landfill emissions, this study evaluates the spatiality and seasonality of macroinvertebrates, in particular shrimps (Macrobrachium amazonicum), exposure to mercury (Hg). Information regarding Hg accumulation in this crustacean may be important for the development of public policies aiming conservation and preservation of ecosystems surrounding landfills in Amazon, and around the world. Sampling occurred quarterly in the following months: November/2015; February/2016; May/2016 and; August/2016. In each of these months, three points were selected: P1, P2 and P3. The samples were processed via acid digestion and the quantification of metal was performed by inductively coupled plasma mass spectrometry. The average concentration of total mercury (T-Hg) was 24.565 ± 6.610 µg kg-1 wet weight, with minimum and maximum limits of 12.742 ± 11.367 (P3) and 35.509 ± 14.761 µg kg-1 wet weight (P1) in November/2015 and August/2016, respectively. The concentration of total mercury (T-Hg) in shrimps was different between points (p = 0.004) and months (p = 0.000). The T-Hg concentrations were significantly higher in May and August 2016, which corresponds to the dry season. The presence of landfills promotes large accumulation of T-Hg in the aquatic biota and represents a risk to human health. However, seasonal changes in T-Hg levels were observed. In the wettest period, bioconcentration factor levels decrease in aquatic organisms.

Social support, role clarity and job satisfaction: a successful combination for nurses.

AIM: To analyse the moderating effect of role clarity on the relationship between social support (supervisor and colleagues) and job satisfaction. BACKGROUND: The social support of supervisors and co-workers and the clarity of roles are important antecedents of job satisfaction. According to the Conservation of Resources theory, the interaction of the instrumental nature of role clarity and social support would result in higher levels of job satisfaction in nursing. METHODS: Through a convenience sample, a final sample of 191 participants (64.92% registered nurses, 35.08% nursing assistants) was obtained from a private hospital complex in Portugal. Hierarchical linear regression models were carried out to check the moderating function of role clarity. RESULTS: Regression models showed the moderating effect of role clarity. Nursing staff with high social support from their supervisors and peers showed higher scores in job satisfaction when role clarity was high. CONCLUSION: An adequate description of roles, through clear and detailed information regarding expected functions, responsibilities and behaviour, allows the effect of social support from supervisors and co-workers on job satisfaction to be stronger. IMPLICATIONS FOR NURSING PRACTICE: Strategies such as defining responsibilities, setting clear expectations and role analysis allow a reduction in sources of uncertainty in jobs. Training in communication and feedback skills would improve the social support given by supervisors and colleagues. IMPLICATIONS FOR NURSING POLICY: Hospital boards and nurse managers should be aware of the importance of clarifying roles, responsibilities, and functions of each professional category and hierarchical level for the provision of adequate quality of care.

Workplace Empowerment and Job Satisfaction in Portuguese Nurses: An Explicative Model.

Greater effectiveness of health care does occur with a more effective management of interpersonal processes. A working management environment, which ensures sufficient access to information, support, resources, and opportunities (structural empowerment), probably can promote a personal perception of capacity and effectiveness (global empowerment) in caregivers to achieve organizational objectives and job satisfaction. This study evaluated the relationship between empowerment and job satisfaction, supported by Kanter's theory of structural empowerment. This study used a convenience sample of 151 nurses from public Portuguese hospitals. The adjustment of the model and the effect of mediation were carried out with a structural equation model (path analysis) through the statistical software STATA. The results show the mediator effect of global empowerment on the relationship between structural empowerment and job satisfaction and the direct and indirect effects of "access to opportunities" in job satisfaction. Managers of these health units should consider that the more the work environment is characterized by having the resources, opportunities, and support indispensable to the good execution of the work by the nurses, the greater the global empowerment and job satisfaction. The results obtained can be an important contribution that can be adopted as a strategy in any health institution without any harm.

Work engagement, social support, and job satisfaction in Portuguese nursing staff: A winning combination.

BACKGROUND: Job Demands-Resources model assumes the mediator role of work engagement between social support (job resource) and job satisfaction (organizational result). However, recent studies suggest that social support can be considered as a moderator variable in the relationship between engagement and job satisfaction in nursing staff. AIM: The aim of this study is to analyze the moderator role of social support, from supervisor and from co-workers, in the relationship between work engagement and job satisfaction in a Portuguese nursing sample. METHOD: We conducted a cross-sectional and correlational study assessing a final sample of 215 participants (55.56% response rate, 77.21% women). Moderation analyses were carried out using multiple and hierarchical linear regression models. RESULTS: Job satisfaction was significantly predicted by work engagement and social support from supervisor and from co-workers. The significant interaction in predicting job satisfaction showed that social support from co-workers enhances the effects of work engagement on nurses' satisfaction. CONCLUSION: A climate of social support among co-workers and higher levels of work engagement have a positive effect on job satisfaction, improving quality care and reducing turnover intention in nursing staff.

Genetic basis of congenital erythrocytosis: mutation update and online databases.

Congenital erythrocytosis (CE), or congenital polycythemia, represents a rare and heterogeneous clinical entity. It is caused by deregulated red blood cell production where erythrocyte overproduction results in elevated hemoglobin and hematocrit levels. Primary congenital familial erythrocytosis is associated with low erythropoietin (Epo) levels and results from mutations in the Epo receptor gene (EPOR). Secondary CE arises from conditions causing tissue hypoxia and results in increased Epo production. These include hemoglobin variants with increased affinity for oxygen (HBB, HBA mutations), decreased production of 2,3-bisphosphoglycerate due to BPGM mutations, or mutations in the genes involved in the hypoxia sensing pathway (VHL, EPAS1, and EGLN1). Depending on the affected gene, CE can be inherited either in an autosomal dominant or recessive mode, with sporadic cases arising de novo. Despite recent important discoveries in the molecular pathogenesis of CE, the molecular causes remain to be identified in about 70% of the patients. With the objective of collecting all the published and unpublished cases of CE the COST action MPN&MPNr-Euronet developed a comprehensive Internet-based database focusing on the registration of clinical history, hematological, biochemical, and molecular data (http://www.erythrocytosis.org/). In addition, unreported mutations are also curated in the corresponding Leiden Open Variation Database.

The ADnet Bayesian belief network for alder decline: Integrating empirical data and expert knowledge.

The globalization in plant material trading has caused the emergence of invasive pests in many ecosystems, such as the alder pathogen Phytophthora ×alni in European riparian forests. Due to the ecological importance of alder to the functioning of rivers and the increasing incidence of P. ×alni-induced alder decline, effective and accessible decision tools are required to help managers and stakeholders control the disease. This study proposes a Bayesian belief network methodology to integrate diverse information on the factors affecting the survival and infection ability of P. ×alni in riparian habitats to help predict and manage disease incidence. The resulting Alder Decline Network (ADnet) management tool integrates information about alder decline from scientific literature, expert knowledge and empirical data. Expert knowledge was gathered through elicitation techniques that included 19 experts from 12 institutions and 8 countries. An original dataset was created covering 1189 European locations, from which P. ×alni occurrence was modeled based on bioclimatic variables. ADnet uncertainty was evaluated through its sensitivity to changes in states and three scenario analyses. The ADnet tool indicated that mild temperatures and high precipitation are key factors favoring pathogen survival. Flood timing, water velocity, and soil type have the strongest influence on disease incidence. ADnet can support ecosystem management decisions and knowledge transfer to address P. ×alni-induced alder decline at local or regional levels across Europe. Management actions such as avoiding the planting of potentially infected trees or removing man-made structures that increase the flooding period in disease-affected sites could decrease the incidence of alder disease in riparian forests and limit its spread. The coverage of the ADnet tool can be expanded by updating data on the pathogen's occurrence, particularly from its distributional limits. Research on the role of genetic variability in alder susceptibility and pathogen virulence may also help improve future ADnet versions.

Molecular study of congenital erythrocytosis in 70 unrelated patients revealed a potential causal mutation in less than half of the cases (Where is/are the missing gene(s)?).

INTRODUCTION: Congenital erythrocytosis can be classified as primary, when the defect is intrinsic to the RBC progenitors and independent of the serum erythropoietin (Epo) concentration, or secondary, when the erythrocytosis is the result of an upregulation of Epo production. Primary erythrocytosis is associated with mutations in the EPOR gene, secondary CE can de due to mutations that stabilize the hemoglobin in the oxygenated form or to mutations in the genes that control the transcriptional activation of the EPO gene - VHL, EGLN1, EPAS1. Chuvash polycythemia, caused by mutations in VHL gene, shares features of both primary and secondary erythrocytosis, with increased Epo production but also hypersensitivity of progenitors to Epo. MATERIAL AND METHODS: With the main objective of describing the etiology and molecular basis of CE, we have studied 70 consecutive unrelated patients presenting with idiopathic erythrocytosis from our hematology clinic or referred from other centers. According to a study algorithm, we have sequenced all the genes described as associated with CE. RESULTS AND DISCUSSION: Erythrocytosis molecular etiology was identify in 25 (36%) of the 70 subjects. High-affinity Hb variants were the most common cause, present in 20% of the cases. New mutations were identified in the JAK2, EPOR, VHL, and EGLN1 genes. CONCLUSIONS: High-affinity hemoglobin variants are a very rare cause of secondary CE, but it seems likely that their incidence may be underestimated. Our experience shows that in erythrocytosis with a dominant inheritance and normal or inappropriate high Epo levels, the HBB and HBA genes should be the first to be studied. In spite of the seven genes known to be involved in CE, the majority of the cases have unknown etiology.

Mechanical ventilation in pediatric intensive care units during the season for acute lower respiratory infection: a multicenter study.

OBJECTIVE: To describe the characteristics and outcomes of mechanical ventilation in pediatric intensive care units during the season of acute lower respiratory infections. DESIGN: Prospective cohort of infants and children receiving mechanical ventilation for at least 12 hrs. SETTING: Sixty medical-surgical pediatric intensive care units. PATIENTS: All consecutive patients admitted to participating pediatric intensive care units during a 28-day period. MEASUREMENTS AND MAIN RESULTS: Of 2,156 patients admitted to pediatric intensive care units, 1185 (55%) received mechanical ventilation for a median of 5 days (interquartile range 2-8). Median age was 7 months (interquartile range 2-25). Main indications for mechanical ventilation were acute respiratory failure in 78% of the patients, altered mental status in 15%, and acute on chronic pulmonary disease in 6%. Median length of stay in the pediatric intensive care units was 10 days (interquartile range 6-18). Overall mortality rate in pediatric intensive care units was 13% (95% confidence interval: 11-15) for the entire population, and 39% (95% confidence interval: 23 - 58) in patients with acute respiratory distress syndrome. Of 1150 attempts at liberation from mechanical ventilation, 62% (95% confidence interval: 60-65) used the spontaneous breathing trial, and 37% (95% confidence interval: 35-40) used gradual reduction of ventilatory support. Noninvasive mechanical ventilation was used initially in 173 patients (15%, 95% confidence interval: 13-17). CONCLUSION: In the season of acute lower respiratory infections, one of every two children admitted to pediatric intensive care units requires mechanical ventilation. Acute respiratory failure was the most common reason for mechanical ventilation. The spontaneous breathing trial was the most commonly used method for liberation from mechanical ventilation.

[Prevalence of hypertension in Portuguese adolescents in Lisbon, Portugal]. / Prevalência de hipertensão arterial em adolescentes portugueses da cidade de Lisboa.

AIMS: To determine the prevalence of pre-hypertension (pre-HTN) and hypertension (HTN) in Portuguese adolescents in Lisbon and to ascertain the relationship between blood pressure (BP) levels and the risk factors of gender, obesity, smoking, alcohol consumption, exercise and family history of HTN. METHODS: This was a cross-sectional study in a non-randomized sample of 234 adolescents of both sexes, aged between 16 and 19 years. Information on habits and family history of HTN was obtained through a self-completed structured questionnaire. RESULTS: The study included 234 adolescents, mean age 16.4±0.9 years, 57% male. The prevalence of HTN was 34%, higher in males (44% vs. 21%, p=0.001) and 12% of pre-HTN, higher in females (13% vs. 10%, p=0.001). Higher body mass index was associated with significantly higher prevalence of pre-HTN (normal weight 9.40%, overweight 16.10%, and obesity 22.70%) and HTN (normal weight 30.4%, overweight 45.2%, and obesity 45.5%). With a family history of HTN, the prevalence of HTN and pre-HTN was approximately double (41% vs. 28% and 18% vs. 9%, respectively). Regular exercise, smoking and alcohol consumption were not significantly associated with BP values. CONCLUSION: The prevalence of pre-HTN and HTN in the sample studied was high. Of the risk factors evaluated, only gender, obesity and family history of HTN were significantly associated with BP values.

COVID-19 screening in a Portuguese pediatric population.

OBJECTIVE: To assess the characteristics of suspected coronavirus disease 19 (COVID-19) and the rate of confirmed COVID-19 in a pediatric population at the beginning of the pandemic in Portugal. STUDY DESIGN: Suspected COVID-19 pediatric cases that were tested in a Portuguese hospital between March 17 and April 2 2020 were included in this descriptive retrospective study. The analyzed data included socio-demographic parameters, characteristics of the household, underlying medical conditions and symptoms. RESULTS: Ninety-four patients were included and all of them were symptomatic and treated without hospitalization. The most common symptoms were cough (80%;n=75), rhinorrhea (72%;n=68) and fever (60%;n=56). There was only one positive for SARS-CoV-2 in a five-year-old child with mild illness without epidemiologic linkage. CONCLUSION: This study showed a low rate of confirmed COVID-19 in children. The causes for this low rate can be multifactorial and illustrates how differently this virus spreads in the pediatric population.

MPTHub: An Open-Source Software for Characterizing the Transport of Particles in Biorelevant Media.

The study of particle transport in different environments plays an essential role in understanding interactions with humans and other living organisms. Importantly, obtained data can be directly used for multiple applications in fields such as fundamental biology, toxicology, or medicine. Particle movement in biorelevant media can be readily monitored using microscopy and converted into time-resolved trajectories using freely available tracking software. However, translation into tangible and meaningful parameters is time consuming and not always intuitive. We developed new software-MPTHub-as an open-access, standalone, user-friendly tool for the rapid and reliable analysis of particle trajectories extracted from video microscopy. The software was programmed using Python and allowed to import and analyze trajectory data, as well as to export relevant data such as individual and ensemble time-averaged mean square displacements and effective diffusivity, and anomalous transport exponent. Data processing was reliable, fast (total processing time of less than 10 s), and required minimal memory resources (up to a maximum of around 150 MB in random access memory). Demonstration of software applicability was conducted by studying the transport of different polystyrene nanoparticles (100-200 nm) in mucus surrogates. Overall, MPTHub represents a freely available software tool that can be used even by inexperienced users for studying the transport of particles in biorelevant media.

Comparison between frail and non-frail older adults' gut microbiota: A systematic review and meta-analysis.

BACKGROUND: Emerging evidence suggests that the intestinal microbiota (IM) undergoes remodelling as we age, and this impacts the ageing trajectory and mortality in older adults. The aim was to investigate IM diversity differences between frail and non-frail older adults by meta-analysing previous studies. METHODS: The protocol of this systematic review with meta-analysis was registered on PROSPERO (CRD42021276733). We searched for studies comparing IM diversity of frail and non-frail older adults indexed on PubMed, Embase, Cochrane, and Web of Science in November 2021. RESULTS: We included 11 studies with 1239 participants, of which 340 were meta-analysed. Frailty was defined by a variety of criteria (i.e. Fried Scale, European Consensus on Sarcopenia). There were no differences in the meta-analyses between the frail and non-frail groups for species richness index (SMD = -0.147; 95% CI = -0.394, 0.100; p = 0.243) and species diversity index (SMD = -0.033; 95% CI = -0.315, 0.250; p = 0.820). However, we identified almost 50 differences between frail and non-frail within the relative abundance of bacteria phyla, families, genera, and species in the primary studies. CONCLUSIONS: The evidence to prove that there are differences between frail and non-frail IM diversity by meta-analysis is still lacking. The present results suggest that further investigation into the role of specific bacteria, their function, and their influence on the physiopathology of frailty is needed.

Catastrophic antiphospholipid syndrome: first signs in the neonatal period.

The term "catastrophic" antiphospholipid syndrome (CAPS) is used to define a subset of the antiphospholipid syndrome (APS) characterized by the clinical evidence of three or more organ involvement by thrombotic events in a short period of time and with laboratory confirmation of the presence of antiphospholipid antibodies. We describe a male infant first admitted at 17 days old for necrotizing enteritis complicated by cardiac and renal failure. Because of progressive renal function deterioration, a renal biopsy was performed at 8 months old, and histopathologic examination was compatible with renal venous thrombosis. Laboratory searching for vascular, prothrombotic, and metabolic disease was negative. Five months later, he developed two different episodes (20-day range) of ischemic stroke. Genetic test for thrombophilic conditions was positive for two different mutations, and repeatedly high titers of lupus anticoagulant, anticardiolipin, and anti-ß2glicoprotein I antibodies were found. He was treated successfully with anticoagulants and showed a favorable clinical evolution. To the best of our knowledge, this is the youngest patient reported with probable CAPS. Although rare, APS/CAPS in the neonatal period or in the first year of life must be suspected in infants presenting with thrombotic phenomena. The present case illustrates the importance of an early diagnosis and treatment to enhance possibilities of survival.

Unfolding the dynamical structure of Lisbon's public space: space syntax and micromobility data.

Space Syntax and the theory of natural movement demonstrated that spatial morphology is a primary factor influencing movement. This paper investigates to what extent spatial morphology at different scales (node, community and global network) influences the use of public space by micromobility. An axial map and corresponding network for Lisbon's walkable and open public space, and data from e-scooters parking locations, is used as case study. Relevant metrics and their correlations (intelligibility, accessibility, permeability and local dimension) for the quantitative characterization of spatial morphology properties are described and computed for Lisbon's axial map. Communities are identified based on the network topological structure in order to investigate how these properties are affected at different scales in the case study. The resulting axial line clustering is compared via the variation of information metric with the clustering obtained from e-scooters' proximity. The results obtained enable to conclude that the space syntax properties are scale dependent in Lisbon's pedestrian network. On the other hand both the correlation between these properties, the number of scooters and the variation of information between clusters indicate that the spatial morphology is not the only factor influencing micromobility. Through the comparative analysis between the main properties of the public space network of Lisbon and data collected from e-scooters locations in a timeframe, centrality becomes a dynamic concept, relying not only on the static topological properties of the urban network, but also on other quantitative and qualitative factors, since the flows' operating on the network will operate several transformations on the spatial network properties through time, uncovering spatiotemporal dynamics.

Mucus-producing 3D cell culture models.

In vitro cell-based models have been used for a long time since they are normally easily obtained and have an advantageous cost-benefit. Besides, they can serve a variety of ends, from studying drug absorption and metabolism to disease modeling. However, some in vitro models are too simplistic, not accurately representing the living tissues. It has been shown, mainly in the last years, that fully mimicking a tissue composition and architecture can be paramount for cellular behavior and, consequently, for the outcomes of the studies using such models. Because of this, 3D in vitro cell models have been gaining much attention, since they are able to better replicate the in vivo environment. In this review we focus on 3D models that contain mucus-producing cells, as mucus can play a pivotal role in drug absorption. Being frequently overlooked, this viscous fluid can have an impact on drug delivery. Thus, the aim of this review is to understand to which extent can mucus affect mucosal drug delivery and to provide a state-of-the-art report on the existing 3D cell-based mucus models.

Exploring the link between structural empowerment and job satisfaction through the mediating effect of role stress: A cross-sectional questionnaire study.

BACKGROUND: Role stress (ambiguity and conflict) is a major psychosocial risk at work negatively associated with job satisfaction in the nursing context. According to Kanter's empowerment theory, high levels of structural empowerment reduce role stress, so role ambiguity and conflict could be potential mediators of the relationship between empowerment and job satisfaction. OBJECTIVE: The aim of this study was to analyze the relationships between structural empowerment, role stress (ambiguity and conflict), and job satisfaction, assuming the mediating role of role stress on the relationship between structural empowerment and job satisfaction. DESIGN: A cross-sectional design was utilized, using questionnaires for data collection and convenience sampling. SETTING(S): Private health care organizations in southern Portugal. PARTICIPANTS: One hundred and twenty-four registered nurses (sample 1) and one hundred and thirty certified nursing assistants (sample 2) completed self-report measures of structural empowerment, role stress, and job satisfaction. METHODS: Mediation analysis was performed using linear regression models and the bootstrapping method. Bias-Corrected confidence intervals (95%) were calculated for the study of direct and indirect effects. RESULTS: In both samples, structural empowerment, role ambiguity, and role conflict were significant predictors of job satisfaction. Both ambiguity and role conflict partially mediated the effect of structural empowerment on job satisfaction. The effect mediated by ambiguity was greater than the effect mediated by role conflict in both registered nurses and certified nursing assistants. CONCLUSIONS: Two processes could explain the effect of structural empowerment on job satisfaction in the nursing context: a direct effect generating experiences and perceptions of power in professionals; and an indirect effect reducing role stress levels in the workplace. The creation of empowering workplaces which clarify work roles and functions of nursing staff should be a priority issue for health managers and nurse executives.

Supervisor Support and Affective Organizational Commitment: The Mediator Role of Work Engagement.

The aim of the study was to verify the mediator role of work engagement between supervisor social support and affective organizational commitment. A cross-sectional and correlational study using questionnaires was conducted. We obtained a convenience sample of 267 participants from 403 nurses from two public hospitals (66.25% response rate). Participants were required to be registered nurses without a supervisor position and to have worked for at least 1 year in the same ward in a public hospital. The mediator role of work engagement was examined using path analysis and bootstrapping method (bias-corrected confidence intervals). Results showed that affective organizational commitment was positively and significantly predicted by supervisor support, vigor, and absorption. Supervisor support had both a direct effect and an indirect effect, through vigor and absorption, on affective organizational commitment. Social support from supervisors allows an increase both in nurses' engagement and their desire to remain in the organization.