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OBJECTIVES:: Reviews of patient safety efforts suggest that technical/administrative change must be augmented by global factors such as organizational culture and climate. The objective was to outline a comprehensive model for healthcare climate and test one of its elements, the nursing subclimate, in terms of several patient safety outcomes. DESIGN:: Measure organizational climate in nursing units, followed by random sampling of patient safety practices in each unit 6 months later. SETTING:: Sixty-nine inpatient units in three hospitals that make up the entire tertiary care system in one metropolitan area. SUBJECTS:: A total of 955 nurses. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: A two-part Nursing Climate Scale referring to hospital- and unit-level climates, followed by five randomly timed observations of patient safety practices covering routine and emergency care in each unit. Climate scales met the criteria of internal reliability, within-unit agreement, and between-unit variability, using standard statistics of climate research. Both the hospital and unit nursing climates exhibited significant variation, which predicted the routine medication safety scores (Z = 2.65 and 2.93 accordingly, p < .01), with similar results for emergency safety scores. A significant interaction (Z = 2.78, p < .01) indicated that best/worst safety is obtained when the unit and hospital climates are aligned (for better or worse) and that positive unit climate can compensate for the detrimental effect of poor hospital climate. Furthermore, climate's strength increased its predictive power with regard to patient safety practices (Z = 3.64 for medication and 2.28 for emergency safety; p < .01). The small number of participating hospitals limits organization-level analyses. CONCLUSIONS:: The nursing climate identifies units where the likelihood of adverse events is greater or lower than the hospital's average. Such information can guide prevention efforts in selected units. These data encourage the development of additional climate subscales subsumed under the healthcare climate model (e.g., physicians subclimate). [ABSTRACT FROM AUTHOR]

Background: Balance control, and specifically balance reactive responses that contribute to maintaining balance when balance is lost unexpectedly, is impaired in older people. This leads to an increased fall risk and injurious falls. Improving balance reactive responses is one of the goals in fall-prevention training programs. Perturbation training during standing or treadmill walking that specifically challenges the balance reactive responses has shown very promising results; however, only older people who are able to perform treadmill walking can participate in these training regimes. Thus, we aimed to develop, build, and pilot a mechatronic Perturbation Stationary Bicycle Robotic system (i.e., PerStBiRo) that can challenge balance while sitting on a stationary bicycle, with the aim of improving balance proactive and reactive control., Methods: This paper describes the development, and building of the PerStBiRo using stationary bicycles. In addition, we conducted a pilot randomized control trial (RCT) with 13 older people who were allocated to PerStBiRo training (N = 7) versus a control group, riding stationary bicycles (N = 6). The Postural Sway Test, Berg Balance Test (BBS), and 6-min Walk Test were measured before and after 3 months i.e., 20 training sessions., Results: The PerStBiRo System provides programmed controlled unannounced lateral balance perturbations during stationary bicycling. Its software is able to identify a trainee's proactive and reactive balance responses using the Microsoft Kinect™ system. After a perturbation, when identifying a trainee's trunk and arm reactive balance response, the software controls the motor of the PerStBiRo system to stop the perturbation. The pilot RCT shows that, older people who participated in the PerStBiRo training significantly improved the BBS (54 to 56, p = 0.026) and Postural Sway velocity (20.3 m/s to 18.3 m/s, p = 0.018), while control group subject did not (51.0 vs. 50.5, p = 0.581 and 15 m/s vs. 13.8 m/s, p = 0.893, respectively), 6MWT tended to improve in both groups., Conclusions: Our participants were able to perform correct balance proactive and reactive responses, indicating that older people are able to learn balance trunk and arm reactive responses during stationary bicycling. The pilot study shows that these improvements in balance proactive and reactive responses are generalized to performance-based measures of balance (BBS and Postural Sway measures).

Physiological or pathological muscle disuse/inactivity or loss of the neural-muscular junction cause muscle atrophy. Atrophy-inducing conditions cause metabolic oxidative stress in the muscle tissue, activation of the ubiquitin-proteasome and of the autophagosome-lysosome systems, enhanced removal of the damaged proteins and organelles, and loss of muscle mass and strength. The signaling pathways that control these catabolic processes are only partially known. In this study, we systematically analyzed the role of p38α mitogen-activated protein kinase (MAPK) in denervation-mediated atrophy. Mice with attenuated activity of p38α (p38 AF ) are partially protected from muscle damage and atrophy. Denervated (Den) muscles of these mutant mice exhibit reduced signs of oxidative stress, decreased unfolded protein response and lower levels of ubiquitinated proteins relative to Den muscles of control mice. Further, whereas autopahagy flux is inhibited in Den muscles of control mice, Den muscles of p38 AF mice maintain normal level of autophagy flux. Last, muscle denervation affects differently the energy metabolism of muscles in normal and mutant mice; whereas denervation appears to increase mitochondrial oxidative metabolism in control mice, it elevates anaerobic glycolytic metabolism in p38 AF mice. Our results indicate, therefore, that attenuation of p38α activity in mice protects Den muscles by reducing oxidative stress, lowering protein damage and improving the clearance of damaged mitochondria by autophagy., (© 2019 Federation of European Biochemical Societies.)

Workplace bullying is a widespread and challenging problem in healthcare organizations, bearing negative consequences for individuals and organizations. Drawing on the job demands-resources theory, in this study, we examined the relationship between workplace bullying and burnout among healthcare employees, as well as the moderating role of job autonomy and occupational self-efficacy in this relationship. Using a cross-sectional design with anonymous questionnaires, data were collected from two samples of 309 healthcare employees in a mental health facility, and 105 nurses studying for their bachelor degree in health systems administration. The findings indicated that workplace bullying was positively related to burnout dimensions, and that this relationship was moderated by job autonomy and occupational self-efficacy resources. Job autonomy interacted with workplace bullying in predicting emotional exhaustion and depersonalization; the interaction of bullying with occupational self-efficacy significantly predicted depersonalization. These results underscore the importance of control-related resources in mitigating the harmful effects of workplace bullying on employees. Implications for research and managerial practices are discussed., (© 2017 John Wiley & Sons Australia, Ltd.)

Background: The optimisation of the lure is essential for the implementation of trapping systems to control insect pests. In this work, the response of the red palm weevil (RPW), Rhynchophorus ferrugineus Olivier, to increasing emission rates of its aggregation pheromone (ferrugineol) and the efficacy of a convenient synthetic kairomone based on fermentation odours (ethyl acetate and ethanol) have been evaluated in different years and locations along the Mediterranean basin., Results: In general, although capture data and emission had noticeable variability among locations, significantly fewer RPW were captured in pyramidal Picusan® traps with the lowest ferrugineol emission rates tested (0.6-3.8 mg day -1 ). Captures increased rapidly with ferrugineol emission up to 4-5 mg day -1 ; then, higher emission rates did not improve or reduce captures, up to the highest emission rate tested of 50.9 mg day -1 . Thus, there is no evidence of an optimum release rate corresponding to a maximum of RPW catches. Traps baited with the synthetic kairomone (1:3 ethyl acetate/ethanol) captured 1.4-2.2 times more total weevils than traps baited only with ferrugineol. Moreover, in most of the locations, the synthetic blend was at least as effective as the local coattractants used (plant material + molasses)., Conclusions: Ferrugineol emission rate can vary in a wide range without significantly affecting RPW response. Coattractants based on fermenting compounds, ethyl acetate and ethanol, are able to improve the attractant level of ferrugineol and could be employed to replace non-standardised natural kairomones in RPW trapping systems after further optimisation of their proportions and doses. © 2016 Society of Chemical Industry., (© 2016 Society of Chemical Industry.)

Kirrel/Neph proteins are evolutionarily conserved members of the immunoglobulin superfamily of adhesion proteins. Kirrel3 is the mouse orthologue of Dumbfounded (Duf), a family member that regulates myoblast pre-fusion events in Drosophila. Yet, the role of Kirrel3 in mammalian myogenesis has not been demonstrated. Experiments performed here indicate that the mouse Kirrel3 protein regulates morphological changes of myoblasts that are required for their subsequent fusion into multinucleated myotubes. We show that Kirrel3 is transiently expressed at the tips of myocytes during early myoblast differentiation and that its expression is dependent on the myogenic transcription factor, MyoD. Kirrel3 is transported in vesicles into the plasma membrane and its extracellular domain is cleaved in a proteasome-dependent manner. C-terminal deletion mutant lacking most of the intracellular domain accumulates at cellular extensions, does not undergo extracellular cleavage and induces the formation of large cell aggregates. This result suggests that the processing of the extracellular domain is regulated by the receptor's intracellular region. Knock-down of Kirrel3 in primary muscle progenitor cells (MPCs) prevented spindle shape myocyte formation, and significantly reduced their fusion with other myocytes to form multinucleated myotubes. In addition, migration of Kirrel3-deficient MPCs was randomized relative to the directed migration of control MPCs. We conclude that mouse Kirrel3 is a myobast adhesion molecule which promotes the morphological change of rounded MPC to a spindle shaped myocyte that migrates in a directed fashion and participates in the tight interactions between myocytes prior to their fusion.

Aim: To examine whether the impact of mistreatment by patients on nurses' burnout can be exacerbated or attenuated depending on emotion-regulation strategies, and to explore the moderating role of supervisor support in the relationship between mistreatment and deep acting., Background: Aggression from patients is known to contribute significantly to nurse burnout. To date, the moderating role of emotion regulation strategies in the mistreatment-outcomes relationship has seldom been considered., Methods: The sample consisted of 105 nurses who were working while studying for their Master's degree. Data were collected using self-reported questionnaires. The research hypotheses were tested using hierarchical regression analyses., Results: Mistreatment and surface acting significantly contributed to nurse burnout. Deep acting had a buffering effect on the relationship between mistreatment and depersonalisation. The results also indicate that supervisor support was negatively associated with surface acting and may increase deep acting in response to mistreatment., Conclusion: The use of an effective strategy for regulating emotions and supervisor support can protect nurses from the depletion of emotional resources., Implications for Nursing Management: By introducing emotion-regulation skills training and by encouraging the availability of support from supervisors, health-care organisations can help nurses better cope with emotionally charged interactions., (© 2016 John Wiley & Sons Ltd.)

The present study examined career adaptability in 100 Israeli emerging adults who were followed from ages 22 to 29. Participants were given an in depth interview and were asked to talk about their current work, difficulties they might have had in the past and how they coped with them. In addition they were asked to elaborate on the extent to which their job fits their interests and is meaningful to them. Analyses of interviews yielded three distinctive career adaptability patterns that were associated with different levels of concurrent wellbeing: Integrated, Compromised, and Vague. A lower level of identified motivation measured seven years earlier predicted membership in the Compromised pattern. A higher level of extrinsic motivation combined with decreased parental support predicted membership in the Vague pattern. Findings are discussed within the framework of the occupational adaptations and compromises that young people must make when approaching the age of 30., (Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)