Search

Aim: Evidence shows that 20%–30% of patients who aspirate do so silently. Research to date has not demonstrated clear evidence to indicate which patients are at higher risk of silent aspiration. Our aim was to use univariate logistic regression analysis of retrospective case review to determine potential patterns of silent aspiration. Materials and methods: We conducted a retrospective analysis of 455 fiberoptic endoscopic evaluation of swallowing (FEES) reports. The patients were divided into four groups: G1 – neurological diseases (n = 93), G2 – head and neck surgery (n = 200), G3 – gastroenterological diseases (n = 94) and G4 – other patients (n = 68). Data included the occurrence or absence of saliva penetration or aspiration, of silent fluid/solid food penetration or aspiration, type of penetration or aspiration, occurrence of cranial nerve paresis, radiotherapy and tracheostomy. Univariate logistic regression was used to evaluate independent risk factors of silent aspiration in the study population. Three models with different independent variables were considered. Results: There is a statistically significant difference in the frequency of occurrence of silent penetration and aspiration within the groups (p < 0.001), with intraglutative being most frequent. Fluid and food penetration and aspiration correlated with saliva penetration and aspiration in all groups (p < 0.001). Cranial nerve paresis (IX and X), radiotherapy and tracheostomy correlate with saliva penetration and aspiration (p = 0.020 for cranial nerve paresis; p = 0.004 for radiotherapy; p < 0.001 for tracheostomy). One hundred and fifteen patients (45.81%) in the subgroup of patients with intraglutative aspiration had cranial nerve paresis (IX, X or IX–X). Conclusions: Patients who should be prioritised or considered to be at a higher need of instrumental swallowing evaluation are those with IX and X cranial nerve paresis, tracheostomy and those who have had radiotherapy, with saliva swallowing problems, especially after paraganglioma, thyroid and parathyroid glands and middle and posterior fossa tumour surgery. WHAT THIS PAPER ADDS: What is already known on the subject: Clinical signs of penetration or aspiration include coughing, throat clearing and voice changes, while silent penetration or aspiration patients aspirate without demonstrating any clinical symptoms. The most common consequences of silent aspiration include aspiration pneumonia, recurrent lower respiratory tract infections and respiratory failure. Additionally, malnutrition and dehydration can be indicators of silent aspiration. Patients may unknowingly reduce their oral intake and lose weight. Retrospective studies have shown that 20%–30% of patients aspirate silently (e.g. patients after stroke, acquired brain injury, head and neck cancer treatment, prolonged intubation). Clinical examination of swallowing can miss up to 50% of cases of silent aspiration. What this paper adds to existing knowledge: Currently, silent aspiration is often discussed in neurological literature, but its applications to head and neck surgery are limited. In this study, we identify head and neck surgery patients who should be prioritised or considered to be in higher need of instrumental swallowing evaluation due to a higher risk of silent aspiration. What are the potential or actual clinical implications of this work?: Post‐treatment structural changes can result in lower cranial nerve paresis (IX, X, XII) and face injury, in which vagus and glossopharyngeal nerves are injured. After tracheostomy and radiotherapy, patients with problems swallowing saliva need careful clinical examination, particularly cranial nerve examination. [ABSTRACT FROM AUTHOR]

Background: Aphasia is often accompanied by impairment of non‐language cognitive functions. Assessment of cognitive capacity in people with aphasia (PWA) with standard neuropsychological methods may be problematic due to their language difficulties. Numerous experimental studies indicate that P300 may be considered as an index of cognitive capacity in both healthy and clinical samples. Accordingly, the measurement of event‐related potentials enables the investigation of behaviourally non‐observable mental processes underlying the cognitive functions that are assessed with neuropsychological tests. Aims: To investigate in PWA the relationship between P300 parameters and cognitive function efficiency measured with neuropsychological methods. Methods & Procedures: A total of 25 PWA after left‐hemispheric stroke participated in the study. Electrophysiological (EEG) signals were recorded during the performance of a visual Go‐No Go task. P300 was identified on nine electrodes, which were then pooled in three lines: left (F3, C3, P3), central (Fz, Cz, Pz) and right (F4, C4, P4). The neuropsychological assessment of cognitive functions included mental speed, short‐term memory, divided attention, executive functions, auditory language comprehension and expression. Outcomes & Results: P300 latency correlated with indices of several cognitive functions: temporal resolution, psychomotor speed, spatial short‐term memory, planning, word and sentence comprehension, as well as verbal fluency. Shorter P300 latencies were accompanied by greater efficiency of the abovementioned functions. In contrast, significant correlations between P300 amplitudes and cognitive measures were fragmentary. Conclusions & Implications: In PWA, P300 latency might be related to cognitive functioning, especially to measures that rely heavily on the speed of information processing. However, P300 seems to be unrelated to more complex cognitive functions. P300 latency may be used as a neurophysiological correlate of cognitive efficiency in PWA and might have potential applications in monitoring the effects of therapeutic interventions in this patient group. What this paper adds: What is already known on the subject: P300 parameters have been reported to be associated with cognitive performance in both healthy individuals and clinical groups (e.g., patients with Alzheimer's disease). Previous studies show that the presence of P300 at the early post‐stroke stage may be a predictor of better recovery of comprehension in PWA. What this paper adds to existing knowledge: Our results show for the first time that P300 may be used as a neurophysiological correlate of cognitive efficiency in PWA. In our study, P300 latency was associated with several languages and non‐language cognitive functions, especially with those whose effectiveness depends mainly on processing speed. In PWA, shorter latency corresponded to more efficient cognitive functioning. What are the potential or actual clinical implications of this work?: P300 measurement may be potentially useful in assessing the efficiency of certain cognitive functions in PWA. It may be also used to monitor the recovery process of PWA and to verify the effects of therapeutic interventions. [ABSTRACT FROM AUTHOR]

Although leisure constraints that individuals have to cope with can negatively affect their social inclusion and satisfaction with life, little research has addressed the link between these variables. Therefore, the current paper examined the moderator role of leisure constraints on the relationship between satisfaction with life and leisure constraints among adults living in five different European countries. The respondents were 1,382 women and 877 men adults. The findings of analysis revealed that all factors used in the study accounted for 15% of the variance in satisfaction with life and social inclusion had a significant and positive impact on satisfaction with life. As a result, it can be said that leisure constraints had a moderating effect on the relationship between satisfaction with life and social inclusion. The present research study recommends that social inclusion should be encouraged through decreasing to leisure constraints to increase the life satisfaction. [ABSTRACT FROM AUTHOR]

This paper presents current information on policy developments, service design, best practices, and approaches to empower the users of health and medical care services for people with intellectual disabilities in Poland. Polish regulations allow systemic support to be provided for all people with disabilities. However, Polish patients with intellectual disabilitiy (PwID) and their caregivers face many barriers. Although a key obstacle is the lack of a standard definition that approaches disability in an interdisciplinary way, PwID are also more likely to experience difficulties in personal communication in medical settings and less likely to encounter specialists prepared to work with this group. There is also a need to pay greater attention to the expectations of PwID. To facilitate a holistic approach to diagnosis and therapy, there needs to be coordination between different specialists, including medical staff, paramedics, psychologists, and teachers. Providing personal communication training for medical personnel, as well as developing dedicated procedures for PwID in primary health care, clinics and hospitals, will improve equal access to health and health literacy for all in Poland. Even so, it is important to respect the autonomy of PwID and the commitment of caregivers. [ABSTRACT FROM AUTHOR]

This paper investigates different uses of the Journal Impact Factor (JIF) in national journal rankings and discusses the merits of supplementing metrics with expert assessment. Our focus is national journal rankings used as evidence to support decisions about the distribution of institutional funding or career advancement. The seven countries under comparison are China, Denmark, Finland, Italy, Norway, Poland, and Turkey—and the region of Flanders in Belgium. With the exception of Italy, top‐tier journals used in national rankings include those classified at the highest level, or according to tier, or points implemented. A total of 3,565 (75.8%) out of 4,701 unique top‐tier journals were identified as having a JIF, with 55.7% belonging to the first Journal Impact Factor quartile. Journal rankings in China, Flanders, Poland, and Turkey classify journals with a JIF as being top‐tier, but only when they are in the first quartile of the Average Journal Impact Factor Percentile. Journal rankings that result from expert assessment in Denmark, Finland, and Norway regularly classify journals as top‐tier outside the first quartile, particularly in the social sciences and humanities. We conclude that experts, when tasked with metric‐informed journal rankings, take into account quality dimensions that are not covered by JIFs. [ABSTRACT FROM AUTHOR]

The Wound‐QoL assesses the impact of chronic wounds on patients' health‐related quality of life (HRQoL). A 17‐item and a shortened 14‐item version are available. The Wound‐QoL‐17 has been validated for multiple languages. For the Wound‐QoL‐14, psychometric properties beyond internal consistency were lacking. We aimed to validate both Wound‐QoL versions for international samples representing a broad range of European countries, including countries for which validation data had yet been pending. Patients with chronic wounds of any aetiology or location were recruited in Austria, Lithuania, the Netherlands, Poland, Slovakia, Spain, Switzerland and Ukraine. Psychometric properties were determined for both Wound‐QoL versions for the overall sample and, if feasible, country‐wise. We included 305 patients (age 68.5 years; 52.8% males). Internal consistency was high in both Wound‐QoL‐17 (Cronbach's α: 0.820–0.933) and Wound‐QoL‐14 (0.779–0.925). Test–retest reliability was moderate to good (intraclass correlation coefficient: 0.618–0.808). For Wound‐QoL‐17 and Wound‐QoL‐14, convergent validity analyses showed highest correlations with global HRQoL rating (r = 0.765; r = 0.751) and DLQI total score (r = 0.684; r = 0.681). Regarding clinical data, correlations were largest with odour (r = −0.371; r = −0.388) and wound size (r = 0.381; r = 0.383). Country‐wise results were similar. Both Wound‐QoL versions are valid to assess HRQoL of patients with chronic wounds. Due to its psychometric properties and brevity, the Wound‐QoL‐14 might be preferrable in clinical practice where time is rare. The availability of various language versions allows for the use of this questionnaire in international studies and in clinical practice when foreign language patients are being treated. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to analyse perinatal care managers' perspectives on the role of doulas in Poland and to consider how managers' perspectives might affect the opportunities for doulas to practice in individual hospitals. Design: This is a qualitative descriptive study. Method: The total of 17 hospitals was selected for the study. Semi‐structured interviews were conducted with 11 manager staff members. Results: Three groups of facilities were identified: '0' (n = 6) – refused to give interviews, 'A' (n = 8) – marginal experience in working with doulas, and 'B' (n = 3) – regular experience in working with doulas. The hospitals from Group A showed indifference towards working with doulas. Group B declared a positive attitude towards such cooperation. Attitudes towards doulas vary among executives and are related to the frequency of doula‐assisted births. Our results indicate factors that may influence the attitude of medical staff towards doulas and which may contribute to improve future initiatives meant to facilitate collaboration between midwives and doulas. Patient or Public Contribution: This study explored the lived experiences of perinatal care managers. [ABSTRACT FROM AUTHOR]

Previous studies show that the effects of (non‐transparent) nudges can spill over to later similar decisions without nudges. In the current study, we aimed to determine whether such nudge temporal spillover effects are affected by making nudges transparent. The latter is recommended to (partly) mitigate ethical concerns surrounding the use of nudges. In two experiments, we nudged participants to complete a longer version of a survey. Participants were randomly assigned to either a control, a non‐disclosed nudge (using a default to promote taking the longer survey) condition or a disclosed nudge (in which the use of the default nudge was explained) condition. In both Study 1 (N = 1270) and Study 2 (N = 1258) we observed a temporal spillover effect of the disclosed nudge, suggesting that transparency does not negatively affect the temporal spillover effect. [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate demographic and occupational factors of professional life on life satisfaction among nurses in Serbia and Poland. Background: Compassion satisfaction and compassion fatigue, as aspects of a nurse's professional life, may affect their satisfaction with life in general. However, most studies on this topic have been conducted in Asian countries, and because there are differences in health care system performance across countries amid a global shortage of nurses, it is necessary to investigate professional quality of life in the European nursing context. Methods: This multicenter, comparative, and correlational study was conducted on a sample of 669 hospital nurses in Serbia and Poland. The survey data were collected between November 2019 and February 2020 using the Demographic and Occupational Questionnaire (DOQ), Professional Quality‐of‐Life Scale (ProQOL‐5), and Satisfaction with Life Scale (SWLS). STROBE Statement guidelines for cross‐sectional studies were followed. Results: Most nurses from both countries reported having moderate compassion satisfaction, moderate risk for compassion fatigue, and an average life satisfaction. The predictive factors of life satisfaction that most stand out include country of origin, financial situation, education, job satisfaction, and compassion fatigue. Discussion and conclusion: Quality of professional life is significantly affected by shift duration, age, work experience, and job satisfaction. Negative aspects of professional life are significant predictors of life satisfaction. Implications for nursing policy: The findings of this study indicate a need for implementing flexible shift patterns and enhancing interventions that will improve job satisfaction and compassion satisfaction while reducing the risk of compassion fatigue. [ABSTRACT FROM AUTHOR]

Background: Cultural competencies are known as a multidimensionalconstruct; however, they usually refer to an individual's sensitivity orcultural attitudes, cultural awareness, knowledge, and skills. Aim: The aim of the study was to compare the cultural competences of nurses in Poland and Lithuania based on an adaptation of the Nurse Cultural Competence Scale (NCCS). Design: The design was a comparative cross‐sectional study. Methods: A total of 383 Polish nurses and 184 Lithuanian nurses took part in the study. The questionnaires of the NCCS—Polish version (NCCS‐v.PL) and the NCCS—Lithuanian version (NCCS‐v.L) were used after linguistic adaptation and an evaluation of psychometric properties. Results: As a result of the comparative analysis, a higher general level of cultural competences (based on the NCCS) was found in the Lithuanian group M‐148.09 (SD = 22.85). The results show statistically significant differences among the respondents in the subscale of Nurse Cultural Competence Scale‐Cultural Knowledge (NCCS‐CK; p ˂ 0.001); higher competences of the nurses were found in the Group LT (M = 31.05; SD = 6.75) than in the Group PL (M = 28.82; SD = 7.82). In the group of Polish nurses (Group PL), the intensity of cultural competences was found to increase along with age (NCCS‐v.P r = 0.157, p < 0.05); this, however, was not observed in the Group LT (NCCS‐v.LT, p > 0.05). Conclusions: Both the nurses in Poland and in Lithuania are characterised by an average level of cultural competences. Diversity in the level of cultural competences was found in both groups depending on age, education and work experience. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, a reduction in the life expectancy gap between people living with HIV (PLWH) and the general population has been observed, irrespective of CD4 lymphocyte count, due to widespread access to antiretroviral treatment. The increase in the life expectancy of PLWH has increased awareness of both the ageing process and gender discrepancies in immune restoration and survival. Materials and Methods: Longitudinal data were collected for 2240 patients followed up at the Hospital for Infectious Diseases in Warsaw, Poland (n = 1482), and the Department of Acquired Immunodeficiency, Pomeranian Medical University, Szczecin, Poland (n = 758). Immune restoration was measured from the time of starting combination antiretroviral therapy until achieving 500 CD4 lymphocytes/μL, 800 CD4 lymphocytes/μL, and CD4/CD8 lymphocyte ratios of > 0.8 and > 1.0. Full recovery was achieved when the patient was restored to both 800 CD4 lymphocytes/μL and a CD4/CD8 lymphocyte ratio > 1.0. Results: For all endpoints, immune restoration had a protective effect by reducing mortality. Patients who achieved immune restoration had a greater chance of reduced mortality than those who did not achieve immune restoration: for CD4 count > 500 cells/μL, HR = 5.4 (interquartile range: 3.09–9.41), p < 0.001; for CD4 > 800 cells/μL, HR = 5.37 (2.52–11.43), p < 0.001; for CD4/CD8 ratio > 0.8, HR = 3.16 (1.81–5.51), p < 0.001; for CD4/CD8 ratio > 1.0, HR = 2.67 (1.49–5.24), p = 0.001, and for full immune recovery, HR = 3.62 (1.63–8.04), p = 0.002. Conclusions: Immune restoration remains a powerful factor in improving the survival of PLWH, regardless of the speed of recovery. [ABSTRACT FROM AUTHOR]

Background: Stress is an integral part of daily work for nurses, especially those who work in intensive care units (ICUs). However, chronic stress can affect nurses' mental and physical well‐being, increasing their risk of burnout and decreasing the quality of care. A higher emotional intelligence (EI) level may be correlated with greater use of effective coping strategies, leading to a reduction of the adverse effects of stress. Aim: This study aimed to examine the relationship between EI and coping strategies among adult ICU nurses in Poland. Study Design: A cross‐sectional survey design was used. Current adult ICU nurses in nine Polish hospitals were invited to participate. The survey instruments used were: the Polish version of the Schutte Self‐Report Emotional Intelligence Test, the Inventory to Measure Coping Strategies with Stress (Brief‐COPE), and a self‐constructed questionnaire. Results: 114/543 (21%) nurses completed the survey. ICU nurses showed an average level of EI (70.2%). The main stress coping strategies were active coping and planning, the rarest being substance use, behavioural disengagement, and denial. For nurses with a higher EI level, the most frequently used strategies included positive reframing (R = 0.43; p <.001), active coping (R = 0.38; p <.001), planning (R = 0.37; p <.001) and religion (R = 0.25; p =.006). Nurses were less likely to utilize strategies of behavioural disengagement (R = –0.32; p =.001) and self‐blame (R = –0.40; p <.001). Conclusions: EI may have an impact on coping strategies, as a higher EI level was correlated with the greater use of effective coping strategies in ICU nurses. Relevance to Clinical Practice: Training in coping with stress and increasing EI may have a positive impact on reducing the risk of burnout in nurses and thus improving the quality of care delivered. [ABSTRACT FROM AUTHOR]

Background: The Scottish Government introduced a free Baby Box scheme for all new parents in 2017, modelled on the Finnish scheme, to give every baby 'an equal start in life'. There is little evidence that it results in better health outcomes, but there has been limited research into different perspectives and discourses on such schemes. Methods: Four focus groups were conducted with 21 parents in North‐East Scotland. Recordings were transcribed verbatim, anonymized and analysed thematically with NVivo 12 software. Our thematic analysis was both inductive and deductive—remaining open to themes identified by participants themselves but also informed by the social policy literature on universalism and social cohesion. Results: Across all the focus groups, we found a high degree of positivity about the principle of the Baby Box scheme, and for the most part the practical value of the contents. This was remarkably consistent across different communities and backgrounds. There was little evidence of the strongly polarized views present in media reporting. Parents seemed considerably less focused than the media on safety and health outcomes, and more focused on practical, material and social impacts. They reported little in the way of feeling patronized or monitored by the government. Conclusion: Our findings have important implications for future economic evaluations of the baby box. Such evaluations should broaden the valuation space beyond health outcomes to allow for the value of feelings of inclusion, solidarity and being part of a community. Patient or Public Contribution: This small project was designed in response to parent views already collected in the early roll‐out of the Baby Box scheme in Scotland, about their priorities and responses to the scheme. Additional views were sought on the topic guide for the focus groups, and local community groups advised us on recruitment and the best timing and location for the focus groups to be held. The focus groups themselves were conducted as research, but with the intent of ensuring parent views featured more prominently in a debate that has been largely dominated by clinical and public health perspectives. [ABSTRACT FROM AUTHOR]

The COVID‐19 lockdown experience is a unique and unexpected stressful life situation. In our research project, we explored gender differences in the mean level of stress appraisal (SAQ), the frequency of stress coping strategies (COPE), and the sense of coherence (SOC), as well as gender differences in the strength of the relationships between SAQ, COPE, and SOC during the COVID‐19 lockdown. Finally, we tested if stressor appraisal (as a threat, harm/loss, or challenge) mediates the relationship between SOC and COPE in women and men respectively. Data were collected during the first wave of the COVID‐19 lockdown in Poland in 2020. An online survey was conducted among 326 adults aged between 18 and 72. We observed gender differences in the level of SAQ, COPE, and SOC and gender differences in the significance and strength of the correlations between these variables. SOC had a twofold effect on COPE in men: direct and indirect through SOC‐threat and SOC‐harm/loss. In women, SOC did not directly predict COPE frequency but affected COPE in an indirect way through SAQ. SAQ is an important factor that modifies the strength of the SOC effect on COPE in women and men during the lockdown. [ABSTRACT FROM AUTHOR]

Background: The current literature indicates that intensive care (ICU) patients' sleep quality is generally poor, which is associated with serious physical and psychological consequences. Aims and objectives: To describe the practices nurses use to provide good‐quality sleep to adult ICU patients and assess nurses' perceptions of patients' sleep quality and nurses' professional autonomy in sleep management. Design: A descriptive‐correlational, cross‐sectional study. Methods: A total of 232 ICU nurses from four hospitals in Poland were recruited. Data were collected between May and August 2019 using a previously developed questionnaire and analysed using descriptive statistics and non‐parametric tests. Results: A total of 119 nurses took part in the study (response rate: 51%). On average, nurses rated patients' sleep quality as moderate (4.44 ± 2.23, scale 0‐10). Most of the respondents (95.8%) said they did not use any sleep protocol. Various strategies to improve patients' sleep were used sporadically (2.64 ± 1.55, scale 1‐5). The use of sleep quality assessment methods was positively correlated with patients' sleep quality (rho = 0.22, P =.02). Nurses' professional autonomy regarding sleep management was assessed as average (4.34 ± 2.43, scale 0‐10) and was correlated with the patients' sleep quality (rho = 0.25, P <.01). Nurses who rated their autonomy in patients' sleep management more highly (rho = 0.29, P <.01) and more often influenced patients' sleep decisions (rho = 0.24, P <.01) used more methods to improve patients' sleep. Conclusions: Strengthening the professional autonomy of ICU nurses and creating a reliable sleep assessment and improvement tool, which would describe strategies nurses can implement independently could increase sleep quality among ICU patients. Relevance to clinical practice: Addressing organizational problems, which hamper the patients' sleep management by ICU nurses could result in using more strategies to provide good‐quality sleep to ICU patients. There is a need for clinical guidelines regarding patients' sleep management to help educate and guide nurses how to independently use sleep improvement methods. [ABSTRACT FROM AUTHOR]

Objective: To examine the association of four FCN1 SNPs: −542G>A (rs10120023), −144C>A (rs10117466), +6658C>T (rs148649884), and +7895A>G (rs150625869) with dental caries in Polish children. Subjects and Methods: The study group consisted of 261 15‐year‐old Polish teenagers: 82 children with "higher" caries experience (having Decayed Missing Filled Teeth, DMFT >5) and 179 children with "lower" caries experience (having DMFT ≤5). Moreover, in additional comparison, a group of 229 children with caries experience (DMFT ≥1) was compared to a caries‐free (DMFT =0) group of 32 children. Extraction of genomic DNA was performed from buccal swabs, and genotyping was performed by Real‐Time PCR. Results: FCN1 SNPs +6658C>T and +7895A>G appeared to be monomorphic in our sample. The genotype, allele, or haplotype distributions in FCN1 SNPs −542G>A and −144C>A in children with "higher" caries experience did not differ significantly from those in "lower" caries experience group. Similar results with no significant differences were demonstrated for subjects with DMFT ≥1 compared to subjects with DMFT =0. Conclusion: FCN1 SNPs are not the markers of dental caries susceptibility in Polish children. [ABSTRACT FROM AUTHOR]

Background: Novice nurses (newly qualified within the first 3‐year period of professional practice after registration) must first face the reality and complexity of caring for high‐acuity patients in the critical care setting, which can be an unfamiliar and demanding environment. The successful transition from education to professional practice of novice nurses hired for intensive care must be supported. Aim: To explore Polish novice nurses' readiness to practice in an intensive care unit (ICU). Our study objectives included investigating pre‐registration preparation for work in an ICU, identifying the most needed competencies to work in an ICU, and analysing organizational aspects of the professional orientation period. Study design: A qualitative phenomenology design was applied. Methods: We conducted qualitative content analysis based on individual semi‐structured in‐depth interviews. Study recruitment was performed using a purposeful and network sampling strategy. The final number of participants was 17 Polish novice nurses. Results: The majority of responders replied that they were not prepared to work in an ICU after graduation. Professional orientation was planned—generally for a period of 3 months; however, in most places it was shortened. The respondents identified the five competencies most needed to work in an ICU: communication, teamwork, professional self‐confidence, and knowledge and its practical use. Their enhancement could be achieved through simulations during both pre‐registration and professional training. Conclusion: Analysis of the novice nurses' orientation period revealed many difficulties that indicated a lack of readiness to practice in an ICU after graduation. Identifying novice nurses' strengths and weaknesses regarding clinical competence is important to guide the design of orientation programmes in ICU settings and nursing education programmes. Relevance to clinical practice: Readiness for ICU work may be improved by enriching education with simulations that enable training in the practical use of knowledge and critical care procedures. A supportive work environment is crucial during professional orientation. [ABSTRACT FROM AUTHOR]

To date, there has been no systematic examination of cross‐cultural differences in group‐based shame, guilt, and regret following wrongdoing. Using a community sample (N = 1358), we examined people's reported experiences of shame, guilt, and regret following transgressions by themselves and by different identity groups (i.e., family, community, country) in Burkina Faso, Costa Rica, Indonesia, Japan, Jordan, the Netherlands, Poland, and the United States. We assessed whether any variation in this regard can be explained by the relative endorsement of individualistic or collectivistic values at the individual level and at the country level. Our findings suggest that people's reported experience of these emotions mostly depends on the transgression level. We also observe some variation across individuals and countries, which can be partially explained by the endorsement of collectivistic and individualistic values. The results highlight the importance of taking into account individual and cultural values when studying group‐based emotions, as well as the identity groups involved in the transgression. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore cross‐level mechanisms stimulating employees' innovative behavior in small firms, specifically emotional contagion between small business owners and their employees. Using data from three European countries and applying a multilevel approach, we tested how small business owners' work‐related affect—enthusiasm and comfort—relate to their employees' work‐related affect and innovative work behavior. The sample consisted of 85 small business owners and 711 employees from firms operating in the Netherlands, Poland, and Spain. Controlling for country, the results of multilevel modeling showed that small business owners' work‐related affect was positively related to their employees' work‐related affect. The hypothesized contagion of work‐related affect in small firms was, thus, supported. Employees' work‐related affect, in turn, was positively associated with their innovative behavior. Employees' work‐related affect mediated the relationship between small business owners' work‐related affect and employees' innovative behavior. The results also showed cross‐country differences in the strength of some of the relationships. The study is a step forward in understanding innovation in small firms, extending the insights gained from single‐level investigations. [ABSTRACT FROM AUTHOR]