Uncovering Hidden Framings in Dark Triad Self-Ratings: What Frames-of-Reference Do People Use When Responding to Generic Dark Triad Items?

In typical Dark Triad (DT) questionnaires, generic items oftentimes refer to "others" or "people" in general. Hence, respondents have to mentally aggregate their behavior across several kinds of "others" (e.g., work colleagues, family members, and friends). It remains unknown if individuals consider different kinds of interaction partners equally or if their self-reports contain "hidden" interaction partner-specific tendencies. To shed light on this issue, we assessed generic and contextualized DT items (referring to family, friends, work, and strangers; N = 814 from the general population). The correlated trait-correlated (method - 1) model was used to investigate preregistered research questions. On average, generic DT items showed the strongest association with work-contextualized DT items and the weakest association with family-contextualized DT items. However, the associations varied considerably across DT items and traits. In sum, our results suggest that hidden framings exist in some DT items, which may impact their ability to predict relevant criteria due to contextual (a)symmetries. The generalizability of the findings to other DT instruments, items, and participant groups should be examined in future research.

Insights on historical milestones of mental health in Nepal: Country profile

The present paper has highlighted the mental health development in Nepal. It covers the current state of mental health system and services and a throwback on the significant changes over a period of time. This review grabs a sneak into mental health plan/policies, prevalence; health facilities and human resources, monitoring and supervision, budget allocation, nongovernmental sector involvement, and international agreements. Every description in this paper is substantially based on the progression made at the different time frames, which provides clear understanding of the mental health situation in Nepal. Furthermore, this article throws insights on the main challenges to overcome the current situation on mental health and the associated treatment gap due to stigma toward mental illness, lack of appropriate budget allocation, shortage of human resources, and fear of discrimination.

A situational analysis of ear and hearing care in South Korea using WHO ear and Hearing Care Situation Analysis tool

Objectives

The WHO emphasizes lifelong management of hearing diseases such as hearing loss and advocates for prevention. The Ear and Hearing Care Situation Analysis (EHCSA) tool was designed by the WHO for assessment and quality improvement of state-led management of hearing loss prevention and management programs. The purpose of this study was to use the EHCSA to assess the ear and hearing management program in Korea and to establish goals consistent with best practices for improving policies and services related to ear and hearing care.

Methods

The EHCSA was used as a need assessment of the ear and hearing management services in the country. The EHCSA consists of two sections. Section 1 consists of 41 questions to evaluate health policies and support services. Section 2 consists of 203 questions to evaluate human resources and services of the ear and hearing management sector.

Results

There are an estimated 800,000 people with hearing loss in Korea. Policies such as hearing aid support are in place, and outreach services such as free hearing tests are also being actively conducted. In all medical institutions, ear and hearing management treatment and medication prescriptions could be received without barriers. Workers in the fields of ear and hearing management, such as audiologists, language therapists, special education teachers, and sign language interpreters, are specialized and have well-established guidelines for training.

Conclusion

Overall, the domestic ear and hearing management sector has confirmed that policies and services are well-prepared in comparison with advanced countries such as the United States, Iran, and China. The use of the EHCSA was functional in collecting data on the current state of domestic ear and hearing management policies and services in Korea, can be used for continuous quality improvement and expansion of medical services, and can be used as a reporting mechanism to the WHO.

In Which Situations Do We Eat? A Diary Study on Eating Situations and Situational Stability

Eating situations are crucial for understanding and changing eating behavior. While research on individual situational dimensions exists, little is known about eating situations as a whole. This study aimed to fill this gap by identifying eating situations as combinations of multiple situational dimensions and describing how stable individuals eat in those situations. In a five-day online diary study, 230 participants reported a total of 2461 meals and described the corresponding eating situation using predefined situational dimensions. Divisive hierarchical cluster analyses were conducted separately for breakfast, lunch, and dinner, resulting in unique cluster solutions that characterized the most common eating situations. The most common breakfast situations were characterized by a combination of the dimensions social, affect, and hunger. The most common lunch and dinner situations were characterized by varying combinations of the dimensions social, affect, and activity. Based on the identified situations, a situational stability index was developed to describe how stable individuals eat in the same situations. The findings suggest high interindividual differences in situational stability, which were associated with socio-demographic characteristics like age or employment. This study enhances our understanding of the situational aspects of eating behavior while offering tools to describe eating situations and situational stability.

The Role of Situational Factors in Child-to-Parent Abuse: Implications for Assessment, Management, and Intervention

Situational factors are relevant to the initiation and maintenance of violent behavior yet are infrequently examined in relation to family violence. Content analysis was used to conduct an inductive thematic analysis of police narratives to identify and quantify the occurrence of situational factors among Australian young people (10-24 years) reported to police for using violence toward a parent (n = 82). Descriptive information about demographics (e.g., age and sex), background characteristics (e.g., victimization history, employment/school issues, mental health issues, and neurodevelopmental conditions), and features of the index incident (e.g., type of aggression) were also extracted from police records. Interpersonal conflict and parental limit-setting were the most common situational antecedents of child-to-parent abuse, with additional situational factors including use of weapons, role of third parties, mental health concerns, and substance abuse issues. Families experiencing child-to-parent abuse showed heightened levels of intrafamilial violence and neurodevelopmental conditions. Implications for risk assessment, management, and intervention are discussed.

The effects of materialism and ego depletion on intertemporal choice: An event-related potential study

Objective

The study aims to promote human beings to make scientific and reasonable decisions for the long-term and beautiful future.

Methods

We designed two experiments to explore the influence of materialism and ego depletion from the perspective of behavioral decision-making and neural mechanism.

Results

In Experiment 1, there was asymmetry in intertemporal choice between gain and loss situations. In the gain situation, high materialism were more likely to choose the later and larger option (LL). However, in a loss situation, we found a reverse sign effect, and the proportion of subjects choosing sooner and smaller options (SS) increased. In Experiment 2, in the gain situation, after adding the low ego depletion task, there was a marginal significant difference between high and low materialism in the percentage of choosing LL options, F(1, 40) = 3.37, P = 0.07, η² = 0.08; After adding the high ego depletion task, the percentage of choosing LL options was no difference, F(1, 40) = 1.42, P > 0.05. In the loss situation, whether in the high ego depletion task [F(1, 40) = 2.25, P > 0.05) or in the low ego depletion task [F(1, 40) = 1.44, P > 0.05), there was no difference between high and low materialism in the percentage of choosing LL options, and they both tended to choose SS options. The EEG study showed that in high materialism, there was a significant difference between the high and low ego depletion conditions, and the N1 amplitude induced under the low ego depletion condition was larger than that under the high ego depletion condition. However, there was no significant difference in N1 amplitude between the high and low ego depletion conditions in the low materialism. The amplitude of P2 evoked in the loss situation was larger than that in the gain situation.

Conclusion

In conclusion, Materialism dominated people's intertemporal choices, and ego depletion affected the intertemporal choice to a certain extent by influencing the subjects' thinking activities. The COVID-19 epidemic maybe affected intertemporal choice indirectly by acting on materialistic values and subjects' emotions.

Analysis of influencing factors of subjective career unsuccessfulness of vocational college graduates from the Department of Navigation in China

The marine talent cultivation and output in higher vocational colleges is an important support to build a strong maritime country and ensure the steady development of the shipping business industry. Vocational colleges should ensure effective career preparation and career guidance education for their students, and train them to acquire the professional abilities to work and adapt effectively and quickly in the future. Some studies show that many crew members experience a decline in job satisfaction, a low sense of achievement, and a series of negative subjective career feelings. Even more, some crew members have poor work performance or unsuccessful career development behaviors such as career change or resignation. This study examined the causes and influencing factors of these circumstances and might be a reference for schools to strengthen the quality of their training programs in the future. In-depth interviews with 12 vocational marine navigation college graduates were conducted, and grounded theory was used to code and analyze the collected interview information. Four types of influencing factors were identified: adaptation preparation, career adaptability, adaptation action, and the situational factor. The adaptation preparation factor could be categorized into psychology, determination, lack of certificates, and simple work; the career adaptability factor could be categorized into boring work, busyness, a big gap between expectations and reality, danger, promotion difficulty, poor interpersonal relationships, high pressure, and maladaptation to the surroundings; the adaptation action factor could be categorized into passive fatigue, lack of training, competition, confidence, and planning; while the situational factor could be categorized into the impact of the epidemic, low social status, lack of support from family, and advantages of living on land. To help the marine navigation students better adapt to their jobs and avoid subjective career unsuccessfulness, higher vocational colleges need to strengthen students' mental health education, consolidate knowledge and skills training, encourage students to obtain more vocational competency certificates, enhance their interpersonal communication skills, do effective career planning, pay attention to physical exercise and safety awareness training, and adopt other career management and counseling suggestions.

The effect of situation, background, assessment, recommendation-based safety program on patient safety culture in intensive care unit nurses

BACKGROUND

Patient safety culture is an integral part of patient care standards and a prerequisite for safe care. SBAR is an acronym for Situation, Background, Assessment, Recommendation; this communication model has gained popularity in health-care settings, especially among professions such as nursing. However, there is little evidence that nursing professional education can enhance patient safety culture. The aim of this study was to investigate the effect of a SBAR-based training program on patient safety culture in intensive care unit (ICU) nurses.

MATERIALS AND METHODS

The quasi-experimental study was carried out in 2018-2019 at areas covered by Shahrekord University of Medical Sciences, Iran. This study was performed on 60 nurses working in ICU. The participants were randomly assigned to two experimental and control groups of 30 each. For the experimental group, five workshop sessions of SBAR-based program were held. For the control group, the patient delivery process was performed according to the ward routine. Data were collected using patient safety culture questionnaires before and 1 month after the intervention, and were analyzed using descriptive and analytical tests such as paired t-test, independent t-test, and Chi-square test by SPSS 22.

RESULTS

The mean score of safety culture was 31 ± 23.5 and 55.2 ± 28.6 in frequency of reporting events, 32.8 ± 17.8 and 54.3 ± 19 in overall perception of patient safety, 23 ± 20.1 and 52.9 ± 26 in communication channel openness, and 35.2 ± 19.8 and 52.4 ± 18.8 in information exchange and conveyance before and after training intervention, respectively, so that they improved from poor level to neutral-moderate level. There was no strength in any dimensions of safety culture; however, the implementation of the SBAR-based program was significantly associated with patient safety culture (P < 0.001).

CONCLUSIONS

Improving patient safety culture requires attention to patient safety models such as SBAR approach that provides an appropriate and reliable structure for quality improvement. SBAR-based program training is effective in promoting patient safety culture; therefore, it is recommended that managers use this technique to promote patient safety culture.

Adaptive Intelligence: Intelligence Is Not a Personal Trait but Rather a Person × Task × Situation Interaction

This article explores the advantages of viewing intelligence not as a fixed trait residing within an individual, but rather as a person × task × situation interaction. The emphasis in the article is on the role of persons solving tasks embedded in situations involving learning, intellectual abilities, and competencies. The article opens with a consideration of the role of situations in intelligent behavior. The article then discusses how intelligence is more similar to creativity and wisdom, in terms of the role of situations, than many psychologists have realized. Then the article reviews the role of situations in identity-based and irrational thinking and in conspiratorial thinking and cults. Next the article discusses the demonstrated importance of situations in assessment, but also notes the difficulties in sampling situations. Finally, the article draws conclusions, in particular, that, given our lack of situation-based tests, we need to be more modest in our interpretations results from conventional tests of intelligence.

Painful Subjects: Treating Chronic Pain among People Living with HIV in the Age of Opioid Risk

Public narratives often attribute the opioid overdose epidemic in the United States to liberal prescribing practices by health care providers. Consequently, new monitoring guidelines for the management of opioid prescriptions in patients with chronic pain have become recognized as key strategies for slowing this tide of overdose deaths. This article examines the social and ontological terrain of opioid-based pain management in an HIV clinic in the context of today's opioid overdose epidemic. We engage with anthropological analyses of contemporary drug policy and the nonverbal/performative ways patients and clinicians communicate to theorize the social context of the opioid overdose epidemic as a "situation," arguing that the establishment of new monitoring strategies (essentially biomedical audit strategies) trouble patient subjectivity in the HIV clinic-a place where that subjectivity has historically been protected and prioritized in the establishment of care.

What Cognitive Mechanism, When, Where, and Why? Exploring the Decision Making of University and Professional Rugby Union Players During Competitive Matches

Over the past 50 years decision making research in team invasion sport has been dominated by three research perspectives, information processing, ecological dynamics, and naturalistic decision making. Recently, attempts have been made to integrate perspectives, as conceptual similarities demonstrate the decision making process as an interaction between a players perception of game information and the individual and collective capability to act on it. Despite this, no common ground has been found regarding what connects perception and action during performance. The differences between perspectives rest on the role of stored mental representations, that may, or may not facilitate the retrieval of appropriate responses in time pressured competitive environments. Additionally, in team invasion sports like rugby union, the time available to players to perceive, access memory and act, alters rapidly between specific game situations. Therefore, the aim of this study was to examine theoretical differences and the mechanisms that underpin them, through the vehicle of rugby union. Sixteen semi-elite rugby union players took part in two post-game procedures to explore the following research objectives; (i) to consider how game situations influence players perception of information; (ii) to consider how game situations influence the application of cognitive mechanisms whilst making decisions; and (iii) to identify the influence of tactics and/or strategy on player decision making. Deductive content analysis and elementary units of meaning derived from self-confrontation elicitation interviews indicate that specific game situations such as; the lineout, scrum or open phases of play or the tackle situation in attack or defence all provide players with varying complexity of perceptual information, formed through game information and time available to make decisions. As time increased, players were more likely to engage with task-specific declarative knowledge-of the game, stored as mental representations. As time diminished, players tended to diagnose and update their knowledge-in the game in a rapid fashion. Occasionally, when players described having no time, they verbalised reacting on instinct through a direct connection between perception and action. From these findings, clear practical implications and directions for future research and dissemination are discussed.

Considering Situational Variety in Contextualized Aging Research - Opinion About Methodological Perspectives

Due to the increasingly heterogeneous trajectories of aging, gerontology requires theoretical models and empirical methods that can meaningfully, reliably, and precisely describe, explain, and predict causes and effects within the aging process, considering particular contexts and situations. Human behavior occurs in contexts; nevertheless, situational changes are often neglected in context-based behavior research. This article follows the tradition of environmental gerontology research based on Lawton’s Person-Environment-Interaction model (P-E model) and the theoretical developments of recent years. The authors discuss that, despite an explicit time component, current P-E models could be strengthened by focusing on detecting P-E interactions in various everyday situations. Enhancing Lawton’s original formula via a situationally based component not only changes the theoretical perspectives on the interplay between person and environment but also demands new data collection approaches in empirical environmental research. Those approaches are discussed through the example of collecting mobile data with smartphones. Future research should include the situational dimension to investigate the complex nature of person environment interactions.

Modeling Evaluations of Low-Level Sounds in Everyday Situations Using Linear Machine Learning for Variable Selection

Human sound evaluations not only depend on the characteristics of the sound but are also driven by factors related to the listener and the situation. Our research aimed to investigate crucial factors influencing the perception of low-level sounds as they—in addition to the often-researched loud-level sounds—might be decisive to people’s quality of life and health. We conducted an online study in which 1,301 participants reported on up to three everyday situations in which they perceived low-level sounds, resulting in a total of 2,800 listening situations. Participants rated the sounds’ perceived loudness, timbre, and tonality. Additionally, they described the listening situations employing situational eight dimensions and reported their affective states. All sounds were then assigned to the categories natural, human, and technical. Linear models suggest a significant difference of annoyance ratings across sound categories for binary loudness levels. The ability to mentally fade-out sound was the most crucial situational variable after valence, arousal, and the situation dimensions positivity and negativity. We ultimately selected the most important factors from a large number of independent variables by applying the percentile least absolute shrinkage and selection operator (Lasso) regularization method. The resulting linear regression showed that this novel machine-learning variable-selection technique is applicable in hypothesis testing of noise effects and soundscape research. The typical problems of overfitting and multicollinearity that occur when many situational and personal variables are involved were overcome. This study provides an extensive database of evaluated everyday sounds and listening situations, offering an enormous test power. Our machine learning approach, whose application leads to comprehensive models for the prediction of sound perception, is available for future study designs aiming to model sound perception and evaluation.

No new community COVID-19 infection in four consecutive weeks: what lesson can be learned from Vietnam

Sharing a common land border with China, Vietnam has faced a high risk of transmission of Coronavirus Disease 2019 (COVID-19). Rapid decision making and robust public health measures were established by the Vietnamese Government to control the situation. As of 17 May 2020, Vietnam reported 320 total confirmed cases of COVID-19, of whom 260 had fully recovered, while the remaining 60 cases were still under treatment. Noteworthy, the current data still confirms zero deaths and within the last 32 consecutive days prior to this submission, there have been no new infections in the country. Valuable lessons from Severe Acute Respiratory Syndrome in 2003 such as use of quarantine, early recognition and quick response to the infection, and increased awareness of its citizens have put Vietnam in a somewhat better position against COVID-19 compared to other places. Vietnam, at the current time, mulls declaring an end of the current COVID-19 outbreak.

Effects of a stepwise handovers ISBARQ programme among nursing college students

Background

Due to a lack of standardized guidelines, it is necessary to verify the effectiveness of educational programmes for nursing students' systematic handover training.

Aims

This study aimed to develop a stepwise nursing handover programme and to examine its effects on awareness of handover Situation, Background, Assessment, Recommendation, communication self-efficacy and satisfaction with handover education.

Design

This was a single-group repeated measures ANOVA study.

Methods

This study was conducted in a nursing department, using a convenience sample of 25 senior nursing students from April 2 to June 22, 2018. The programme was divided into lectures, scenario role-playing and nursing case role-playing. The research questions were analysed using repeated measures ANOVA.

Results

Awareness of handover Situation, Background, Assessment, Recommendation, communication self-efficacy and satisfaction with handover education gradually increased after each step of the programme. The stepwise nursing handover programme, progressing from low to high levels of learning, can be used to improve the nursing handover system and handover communication ability.

Situated Food Safety Risk and the Influence of Social Norms

Previous studies of risk behavior observed weak or inconsistent relationships between risk perception and risk-taking. One aspect that has often been neglected in such studies is the situational context in which risk behavior is embedded: Even though a person may perceive a behavior as risky, the social norms governing the situation may work as a counteracting force, overriding the influence of risk perception. Three food context studies are reported. In Study 1 (N = 200), we assess how norm strength varies across different social situations, relate the variation in norm strength to the social characteristics of the situation, and identify situations with consistently low and high levels of pressure to comply with the social norm. In Study 2 (N = 502), we investigate how willingness to accept 15 different foods that vary in terms of objective risk relates to perceived risk in situations with low and high pressure to comply with a social norm. In Study 3 (N = 1,200), we test how risk-taking is jointly influenced by the perceived risk associated with the products and the social norms governing the situations in which the products are served. The results indicate that the effects of risk perception and social norm are additive, influencing risk-taking simultaneously but as counteracting forces. Social norm had a slightly stronger absolute effect, leading to a net effect of increased risk-taking. The relationships were stable over different social situations and food safety risks and did not disappear when detailed risk information was presented.

Contextualising Smiles: Is Perception of Smile Genuineness Influenced by Situation and Culture?

Considerable evidence for contextual effects in emotion perception has been reported, but little is known about how contexts influence the perception of smiles, a rich source of social information. We investigated whether the perceived genuineness of a smile depends on the valence of the situation accompanying the smile, and whether such contextual effects depend on culture. Seventy-two North Americans and 83 mainland Chinese rated the genuineness of smiles displayed by Caucasians and East Asians in three situational contexts (positive, negative, and in isolation). Smiles in a negative situation were considered less genuine than the same smiles rated in isolation; this effect was observed for both groups of observers but stronger for North Americans, a finding at odds with the notion that East Asians are more likely to engage in holistic perceptual processes. Our study demonstrates contextual effects in assessment of smile genuineness, contributing new insights into the perception of affective information.

[Spatiality and Temporality: Body Image of Chronic Illness Patients]

This paper proposed the concepts of "body me" and "I body". Furthermore, the images of colostomy and fistula are used as examples to show that the body image of chronic illness has both temporal and situational meanings and shares a reciprocal relationship with self-identity (i.e., idem identity and ipse identity). Rather than providing an organic explanation, body image is an interactive relationship among time, situation, body, self, and others, which are all important aspects necessary to understand the individual and the world in which she/he lives. Finally, reflecting on humanistic clinical psychology, the ethical relationship practice of "we-ness" is proposed to shed illustrative light on the body image of chronic illness patients from a new perspective.

Better Than Its Reputation? Gossip and the Reasons Why We and Individuals With "Dark" Personalities Talk About Others

Gossip is an ubiquitous phenomenon. Hearing information about others serves important social functions such as learning without direct interaction and observation. Despite important social functions gossip has a rather negative reputation. Therefore, the present online study focuses on the reasons why people gossip and how these reasons are related to personality (i.e., dark triad) and situational settings. Six distinct motives were identified that underlie gossip behavior: information validation, information gathering, relationship building, protection, social enjoyment, and negative influence. The most important motive was validating information about the gossip target followed by the motive to acquire new information about the gossip target. The least important motive was harming the gossip target. The motivational pattern was highly similar between private and work context. Interestingly, the importance of motives mainly depends on the gossiper's narcissism both in work and in private settings. The findings suggest that the negative reputation of gossip is not justified. In fact, even "dark" personalities appear to use gossip to tune their picture of other humans and themselves and not to harm others.

Essential Medicine Utilization and Situation in Selected Ten Developing Countries: A Compendious Audit

Medicine improves the quality of life and increases mean age of human beings as it fights against diseases. Accessibility to medicines is the fundamental right of every person. The principle of the essential medicines (EMs) is that a limited number of availability of medicine will promote to a better supply chain and rational prescribing to the rural and remote health centers for any developing countries. Furthermore, it was also expected that this concept will also ensure better procurement policy at lower costs, more in amount, with easier storage. Thereby, EMs will safeguard and improve distribution and dispensing of medicine. Correspondingly, motivational and dedicated training program regarding drug information and adverse drug reactions will boost up access to medicine and health-care. In addition, the selection of medicine from EM is the first step in the direction of the rational use of medicine and progress and ensuring the quality of health care. Thereafter, selection needs to be followed by appropriate use. Everyone should receive the right medicine, in an adequate dose for an adequate duration, with appropriate information and follow-up treatment, and at an affordable cost. The acceptance and implementation of World Health Organization-promoted EM policies in deferent countries have improved quality use of medicine in terms of accessibility and affordability, predominantly in developing countries. The corporations and teamwork among various participants of health care are instantly obligatory to progress equitable access to medicines in low- and middle-income countries.

Is Focus on Prevention Missing in National Health Programs? A Situation Analysis of IEC/BCC/Health Promotion Activities in a District Setting of Punjab and Haryana

Context:

Health promotion (HP) has been an integral part of all national programs although it has been a low priority in India, which has resulted in a failure to achieve the desired results.

Settings and Design:

Situation analysis of information education communication (IEC)/behavior change communication (BCC)/HP activities within the existing national health programs was undertaken in the district of Hoshiarpur in Punjab and the district of Ambala in Haryana during 2013-14.

Materials and Methods:

Facility-based assessments were done by conducting in-depth interviews with stakeholders, program officers, medical officers, health workers, and counselors. Household survey (332 individuals) and exit interview (102 interviews) were conducted to assess the knowledge of the community regarding key risk factors.

Results:

There was a high vacancy in the mass media division with 40% (2 out of 5) and 89% (8 out of 9) of the sanctioned positions vacant in Hoshiarpur and Ambala, respectively, with low capacity of staff and budget. There was no annual calendar, logbook of activities with poor recording of IEC material received and disseminated. The knowledge of community members regarding key risk factors such as tobacco use, salt intake, blood pressure level, anemia, and tuberculosis was 77.3%, 26.4%, 16.4%, 32.7%, and 91.8%, respectively, in the district of Ambala as compared to 77.5%, 37.5%, 33.3%, 25.8%, and 88.3%, respectively, in the district of Hoshiarpur. The village health and sanitation committee (VHSC) in the district of Hoshiarpur and village level core committee (VLCC) in the district of Ambala were found to be nonfunctional with no Iec/Bcc activities in the covered villages in the last month. Monitoring and supervision of Iec/Bcc activities were poor in both the districts.

Conclusions:

Iec/Bcc/HP is a neglected area in national health programs in the selected districts with inadequate budget, human resources with poor implementation, and requires strengthening for better implementation of the national health programs.

Impact of an education session on clinical handover between medical shifts in an emergency department: A pilot study

OBJECTIVE

To evaluate the impact of a medical education session on the implementation of a new change of shift medical clinical handover format in an urban hospital ED.

METHODS

This pilot study used a pre- and post-intervention design. The intervention consisted of a 1 h education session to teach a new handover format, SBARM (Situation, Background, Assessment, Recommendation, Medication). Data were collected through observations of doctors performing clinical handover and individual interviews with participants.

RESULTS

The educational intervention led to an increased focus on checking medication charts, but had minimal effect on changing other aspects of clinical handover at doctors' change of shift times. Perceived increased time spent on handover using the new system was seen as a major barrier to the implementation of SBARM. The addition of 'M' to 'SBAR' heightened awareness of checking medication and fluid charts.

CONCLUSION

Time pressures need to be taken into consideration when introducing changes to current processes. Also, it is recommended that, in addition to ongoing education, senior clinicians are engaged during the planning and execution stages of changes to practice.

Introduction of Situation, Background, Assessment, Recommendation into Nursing Practice: A Prospective Study

Objective:

The aim of the study was to introduce and evaluate the compliance to documentation of situation, background, assessment, recommendation (SBAR) form.

Methods:

Twenty nurses involved in active bedside care were selected by simple random sampling. Use of SBAR was illustrated thru self-instructional module (SIM). Content validity and reliability were established. The situation, background, assessment, recommendation (SBAR) form was disseminated for use in a clinical setting during shift handover. A retrospective audit was undertaken at 1^st week (A1) and 16^th week (A2), post introduction of SIM. Nurse's opinion about the SBAR form was also captured.

Results:

Majority of nurses were females (65%) in the age group 21-30 years (80%). There was a significant association (P = 0.019) between overall audit scores and graduate nurses. Significant improvement (P = 0.043) seen in overall scores between A1 (mean: 23.20) and A2 (mean: 24.26) and also in “Situation” domain (P = 0.045) as compared to other domains. There was only a marginal improvement in documentation related to patient's allergies and relevant past history (7%) while identifying comorbidities decreased by 40%. Only 70% of nurses had documented plan of care. Most (76%) of nurses expressed that SBAR form was useful, but 24% nurses felt SBAR documentation was time-consuming. The assessment was easy (53%) to document while recommendation was the difficult (53%) part.

Conclusions:

SBAR technique has helped nurses to have a focused and easy communication during transition of care during handover. Importance and relevance of capturing information need to be reinforced. An audit to look for reduced number of incidents related to communication failures is essential for long-term evaluation of patient outcomes. Use of standardized SBAR in nursing practice for bedside shift handover will improve communication between nurses and thus ensure patient safety.

[Thinking ethics education]

Ethics emerges in the interstices of deontology, in difficult situations generating internal conflicts for the caregiver, sources of anxiety and questioning. Ethics education has always played a major in nursing programs by initiating a reflection on human values. Faced with current uncertainties in the context of care, it is now based on the appropriation of a reflexive approach to the meaning of action.

How do people respond to health news? The role of personality traits

When a patient receives a health diagnosis, their response (e.g. changes in behaviour, seeking support) can have significant consequences for long-term health and well-being. Characteristics of health news are known to influence these responses, but personality traits have been omitted from this line of research. The current study examines the role of personality traits in predicting response to health news. Participants (N = 298) read scenarios in which they received health news that was manipulated to vary in severity, controllability and likelihood of outcomes. Participants then rated how likely they were to engage in a number of response behaviours. We examined the main effects and interaction of situational manipulations and personality traits on ratings of these behaviours. Both situations and personality traits influenced behavioural responses to health events. In particular, conscientiousness predicted taking action and seeking social support. Neuroticism predicted both maladaptive and adaptive behavioural responses, providing support for the 'healthy neurotic' hypothesis. Moreover, personality traits predicted best in weak (unlikely, controllable) situations. Both personality traits and situational characteristics contribute to behavioural responses to health news.

Neural mechanisms underlying the integration of situational information into attribution outcomes

When forming impressions and trying to figure out why other people behave the way they do, we should take into account not only dispositional factors (i.e., personality traits) but also situational constraints as potential causes for a behavior. However, in their attributions, people often ignore the importance of situational factors. To investigate the neural mechanisms underlying the integration of situational information into attributions, we decomposed the attribution process by separately presenting information about behaviors and about the situational circumstances in which they occur. After reading the information, participants judged whether dispositional or situational causes explained the behavior (attribution), and how much they liked the person described in the scenario (affective evaluation). The dorsolateral prefrontal cortex showed increased blood oxygenation-level-dependent activation during the encoding of situational information when the resulting attribution was situational, relative to when the attribution was dispositional, potentially reflecting a controlled process that integrates situational information into attributions. Interestingly, attributions were strongly linked to subsequent affective evaluations, with the dorsomedial prefrontal cortex emerging as potential substrate of the integration of attributions and affective evaluations. Our findings demonstrate how top-down control processes regulate impression formation when situational information is taken into account to understand others.

The double embarrassment: Understanding the actions of nursing staff in an unexpected situation

A nursing home is a complex multifactorial environment that influences the decisions and actions of nursing staff. Many of the actions performed by nursing staff appear to be straightforward or simple because they are repetitive, encompassing everyday activities such as helping a resident to get up in the morning, shower or get dressed. These daily activities are usually performed smoothly as part of normal care. This article draws on ethnographic data from a study of caring practices in a nursing home with the aim of investigating how a seemingly ordinary, but unexpected, event can develop into a chaotic situation. Staff appeared to have difficulty managing the situation, and they seemed to be disorganized in the application of their skills. First, we describe the situation in detail before investigating and discussing the situation to provide a deeper understanding of the complexity of nursing home practice.

[Current situation of hypertensive patients over 75 years old: the DISEHTAE study]

OBJECTIVE

To assess in patients over 75 years old the degree of their compliance with recommendations on follow-up, control and treatment of hypertension.

DESIGN

Descriptive, multi-centre study, covering the whole of Spain.

SETTING

A total of 107 health centres from 14 autonomous communities.

PARTICIPANTS

Hypertensive patients over 75: 1,369 clinical charts. INTERVENTIONS AND MAIN MEASUREMENTS: The variables studied were: age and sex, place monitored, blood pressure figures, screening for, and diagnosis of diabetes, hypercholesterolaemia, smoking, left ventricular hypertrophy (LVH) and obesity. Blood creatinine, proteinuria, prescribed medication, and infrastructure variables were also included.

RESULTS

The most often screened cardiovascular risk factor (CRF) was obesity (76.1%), whilst the most prevalent was hypercholesterolaemia (31.3%). Of the patients, 25.5% had associated diabetes and 48.5% had a body mass index (BMI) >25. Low microalbuminuria (8.4%) was found. The proportion of patients with their blood pressure controlled was higher among those monitored in primary care (32.8%) than out of primary care (23.2%). No drug treatment was prescribed for 7.9%, only hygiene-dietary measures. The most common pharmacological group was that of the diuretics, followed by IECAS and ARA II.

CONCLUSIONS

Though we can say that the degree of control of hypertension in elderly patients is steadily increasing, it is still far from optimal in most of our patients.