The co-design, implementation and evaluation of a serious board game 'PlayDecide patient safety' to educate junior doctors about patient safety and the importance of reporting safety concerns.

BACKGROUND: We believe junior doctors are in a unique position in relation to reporting of incidents and safety culture. They are still in training and are also 'fresh eyes' on the system providing valuable insights into what they perceive as safe and unsafe behaviour. The aim of this study was to co-design and implement an embedded learning intervention - a serious board game - to educate junior doctors about patient safety and the importance of reporting safety concerns, while at the same time shaping a culture of responsiveness from senior medical staff. METHODS: A serious game based on the PlayDecide framework was co-designed and implemented in two large urban acute teaching hospitals. To evaluate the educational value of the game voting on the position statements was recorded at the end of each game by a facilitator who also took notes after the game of key themes that emerged from the discussion. A sample of players were invited on a voluntary basis to take part in semi-structured interviews after playing the game using Flanagan's Critical Incident Technique. A paper-based questionnaire on 'Safety Concerns' was developed and administered to assess pre-and post-playing the game reporting behaviour. Dissemination workshops were held with senior clinicians to promote more inclusive leadership behaviours and responsiveness to junior doctors raising of safety concerns from senior clinicians. RESULTS: The game proved to be a valuable patient safety educational tool and proved effective in encouraging deep discussion on patient safety. There was a significant change in the reporting behaviour of junior doctors in one of the hospitals following the intervention. CONCLUSION: In healthcare, limited exposure to patient safety training and narrow understanding of safety compromise patients lives. The existing healthcare system needs to value the role that junior doctors and others could play in shaping a positive safety culture where reporting of all safety concerns is encouraged. Greater efforts need to be made at hospital level to develop a more pro-active safe and just culture that supports and encourages junior doctors and ultimately all doctors to understand and speak up about safety concerns.

Examining wellness programs over time: Predicting participation and workplace outcomes.

The return on investment of employer wellness programs has been heavily debated in recent years, yet existing research has failed to adequately assess the psychological factors that motivate program participation and how participation relates to organizationally relevant employee attitudes and behaviors. Using data over a 3-year period, we found beliefs about the value of employee wellness programs and perceived organizational support (POS) for wellness to be linked to wellness program participation through the mediation of intention to participate in the wellness program. Those with greater wellness participation were found to have higher performance ratings, higher job satisfaction, higher intention to stay, and lower turnover. However, the effects for job satisfaction and intention to stay disappeared when controlling for prior levels of satisfaction and intention to stay in cross-lagged models. Implications for scholars and practitioners are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Emotion identification across adulthood using the Dynamic FACES database of emotional expressions in younger, middle aged, and older adults.

Facial stimuli are widely used in behavioural and brain science research to investigate emotional facial processing. However, some studies have demonstrated that dynamic expressions elicit stronger emotional responses compared to static images. To address the need for more ecologically valid and powerful facial emotional stimuli, we created Dynamic FACES, a database of morphed videos (n = 1026) from younger, middle-aged, and older adults displaying naturalistic emotional facial expressions (neutrality, sadness, disgust, fear, anger, happiness). To assess adult age differences in emotion identification of dynamic stimuli and to provide normative ratings for this modified set of stimuli, healthy adults (n = 1822, age range 18-86 years) categorised for each video the emotional expression displayed, rated the expression distinctiveness, estimated the age of the face model, and rated the naturalness of the expression. We found few age differences in emotion identification when using dynamic stimuli. Only for angry faces did older adults show lower levels of identification accuracy than younger adults. Further, older adults outperformed middle-aged adults' in identification of sadness. The use of dynamic facial emotional stimuli has previously been limited, but Dynamic FACES provides a large database of high-resolution naturalistic, dynamic expressions across adulthood. Information on using Dynamic FACES for research purposes can be found at http://faces.mpib-berlin.mpg.de .

Imbuing medical professionalism in relation to safety: a study protocol for a mixed-methods intervention focused on trialling an embedded learning approach that centres on the use of a custom designed board game.

INTRODUCTION: Healthcare organisations have a responsibility for ensuring that the governance of workplace settings creates a culture that supports good professional practice. Encouraging such a culture needs to start from an understanding of the factors that make it difficult for health professionals to raise issues of concern in relation to patient safety. The focus of this study is to determine whether a customised education intervention, developed as part of the study, with interns and senior house officers (SHOs) can imbue a culture of medical professionalism in relation to patient safety and support junior doctors to raise issues of concern, while shaping a culture of responsiveness and learning. METHODS AND ANALYSIS: We will use quantitative and qualitative methods to collect data. The sample size will be approximately 200 interns and SHOs across the two hospital sites. Two surveys will be included with one measuring leadership inclusiveness and psychological safety and a second capturing information on safety concerns that participants may have witnessed in their places of work. The PlayDecide embedded learning intervention will be developed with key stakeholders. This will be trialled in the middle stage of data collection for both interns and SHOs. A detailed content analysis will be conducted on the surveys to assess any changes in reporting following the PlayDecide intervention. This will be compared with the incident reporting levels and the results of the preintervention and postintervention leadership inclusiveness and psychological safety survey. Statistical analysis will be conducted using SPSS. Differences will be considered statistically significant at p<0.05. Semistructured interviews using a critical incident technique will be used for the ongoing analysis and evaluation of the project. These will be transcribed, de-identified and coded into themes. ETHICS AND DISSEMINATION: The study has been granted ethics approval from University College Dublin (Ref. LS-15-19-Ward-McAuliffe: Imbuing Medical Professionalism in Relation to Safety). The study results will be disseminated through peer-reviewed publications.

Culture and vocational interests: the moderating role of collectivism and gender egalitarianism.

In some cultures, individuals are free to pursue careers that match their personalities. In others, familial and societal expectations regarding career paths may restrict the links between individual personality and interests. Gender role expectations also may vary across cultures and may be associated with gender differences in interests. Past meta-analytic research has shown some career interests are related to personality traits (Barrick, Mount, & Gupta, 2003; Larson, Rottinghaus, & Borgen, 2002), but the cross-cultural variation of these relationships has not been sufficiently explored. Interest and personality data were obtained from an archival data set of 391,485 individuals from 20 countries. Results indicated that in cultures with high in-group collectivism, connections between personality traits and occupational interests may be less pronounced. Cultural gender egalitarianism moderated the level of gender differences in interests, unexpectedly demonstrating that gender differences may be wider in egalitarian cultures. Implications for career guidance in multicultural settings are discussed.

A link between impaired purine nucleotide synthesis and apoptosis in Drosophila melanogaster.

The biosynthetic pathways and multiple functions of purine nucleotides are well known. However, the pathways that respond to alterations in purine nucleotide synthesis in vivo in an animal model organism have not been identified. We examined the effects of inhibiting purine de novo synthesis in vivo and in cultured cells of Drosophila melanogaster. The purine de novo synthesis gene ade2 encodes phosphoribosylformylglycinamidine synthase (EC 6.3.5.3). An ade2 deletion, generated by P-element transposon excision, causes lethality in early pupal development, with darkening, or necrosis, of leg and wing imaginal disc tissue upon disc eversion. Together with analysis of a previously isolated weaker allele, ade2(4), and an allele of the Prat gene, which encodes an enzyme for the first step in the pathway, we determined that the lethal arrest and imaginal disc phenotypes involve apoptosis. A transgene expressing the baculovirus caspase inhibitor p35, which suppresses apoptosis caused by other stresses such as DNA damage, suppresses both the imaginal disc tissue darkening and the pupal lethality of all three purine de novo synthesis mutants. Furthermore, we showed the presence of apoptosis at the cellular level in both ade2 and Prat mutants by detecting TUNEL-positive nuclei in wing imaginal discs. Purine de novo synthesis inhibition was also examined in tissue culture by ade2 RNA interference followed by analysis of genome-wide changes in transcript levels. Among the upregulated genes was HtrA2, which encodes an apoptosis effector and is thus a candidate for initiating apoptosis in response to purine depletion.

Health hazards and preventive measures of farm women. Emerging issues.

Currently, an increasing number of farms are family owned and women are directly involved in the farming operations as an independent manager or partner. Women play an important role in farm management by marketing farm products, purchasing materials, and financial planning. Because of this involvement, women can be exposed to potential health hazards that can result in chronic illness, debilitation, or death. This study explored and described health hazards affecting farm women in southeast Louisiana, preventive measures used by farm women, and their consistency in using protective equipment with varying levels of time commitment toward farm operations. This cross sectional study included women older than 18 whose family participated in farming operations. A stratified, random sample design with parishes comprising the strata and simple random selection without replacement within each stratum was used to select family addresses. A total of 519 women who met the criteria completed a structured 30 minute telephone interview conducted using The Louisiana Farm Health and Injury Survey instrument. Information elicited included farm work characteristics, prevention practices, and demographics. Results showed that women working 1 to 20 hours per week were less likely to wear personal protective equipment (PPE) than women working more than 20 hours per week. This included wearing seat belts on tractors; using hearing, eye, or breathing protection; and wearing gloves or boots. No differences were found between groups for use of skin protection, hair holders, or helmets on all terrain vehicles (ATVs). The researchers concluded that if nursing interventions such as teaching and counseling related to prevention methods could be provided, the incidence of acute and chronic illnesses and traumatic injury would decline.