Burnout, Resilience, and Mindfulness in Healthcare Workers in a Medically Underserved Region during the COVID-19 Pandemic.

OBJECTIVES: To evaluate employee burnout, work conditions, resilience, and mindfulness at an academic medical center in a US medically underserved region during the coronavirus disease 2019 pandemic. METHODS: We surveyed employees from August 7, 2020 to January 17, 2021. Respondents completed the Maslach Burnout Inventory (MBI), the Areas of Worklife Survey, the Connor-Davidson Resilience Scale, and the Philadelphia Mindfulness Scale (PHLMS) and answered a question about intention to stay in the present job until retirement. We performed exploratory stepwise logistic regression to evaluate associations between variables and intention to stay. We evaluated associations between variables with a structural equation model (SEM). RESULTS: The 655 respondents mostly were White women providers, aged 50 years and younger, who worked in inpatient wards, emergency departments, or intensive care units. Respondents had high mean MBI emotional exhaustion (35 ± 12) and moderate MBI depersonalization (12 ± 6), despite high MBI personal accomplishment (43 ± 8), middle-range Areas of Worklife Survey results, and middle to high Connor-Davidson Resilience Scale scores (29 ± 5), PHLMS awareness scores (37 ± 6), and PHLMS acceptance scores (30 ± 8). There were 408 respondents (62%) with MBI latent profiles consistent with being burned out, but 447 respondents (68%) were willing to stay in their present job. Older age was associated with intention to stay (coefficient 1.1 ± 0.1; P < 0.001). The latent variable burnout structural equation model (burnout-SEM) constructed from the MBI subscales inversely predicted intention to stay (coefficient - 0.33; P < 0.001), and this relationship was mediated by age. CONCLUSIONS: Burnout was prevalent despite substantial personal accomplishment, resilience, and mindfulness.

A Laboratory Word Memory Test Analogue Differentiates Intentional Feigning from True Responding Using the P300 Event-Related Potential.

Symptom exaggeration and feigned cognitive impairment occur commonly in forensic and medicolegal evaluations. As a result, methods to detect feigned cognitive impairment are an indispensable component of neuropsychological assessments. This study reports the results of two neurophysiological experiments using a forced-choice recognition task built from the stimuli of the Word Memory Test and Medical Symptom Validity Test as well as a new linguistically informed stimulus set. Participant volunteers were instructed either to do their best or to feign cognitive impairment consistent with a mild traumatic brain injury while their brain activity was monitored using event-related potentials (ERP). Experiment 1 varied instructions across individuals, whereas Experiment 2 varied instructions within individuals. The target brain component was a positive deflection indicating stimulus recognition that occurs approximately 300 ms after exposure to a stimulus (i.e., the P300). Multimodal comparison (P300 amplitude to behavioral accuracy) allowed the detection of feigned cognitive impairment. Results indicate that, for correct responses, P300s were equivalent for the simulated malingering and good effort conditions. However, for incorrect responses, feigned impairment produced reliable but significantly reduced P300 amplitudes. Although the P300 is an automatic index of recognition-even when knowledge is hidden-its amplitude appears capable of modulation by feigning strategies. Implications of this finding are discussed for research and clinical applications.

Electrophysiological evidence for the action of a center-surround mechanism on semantic processing in the left hemisphere.

Physiological evidence was sought for a center-surround attentional mechanism (CSM), which has been proposed to assist in the retrieval of weakly activated items from semantic memory. The CSM operates by facilitating strongly related items in the "center" of the weakly activated area of semantic memory, and inhibiting less strongly related items in its "surround". In this study weak activation was created by having subjects acquire the meanings of new words to a recall criterion of only 50%. Subjects who attained this approximate criterion level of performance were subsequently included in a semantic priming task, during which ERPs were recorded. Primes were newly learned rare words, and targets were either synonyms, non-synonymously related words, or unrelated words. All stimuli were presented to the RVF/LH (right visual field/left hemisphere) or the LVF/RH (left visual field/right hemisphere). Under RVF/LH stimulation the newly learned word primes produced facilitation on N400 for synonym targets, and inhibition for related targets. No differences were observed under LVF/RH stimulation. The LH thus, supports a CSM, whereby a synonym in the "center" of attention, focused on the newly learned word, is facilitated, whereas a related word in the "surround" is inhibited. The data are consistent with the view of this laboratory that semantic memory is subserved by a spreading activation system in the LH. Also consistent with our view, there was no evidence of spreading activation in the RH. The findings are discussed in the context of additional recent theories of semantic memory. Finally, the adult right hemisphere may require more learning than the LH in order to demonstrate evidence of meaning acquisition.

Is there a common linkage among reading comprehension, visual attention, and magnocellular processing?

The authors examined the relationships between reading comprehension, visual attention, and magnocellular processing in 42 Grade 7 students. The goal was to quantify the sensitivity of visual attention and magnocellular visual processing as concomitants of poor reading comprehension in the absence of either vision therapy or cognitive intervention. Nineteen good readers (M = grade equivalent of 11.2) and 23 poor readers (M = grade equivalent of 3.5) were identified. Participants were tested for visual attention skills (Cognitive Assessment System: CAS) and magnocellular integrity (Coherent Motion Threshold: CM). Individual and combined correlations of dependent variables with reading were significant at the 0.01 level. When combined, the two tests (CAS + CM) accounted for 61% of the variance in reading comprehension. Logistic regression analysis measured sensitivity of the two diagnostic tests. Attention tests correctly classified 95.7% of poor readers, and coherent motion correctly classified 78.3% of poor readers. When the data were combined, 91.3% of poor readers were correctly classified. The research reinforces the notion that a common linkage exists between reading comprehension, visual attention, and magnocellular processing. Diagnostic test batteries for students who have been identified as reading disabled should include magnocellular and visual attention tests. Procedures to diagnose and ameliorate these disabilities are discussed.