Positive Leadership within Breast Imaging: Impact on Burnout, Intent to Leave, and Engagement.

Background High rates of provider burnout and turnover, as well as staffing shortages, are creating crises within radiology departments. Identifying ways to support health care workers, such as the Positively Energizing Leadership program, is important during these ongoing crises. Purpose To identify the relationship between leadership behaviors and workplace climate and health care worker outcomes (ie, burnout, intent to leave, and engagement) and to determine whether the positive leadership program could improve workplace climate and health care worker outcomes. Materials and Methods This prospective study involved two parts. First, a web-based survey was administered to faculty and staff in a breast imaging unit of a large academic medical center in February 2021 to identify relationships between leadership behaviors and workplace climate and health care worker outcomes. Second, a web-based survey was administered in February 2023, following the implementation of a positive leadership program, to determine improvement in engagement and reduction of burnout and intent to leave since 2021. Multiple regression, the Sobel test, Pearson correlation, and the t test were used, with a conservative significance level of P < .001. Results The sample consisted of 88 respondents (response rate, 95%) in 2021 and 85 respondents (response rate, 92%) in 2023. Leadership communication was associated with a positive workplace climate (ß = 0.76, P < .001) and a positive workplace climate was associated with improved engagement (ß = 0.53, P < .001), reduction in burnout (ß = -0.42, P < .001), and reduction in intent to leave (ß = -0.49, P < .001). Following a 2-year positive leadership program, improved perceptions were observed for leadership communication (pretest mean, 4.59 ± 1.51 [SD]; posttest mean, 5.80 ± 1.01; t = 5.97, P < .001), workplace climate (pretest mean, 5.09 ± 1.43; posttest mean, 5.77 ± 1.11; t = 3.35, P < .001), and engagement (pretest mean, 5.27 ± 1.20, posttest mean, 5.68 ± 0.96; t = 2.50, P < .01), with a reduction in burnout (pretest mean, 2.69 ± 0.94; posttest mean, 2.18 ± 0.74; t = 3.50, P < .001) and intent to leave (pretest mean, 3.12 ± 2.23; posttest mean, 2.56 ± 1.84; t = 1.78, P < .05). Conclusion After implementation of a positive leadership program in a radiology department breast imaging unit, burnout and intention to leave decreased among health care workers, while engagement increased. © RSNA, 2024 See also the editorial by Thrall in this issue.

A Focus on Leadership Communication and Feeling Valued to Prevent Burnout and Turnover Among Healthcare Professionals.

OBJECTIVE: The purpose of this study was to examine the relative importance of leadership communication in predicting burnout and intention to stay among faculty and staff while controlling for other factors such as satisfaction with compensation and work-home flexibility. METHODS: This study involved a secondary analysis of data derived from an organizational engagement survey that included 2336 faculty members (75% response rate) and 17,664 staff members (72% response rate). RESULTS: Effective leadership communication was a stronger predictor of burnout and intent to stay than satisfaction with compensation and work-home flexibility. Feeling valued by the organization mediated the relationship between leadership communication and the outcome variables. CONCLUSIONS: Leadership communication provides a low-cost solution to burnout and staff shortages and is primarily effective because it conveys to both faculty and staff that they are valued by the organization.

Positive Schemas: Replication, Associations With Negative Schemas, and the Dark Triad.

The purpose of the current study was to replicate the factor structure of the 14 positive schemas identified in the earlier study by Louis et al. (2018). Using confirmatory factor analysis (CFA), and Multi-group CFA, the 14 positive schemas were found to be robust across four new non-clinical English-speaking community samples - USA (n = 396), South Africa (n = 390), Nigeria (n = 364), and India (n = 306). Further, results from CFA, and chi square tests showed that positive and negative schemas were independent but related constructs, and that they do not reflect bipolarity. Using hierarchical regression and Pearson's correlations the negative schemas of Entitlement, Approval Seeking and Mistrust, and the positive schema of Empathic Consideration were found to be associated positively and negatively respectively with Machiavellianism, narcissism, and psychopathy of the Dark Triad scale in all four worldwide samples. Implications of this finding in Schema Therapy treatment were discussed.

From a Culture of Incivility to Virtuousness: A Call to Elevate Workplace Behaviors in Radiology.

Radiology has been identified as a subspecialty with exceptionally high rates of incivility among colleagues. Such behaviors are detrimental to the well-being, productivity, and retention of health care practitioners and to the quality of patient care. Addressing incivility has become imperative given current and anticipated staff shortages, yet research from positive organizational scholarship suggests a greater opportunity to be had. Going forward, we need not only to address incivility but also to build purpose-driven, compassionate, and supportive workplaces.

Influence of Fusarium virguliforme Temporal Colonization of Corn, Tillage, and Residue Management on Soybean Sudden Death Syndrome and Soybean Yield.

The asymptomatic host range of Fusarium virguliforme includes corn, a common crop rotated with soybean that we hypothesize may alter F. virguliforme population dynamics and disease management. A field-based approach explored the temporal dynamics of F. virguliforme colonization of corn and soybean roots under different tillage and residue managements. Experiments were conducted in Iowa, Indiana, Michigan, and Wisconsin, United States and Ontario, Canada from 2016 to 2018. Corn and soybean roots were sampled at consecutive timepoints between 1 and 16 weeks after planting. DNA was extracted from all roots and analyzed by real-time quantitative PCR for F. virguliforme quantification. Trials were rotated between corn and soybean, containing a two-by-two factorial of tillage (no-tilled or tilled) and corn residue (with or without) in several experimental designs. In 2016, low amounts (approximately 100 fg per 10 mg of root tissue) of F. virguliforme were detected in the inoculated Iowa, Indiana, and Michigan locations and noninoculated Wisconsin corn fields. However, in 2017, greater levels of F. virguliforme DNA were detected in Iowa, Indiana, and Michigan across sampling timepoints. Tillage practices showed inconsistent effects on F. virguliforme root colonization and sudden death syndrome (SDS) foliar symptoms among trials and locations. However, residue management did not alter root colonization of corn or soybean by F. virguliforme. Plots with corn residue had greater SDS foliar disease index in Iowa in 2016. However, this trend was not observed across the site-years, indicating that corn residue may occasionally increase SDS foliar symptoms depending on the disease level and soil and weather factors.

Economic Impact of Fluopyram-Amended Seed Treatments to Reduce Soybean Yield Loss Associated with Sudden Death Syndrome.

Soybean (Glycine max) sudden death syndrome (SDS), caused by Fusarium virguliforme, is a key limitation in reaching soybean yield potential, stemming from incomplete disease management through cultural practices and partial host resistance. A fungicidal seed treatment was released in 2014 with the active ingredient fluopyram and was the first chemical management strategy to reduce soybean yield loss stemming from SDS. Although farm level studies have found fluopyram profitable, we were curious to discover whether fluopyram would be beneficial nationally if targeted to soybean fields at risk for SDS yield loss. To estimate economic benefits of fluopyram adoption in SDS at-risk acres, in the light of U.S. public research and outreach from a privately developed product, we applied an economic surplus approach, calculating ex ante net benefits from 2018 to 2032. Through this framework of logistic adoption of fluopyram for alleviation of SDS-associated yield losses, we projected a net benefit of $5.8 billion over 15 years, considering the costs of public seed treatment research and future extension communication. Although the sensitivity analysis indicates that overall net benefits from fluopyram adoption on SDS at-risk acres are highly dependent upon the market price of soybean, the incidence of SDS, the adoption path, and ceiling of this seed treatment, the net benefits still exceeded $407 million in the worst-case scenario.

Direct colorimetric detection of unamplified pathogen DNA by dextrin-capped gold nanoparticles.

The interaction between gold nanoparticles (AuNPs) and nucleic acids has facilitated a variety of diagnostic applications, with further diversification of synthesis match bio-applications while reducing biotoxicity. However, DNA interactions with unique surface capping agents have not been fully defined. Using dextrin-capped AuNPs (d-AuNPs), we have developed a novel unamplified genomic DNA (gDNA) nanosensor, exploiting dispersion and aggregation characteristics of d-AuNPs, in the presence of gDNA, for sequence-specific detection. We demonstrate that d-AuNPs are stable in a five-fold greater salt concentration than citrate-capped AuNPs and the d-AuNPs were stabilized by single stranded DNA probe (ssDNAp). However, in the elevated salt concentrations of the DNA detection assay, the target reactions were surprisingly further stabilized by the formation of a ssDNAp-target gDNA complex. The results presented herein lead us to propose a mechanism whereby genomic ssDNA secondary structure formation during ssDNAp-to-target gDNA binding enables d-AuNP stabilization in elevated ionic environments. Using the assay described herein, we were successful in detecting as little as 2.94 fM of pathogen DNA, and using crude extractions of a pathogen matrix, as few as 18 spores/µL.

Right Ventricular Hemangioma in the Outflow Tract: A Rare Cause of Obstruction.

We present a patient with a right ventricular hemangioma and symptomatic right ventricular outflow tract obstruction.

Hook-up Sexual Experiences and Problem Behaviors Among Adolescents.

This study focused on the sexual phenomenon of "hooking-up." A hook-up is defined as a single sexual encounter that may or may not include sexual intercourse with someone who is a stranger, brief acquaintance, or friend. The aim of this study was to document the prevalence of hook-ups in a sample of 1,011 urban, middle and high school students and to examine the relationship between hooking-up and a variety of problem behaviors, including, alcohol, cigarette, illicit drug use, truancy, and school suspensions. The results revealed that 28% of the sample had engaged in at least one hook-up experience, and this percentage increased with age. Hook-ups were correlated moderately with all problem behaviors examined.

Adolescent peer-on-peer sexual aggression: characteristics of aggressors of alcohol and non-alcohol-related assault.

OBJECTIVE: The purpose of this study was to examine the characteristics of adolescents involved in alcohol-related and non-alcohol-related sexual assault of peers. METHOD: A Web-based survey was administered to 1,220 7th- to 12th-grade students from a middle school and high school in southeastern Michigan. RESULTS: Adolescents who reported alcohol-related and non-alcohol-related sexual aggression had higher levels of impulsivity and more extensive histories of dating, early sexual activity, and alcohol consumption than adolescents who did not assault. Moreover, aggressors of alcohol-related assault had higher levels of past-30-day alcohol use and reported more alcohol-/drug-related problems than aggressors of non-alcohol-related assault. CONCLUSIONS: Early identification of the characteristics associated with alcohol-related sexual aggression suggests that targeted interventions may be feasible for this group of adolescents at high risk for both sexual perpetration and alcoholism during adulthood.

Adolescents' experiences of sexual assault by peers: prevalence and nature of victimization occurring within and outside of school.

This study examined adolescent peer-on-peer sexual assault victimization occurring within and outside school. The sample consisted of 1,086 7th through 12th grade students, with a mean age of 15. Most of the respondents were White (54%) or Black (45%), and approximately half of respondents were female (54%). A modified version of the Sexual Experiences Survey was used to assess opposite sex sexual victimization in 7th through 12th grade students. Rates of peer sexual assault were high, ranging from 26% of high school boys to 51% of high school girls. School was the most common location of peer sexual victimization. Characteristics of assault varied by location, including type of victimization, victims' grade level, relationship to the perpetrator, type of coercion, and how upsetting the assault was. Distinctions between sexual assault occurring in and out of school are conceptualized with literature on developmental changes in heterosexual relationships and aggression.

Older boyfriends of adolescent girls: the cause or a sign of the problem?

PURPOSE: There were two aims of this study: (a) to determine the causal relationship between adolescent girls' early sexual activity and the presence of an older boyfriend, and (b) theoretically and empirically contextualize the relationship between these two variables within a model of adolescent problem behavior. METHODS: Secondary analysis was conducted with the 670 adolescent girls of Waves I and II of the public use version of the National Longitudinal Study of Adolescent Health. Girls included in the analyses had not already had an older romantic partner in Wave I but did have a romantic partner in the 18 months before Wave II. Four alternative causal models are proposed and tested using structural equation modeling and a nested model comparison analysis strategy. RESULTS: The model with the best fit to the data depicted the presence of an older partner as a mediator of psychosocial risk factors and adolescent problem behaviors (including early sexual activity). Psychosocial characteristics of adolescent girls in Wave I predicted whether they would enter romantic relationships with older boyfriends by Wave II. In turn, though, the presence of an older boyfriend increased problem behavior in Wave II above and beyond the effects of the psychosocial risk factors. CONCLUSIONS: These findings are discussed in terms of the need for a more comprehensive understanding of the unions between adolescent girls and older boyfriends before statutory rape policies are modified.

Drinking like a guy: frequent binge drinking among undergraduate women.

The purpose of this exploratory study was to examine why there has been an increase in frequent binge drinking among the most recent generation of female undergraduate students. Specifically, we examined whether female undergraduate women associated being able to "drink like a guy" (e.g., drink large amounts of alcohol, drinking competitively) with gender equality. Focus groups were conducted in March of 2003 with 42 female undergraduate women who consumed alcohol. Participants were recruited from respondents of a random sample survey of undergraduate students attending a large, public university and reflected the demographic characteristics of this population: traditional-age college students (i.e., attending college between 18 and 22 years of age), who were primarily white from middle or upper middle class families and living on or near the college campus. Focus groups were based on drinking trajectories during college (Stable High, Stable Low, Decreasers, Increasers) and sorority status. While women of all drinking levels reported feeling pressure to drink "heavily" because of the favorable impression they could make on their male peers, primarily women who were frequent binge drinkers throughout college felt that "drinking like a guy" described their own drinking behaviors. While women reported that being able to "drink like a guy" provided them with a sense of equality with their male peers, analysis of the transcripts suggests that "drinking like a guy" had less to do with gender equality and more to do with emphasizing women's (hetero)sexuality. Findings are discussed in terms of how "heavy alcohol consumption" affords college women positive attention from their male peers, but likely increases their vulnerability to sexual assault and alcohol use related health problems.

Self-perceived effects of sexual trauma among women who smoke crack.

This descriptive study examined how Black women who smoke crack cocaine spoke about their experiences of sexual trauma, drug use, and the implications of these experiences for their lives. The authors also explored whether the women's perceptions of the effects of sexual abuse were related to objective indicators of mental health and drug use. The most commonly reported effects of sexual trauma were feeling dirty or ashamed or blaming self, having negative feelings toward the perpetrator, experiencing a general dislike of men or sex, and reporting a conscious reluctance to cope with the incident. In addition, conscious or unconscious denial of the effects of sexual trauma was associated with use of drugs to cope with intrapersonal and interpersonal feelings, inwardly directed responses to the trauma (e.g., self-blaming, feeling ashamed) were positively related to depression, and outwardly directed responses to the trauma (e.g., anger at the perpetrator) were positively related to self-esteem. These findings are discussed in terms of their implications for the self-medication model of substance use, treatment implications for women who have been sexually abused, and the role of self-perception in the relationship between sexual trauma and long-term outcomes.

African American girls' smoking habits and day-to-day experiences with racial discrimination.

BACKGROUND: Although it is recognized that African Americans experience racial discrimination, relatively little research has explored the health implications of this experience. Few studies have examined the relationship between racial discrimination and specific health risks. OBJECTIVES: To examine the relationship between smoking habits and perceptions of racial discrimination among African American adolescent girls and to identify and test potential psychological mechanisms through which racial discrimination may operate to increase smoking among this group. METHODS: A sample of 105 African American adolescent girls (mean age 15.45 years) derived from a larger cross-sectional research project comprised the sample. Univariate analyses were conducted to provide descriptive data on the participants of the study, including information about their use of licit and illicit substances. Bivariate correlational analyses were conducted to evaluate the relationship between perceptions of discrimination and smoking habits. The ability of stress to mediate the relationship between discrimination and smoking was examined by using standard analytical procedures for testing mediation models as outlined by Baron and Kenny (1986). RESULTS: The sample (93%) reported experiencing discrimination and racial discrimination was highly correlated with cigarette smoking (r =.35, p >.001). Removing the effects of stress significantly reduced the relationship between racial discrimination and smoking (r =.17, p <.05), indicating that racial discrimination is related to smoking because of its stressful nature. CONCLUSION: Perceptions of racial discrimination are related to the smoking habits of African American adolescent girls.

Ebb and flow when navigating adolescence: predictors of daily hassles among African-American adolescent girls.

ISSUES AND PURPOSE: To examine the nature of daily hassles as perceived by African-American adolescent females. DESIGN AND METHODS: As part of a larger, cross-sectional study, nonrandom network sampling technique was used to survey 178 adolescent girls between the ages of 11 and 19. RESULTS: This study found that the most common hassles were school and academic, followed by family and economic hassles, peer and social hassles, and personal safety hassles. Socioeconomic factors were strongly associated with the level of hassles reported. PRACTICE IMPLICATIONS: Assess African-American girls' perception of daily hassles, specifically school- and family-related hassles, and also examine the interrelationship between the type of hassles and health problems.

Sexual Trauma, Substance Abuse, and Treatment Success in a Sample of African American Women Who Smoke Crack Cocaine.

The purpose of this descriptive study was to examine the relationship among sexual trauma, severity of substance use, and treatment success for African American women who smoke crack cocaine. Using a convenience sample of 208 African American women with a history of crack smoking, participants were interviewed for 2 to 4 hr and asked a variety of questions about their health, relationships, sexuality, and drug use. Women with a history of sexual trauma (N = 134) reported being addicted to more substances than women who had not been sexually traumatized (N = 74), despite the fact that the two groups did not differ on the number of substances used. Differences in the self-reported level of substance abuse was corroborated with external evidence of group differences in substance abuse severity. Women with a history of sexual trauma, compared to women without such a history, were admitted to the hospital or emergency room more often for health issues related to their substance use and were more likely to be negligent in caring for their children because of their drug use. We also found evidence to suggest that there are differences in treatment success between the two groups; women with a history of sexual trauma reported having been to substance abuse treatment programs more often than women without such a history. These findings are discussed in light of the particular treatment needs of women with a history of sexual trauma.