Health and wellbeing of staff working at higher education institutions globally during the post-COVID-19 pandemic period: evidence from a cross-sectional study.

BACKGROUND: The ongoing global crisis of Higher Education (HE) institutions during the post-COVID-19 pandemic period has increased the likelihood of enduring psychological stressors for staff. This study aimed to identify factors associated with job insecurity, burnout, psychological distress and coping amongst staff working at HE institutions globally. METHODS: An anonymous cross-sectional study was conducted in 2023 with staff at HE institutions across 16 countries. Job insecurity was measured using the Job Insecurity Scale (JIS), burnout using the Perceived Burnout measure question, psychological distress using the Kessler Psychological Distress Scale (K10), and coping using the Brief Resilient Coping Scale. Multivariable logistic regression with a stepwise variable selection method was used to identify associations. RESULTS: A total of 2,353 staff participated; the mean age (± SD) was 43(± 10) years and 61% were females. Most staff (85%) did not feel job insecurity, one-third (29%) perceived burnout in their jobs, more than two-thirds (73%) experienced moderate to very high levels of psychological distress, and more than half (58%) exhibited medium to high resilient coping. Perceived job insecurity was associated with staff working part-time [Adjusted Odds Ratio 1.53 (95% Confidence Intervals 1.15-2.02)], having an academic appointment [2.45 (1.78-3.27)], having multiple co-morbidities [1.86 (1.41-2.48)], perceived burnout [1.99 (1.54-2.56)] and moderate to very high level of psychological distress [1.68 (1.18-2.39)]. Perceived burnout was associated with being female [1.35 (1.12-1.63)], having multiple co-morbidities [1.53 (1.20-1.97)], perceived job insecurity [1.99 (1.55-2.57)], and moderate to very high levels of psychological distress [3.23 (2.42-4.30)]. Staff with multiple co-morbidities [1.46 (1.11-1.92)], mental health issues [2.73 (1.79-4.15)], perceived job insecurity [1.61 (1.13-2.30)], and perceived burnout [3.22 (2.41-4.31)] were associated with moderate to very high levels of psychological distress. Staff who perceived their mental health as good to excellent [3.36 (2.69-4.19)] were more likely to have medium to high resilient coping. CONCLUSIONS: Factors identified in this study should be considered in reviewing and updating current support strategies for staff at HE institutions across all countries to reduce stress and burnout and improve wellbeing.

Perspectives of Mental Health Nurses About Sexual Safety in Acute Inpatient Mental Health Units.

The overall aim of this study is to explore the views of mental health nurses (MHNs) about the sexual safety of consumers receiving care in acute inpatient units. In Australia, people accessing mental health inpatient units have reported feeling unsafe while receiving care including experiences of sexual harassment and abuse from other patients. There has been no study to date that has explored the views of the MHNs providing care. An explorative descriptive qualitative study. Data were collected through semi-structured interviews involving n = 8 MHNs working on a metropolitan acute inpatient unit recruited using purposive convenience sampling. Data were analysed using thematic analysis. The findings of this study highlighted the themes of 'It's everyone's job to keep the patient safe', 'Going over expectations', 'Impact on patients' and 'Built environment'. Participants in this study believed that the sexual safety of patients in the inpatient unit is everyone's responsibility and that it was important during the admission process to ensure patients are aware of how to both seek help if needed and ensure that their actions or behaviours do not pose sexual safety concerns in others. Ensuring sexual safety in the mental health inpatient units is a complex issue that requires evidence-based multipronged interventions involving all key stakeholders within the units.

Nurses' Perspectives on the Proposed Seclusion Elimination in Mental Health Wards.

Managing consumers with challenging behaviours by way of secluding them has been practiced for centuries. Many countries have attempted to eliminate seclusion but with very limited success. The Victorian government in Australia has embarked on a plan to stop seclusion within the coming 10 years. A qualitative research design using a purposive cluster sampling technique was utilised to understand nurses' perceptions on attempts to eliminate seclusions in acute wards. Semi-structured interviews and a thematic analysis were used to reveal participants' perceptions. Analysis revealed six themes: personal views, staff skills/resources, safety concerns, stakeholders' influence, doubt about elimination and participants' recommendations. Participants were doubtful of seclusion elimination success if there were no major improvements in nurse security, infrastructure, funding and staffing. Further research is required to establish and develop effective alternatives to seclusion.

Views of Mental Health Nurses on Responding to Clinical Aggression on General Wards.

The overall aim of this study was to explore the views of mental health nurses (MHNs) about their experience of responding to workplace violence (WPV) and aggression (code greys and blacks) within acute general wards. WPV continues to pose a significant source of challenge within healthcare settings despite several initiatives that have been trialled over the years. It has the potential to impact patient care and overall staff health and well-being. Nurses play a significant role in the management of WPV; hence, it is important to understand how they respond to and manage incidents of WPV. The study design was an explorative descriptive qualitative design. Data were collected through semi-structured interviews involving n = 10 MHNs working within a mental health consultation liaison team that responds to incidents of violence and aggression (codes grey and black) in acute general wards. Participants were recruited using a convenient sampling method. Data were analysed using thematic analysis. The findings of this study highlighted the following themes: (1) Patient care (subthemes: patient frustration with hospital processes, lack of time and resources); (2) Staffing skills and confidence (subthemes: lack of adequate training, inability to intervene early and communication skills); (3) Understanding patient behaviours (subthemes: it's a psychiatry problem and zero tolerance approach). The management of WPV within acute hospital settings needs to be given due attention by healthcare services. Although a number of organisations are developing measures and guidelines to manage WPV, there is still a gap in the ability of general nursing staff to properly manage such incidences. Proper attention needs to be taken to the training of staff.

Preceptor's experience in supervising undergraduate nursing students in mental health: A qualitative study.

Preceptorship is considered an essential component in undergraduate nursing student's clinical placement, especially those in speciality units such as mental health. During the preceptorship relationship students are granted the opportunity to work alongside experienced nurses in the ward observing their interactions with patients and other professionals. In addition, students are able to build clinical confidence and competence. There is currently a gap in the literature around the preceptorship experience in the mental health clinical environment which warrants further exploration. The aim of this study was to explore the experiences of Registered Nurses precepting undergraduate nursing students during mental health clinical placements. A qualitative, exploratory approach was performed. A total of eight registered nurses working in an acute in-patient mental health unit in a large regional hospital, were recruited and interviewed using a semi-structured interview technique. Thematic analysis was utilised to analyse the data resulting in the development of four overarching themes; (1) Time consuming and additional workload, (2) creating a safe environment, (3) providing and receiving feedback and (4) precepting is not a choice, it is an expectation. The results highlighted that preceptoring students was considered to be an extra workload that required significant time and effort. Preceptors also expressed concerns about student safety, emphasised the importance of feedback and acknowledged preceptorship as an expectation of registered nurses working in mental health. These findings underscore the necessity for further research to delve deeper into the experience of preceptors in mental health settings.

A systematic review of preceptor's experience in supervising undergraduate nursing students: Lessons learned for mental health nursing.

BACKGROUND: Preceptorship in nursing has been a valued concept in nursing. Speciality area such as mental health nursing has a massive gap in research study. To develop sturdy mental health nursing workforce, it is necessary to conduct more studies. AIM: This literature review aims to explore preceptor's experience in precepting undergraduate nursing students in mental health. DESIGN: Systematic review of literature. METHODS: The systematic review was conducted from January 2021 to August 2021. Population of the studies included Registered Nurses supervising nursing students in the clinical area. Only studies conducted in English were included. A systematic search using EBSCO Host databases, CINAHL Complete, MEDLINE APA Psycinfo & APA PsycArticles, has been used in this review paper. Papers were also selected from the citation reference of included papers. The new version of the PRISMA 2020 guidelines used to represent the process of selection of papers has been incorporated as part of this review. The final set of data included 14 original papers meeting the eligibility criteria which involved quantitative (n = 5), qualitative (n = 4) and mixed-method studies (n = 5). RESULT: Results were presented under three major themes: time-consuming, lack of recognition and need extra support. Further research is required in the mental health clinical setting to effectively explore the impact of relationships between preceptors and the preceptees. CONCLUSION: Preceptors reported supervising students in the clinical area has many benefits. However, some challenges they raised were increase in workload, requiring some guidance and acknowledgement from the organization.

Factors influencing the transition and retention of mental health nurses during the initial years of practice: Scoping review.

AIM: This review aims to identify the factors influencing the transition and retention of mental health nurses during the initial years of practice, recognize gaps in the literature and propose evidence-based strategies. BACKGROUND: Mental health is a challenging specialty; recruitment, transition and retention of mental health nurses are known issues of concern. EVALUATION: The present study undertakes a scoping review to identify factors influencing the transition and retention of mental health nurses during the initial years of practice and the gaps in that research domain. A literature search was conducted using electronic databases. To gain an understanding of the topic of interest, the review of the literature extended from 2000 to 2022. KEY ISSUES: Existing evidence focuses on specific perspectives of transition. There is limited literature on factors influencing transition and retention among mental health nurses. Findings suggested that personal and professional factors could influence the transition and retention of mental health nurses during the initial years of practice. The main themes identified were personal attributes and professional factors with a number of subthemes. CONCLUSION: The scoping review identified only a few studies, which showed personal and professional factors related to the transition and retention of mental health nurses at the early stages of their career. IMPLICATIONS FOR NURSING MANAGEMENT: Potential benefits of effective transition and support with the understanding of factors influencing transition and retention of early career mental health nurses will enhance staff morale, sustainability of the workforce and better patient outcomes. Additionally, a few recommendations for nurse managers and leaders to improve transitional experiences and retention of early career nurses are highlighted.

Mental health nurses perceptions of missed nursing care in acute inpatient units: A multi-method approach.

Nurses have key roles in caring for hospitalized patients. Missed nursing care can lead to adverse outcomes, from minor discomfort to patient death. Mental health nurses have a significant role in advancing knowledge and practice due to missed, delayed, or unfinished nursing care. They are identifying, escalating, and managing warning signs of mental and physical health deterioration where the risk to patients is high in terms of compromised care quality and neglect and the evidence is scant. This study aimed to examine mental health nurses' perceptions of missed nursing care in acute mental health inpatient units in an Australian regional health service. A cross-sectional survey was undertaken using a modified Kalisch Phelan MISSCARE questionnaire and a qualitative content analysis was undertaken for narrative responses. Of 70 participants, the majority were aged 30-44 years, with >5 years of experience. The results indicated that care planning, safety audits, communication, and assessment of oral intake were perceived as care most frequently missed. Factors contributing to missed care need urgent exploration to ensure timely reduction of patient risk and enhancements to safe quality care.

Electronic Cigarettes or Vaping: Are There Any Differences in the Profiles, Use and Perceptions between a Developed and a Developing Country?

The use of electronic cigarettes or vaping is currently increasing in popularity globally. Debate continues regarding their potential role for smoking cessation. We aimed to compare the profiles, use and perceptions of using e-cigarettes amongst online forum users in a developed and a developing country. A cross-sectional survey was conducted among members of different popular online forums in Australia and Bangladesh who were current or ex-users of e-cigarettes. There were 422 study participants, 261 (62%) from Australia and 161 (38%) from Bangladesh. The mean age was 36.3 (±12) years and 83% were men. Australians were more likely to be exclusive users of e-cigarettes (70% vs. 30%, AOR 3.05 [95% CI 1.63-5.71]), but less likely to be dual users of smoking and e-cigarettes (43% vs. 57%, 0.36 [0.19-0.69]); they were also more likely to mention that the perceived reasons for using were their low cost, good taste/flavour, safety and assistance in reducing or quitting smoking (66% vs. 34%, 5.10 [2.04-12.8]), but less likely to mention a social/cool image as a reason for use (23% vs. 77%, 0.11 [0.01-0.87]) compared with Bangladeshi participants. About two-thirds of the participants in both countries perceived the use of e-cigarettes as less addictive than cigarettes and more than three-quarters perceived them as less harmful. E-cigarette users in Australia were more likely to use them to reduce or quit cigarettes compared with those in Bangladesh, and dual use was common in Bangladesh. These findings warrant the consideration of precautions for promoting e-cigarettes as a harm reduction strategy for smoking cessation in developing countries, such as Bangladesh.

Psychological impact of COVID-19 on healthcare workers: cross-sectional analyses from 14 countries.

Background: Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs. Methods: A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively. Results: A total of 2447 HCWs participated; 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs; the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20%; the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63%; the lowest rate was reported in Libya (28%) and the highest in Syria (76%). Conclusion: COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered.

Transition Experiences of Indian Nurses Into Australian Mental Health System.

INTRODUCTION: In the past decade, there has been an influx of migrant nurses from India to Australia. Migrant professionals have specific transition needs associated with working in Mental Health (MH). This study aimed to explore the transition experience of overseas trained nurses from India working in Australian MH settings. METHOD: Hermeneutic phenomenology was the methodological approach used in the study. The participants (N = 16) were overseas trained nurses from India. Data were collected through in-depth interview and analysed using thematic analysis. RESULTS: The findings resulted in the identification of the following themes: (1) Living in dual culture, (2) Loneliness, (3) Discrimination, and (4) Feeling incomplete. DISCUSSION: It is evident that the transition to work in MH in Australia was a journey of mixed experiences. While certain findings of this study are comparable with experiences of migrant nurses in other settings, it provides insight into those that are working in MH.

COVID-19: Factors associated with psychological distress, fear, and coping strategies among community members across 17 countries.

BACKGROUND: The current pandemic of COVID-19 impacted the psychological wellbeing of populations globally. OBJECTIVES: We aimed to examine the extent and identify factors associated with psychological distress, fear of COVID-19 and coping. METHODS: We conducted a cross-sectional study across 17 countries during Jun-2020 to Jan-2021. Levels of psychological distress (Kessler Psychological Distress Scale), fear of COVID-19 (Fear of COVID-19 Scale), and coping (Brief Resilient Coping Scale) were assessed. RESULTS: A total of 8,559 people participated; mean age (±SD) was 33(±13) years, 64% were females and 40% self-identified as frontline workers. More than two-thirds (69%) experienced moderate-to-very high levels of psychological distress, which was 46% in Thailand and 91% in Egypt. A quarter (24%) had high levels of fear of COVID-19, which was as low as 9% in Libya and as high as 38% in Bangladesh. More than half (57%) exhibited medium to high resilient coping; the lowest prevalence (3%) was reported in Australia and the highest (72%) in Syria. Being female (AOR 1.31 [95% CIs 1.09-1.57]), perceived distress due to change of employment status (1.56 [1.29-1.90]), comorbidity with mental health conditions (3.02 [1.20-7.60]) were associated with higher levels of psychological distress and fear. Doctors had higher psychological distress (1.43 [1.04-1.97]), but low levels of fear of COVID-19 (0.55 [0.41-0.76]); nurses had medium to high resilient coping (1.30 [1.03-1.65]). CONCLUSIONS: The extent of psychological distress, fear of COVID-19 and coping varied by country; however, we identified few higher risk groups who were more vulnerable than others. There is an urgent need to prioritise health and well-being of those people through well-designed intervention that may need to be tailored to meet country specific requirements.

Epistasis × environment interactions among Arabidopsis thaliana glucosinolate genes impact complex traits and fitness in the field.

Despite the growing number of studies showing that genotype × environment and epistatic interactions control fitness, the influences of epistasis × environment interactions on adaptive trait evolution remain largely uncharacterized. Across three field trials, we quantified aliphatic glucosinolate (GSL) defense chemistry, leaf damage, and relative fitness using mutant lines of Arabidopsis thaliana varying at pairs of causal aliphatic GSL defense genes to test the impact of epistatic and epistasis × environment interactions on adaptive trait variation. We found that aliphatic GSL accumulation was primarily influenced by additive and epistatic genetic variation, leaf damage was primarily influenced by environmental variation and relative fitness was primarily influenced by epistasis and epistasis × environment interactions. Epistasis × environment interactions accounted for up to 48% of the relative fitness variation in the field. At a single field site, the impact of epistasis on relative fitness varied significantly over 2 yr, showing that epistasis × environment interactions within a location can be temporally dynamic. These results suggest that the environmental dependency of epistasis can profoundly influence the response to selection, shaping the adaptive trajectories of natural populations in complex ways, and deserves further consideration in future evolutionary studies.

Genome Wide Association Mapping in Arabidopsis thaliana Identifies Novel Genes Involved in Linking Allyl Glucosinolate to Altered Biomass and Defense.

A key limitation in modern biology is the ability to rapidly identify genes underlying newly identified complex phenotypes. Genome wide association studies (GWAS) have become an increasingly important approach for dissecting natural variation by associating phenotypes with genotypes at a genome wide level. Recent work is showing that the Arabidopsis thaliana defense metabolite, allyl glucosinolate (GSL), may provide direct feedback regulation, linking defense metabolism outputs to the growth, and defense responses of the plant. However, there is still a need to identify genes that underlie this process. To start developing a deeper understanding of the mechanism(s) that modulate the ability of exogenous allyl GSL to alter growth and defense, we measured changes in plant biomass and defense metabolites in a collection of natural 96 A. thaliana accessions fed with 50 µM of allyl GSL. Exogenous allyl GSL was introduced exclusively to the roots and the compound transported to the leaf leading to a wide range of heritable effects upon plant biomass and endogenous GSL accumulation. Using natural variation we conducted GWAS to identify a number of new genes which potentially control allyl responses in various plant processes. This is one of the first instances in which this approach has been successfully utilized to begin dissecting a novel phenotype to the underlying molecular/polygenic basis.

The Defense Metabolite, Allyl Glucosinolate, Modulates Arabidopsis thaliana Biomass Dependent upon the Endogenous Glucosinolate Pathway.

Glucosinolates (GSLs) play an important role in plants as direct mediators of biotic and abiotic stress responses. Recent work is beginning to show that the GSLs can also inducing complex defense and growth networks. However, the physiological significance of these GSL-induced responses and the molecular mechanisms by which GSLs are sensed and/or modulate these responses are not understood. To identify these potential mechanisms within the plant and how they may relate to the endogenous GSLs, we tested the regulatory effect of exogenous allyl GSL application on growth and defense metabolism across sample of Arabidopsis thaliana accessions. We found that application of exogenous allyl GSL had the ability to initiate changes in plant biomass and accumulation of defense metabolites that genetically varied across accessions. This growth effect was related to the allyl GSL side-chain structure. Utilizing this natural variation and mutants in genes within the GSL pathway we could show that the link between allyl GSL and altered growth responses are dependent upon the function of known genes controlling the aliphatic GSL pathway.

Quantitative Variation in Responses to Root Spatial Constraint within Arabidopsis thaliana.

Among the myriad of environmental stimuli that plants utilize to regulate growth and development to optimize fitness are signals obtained from various sources in the rhizosphere that give an indication of the nutrient status and volume of media available. These signals include chemical signals from other plants, nutrient signals, and thigmotropic interactions that reveal the presence of obstacles to growth. Little is known about the genetics underlying the response of plants to physical constraints present within the rhizosphere. In this study, we show that there is natural variation among Arabidopsis thaliana accessions in their growth response to physical rhizosphere constraints and competition. We mapped growth quantitative trait loci that regulate a positive response of foliar growth to short physical constraints surrounding the root. This is a highly polygenic trait and, using quantitative validation studies, we showed that natural variation in EARLY FLOWERING3 (ELF3) controls the link between root constraint and altered shoot growth. This provides an entry point to study how root and shoot growth are integrated to respond to environmental stimuli.

Natural genetic variation in Arabidopsis thaliana defense metabolism genes modulates field fitness.

Natural populations persist in complex environments, where biotic stressors, such as pathogen and insect communities, fluctuate temporally and spatially. These shifting biotic pressures generate heterogeneous selective forces that can maintain standing natural variation within a species. To directly test if genes containing causal variation for the Arabidopsis thaliana defensive compounds, glucosinolates (GSL) control field fitness and are therefore subject to natural selection, we conducted a multi-year field trial using lines that vary in only specific causal genes. Interestingly, we found that variation in these naturally polymorphic GSL genes affected fitness in each of our environments but the pattern fluctuated such that highly fit genotypes in one trial displayed lower fitness in another and that no GSL genotype or genotypes consistently out-performed the others. This was true both across locations and within the same location across years. These results indicate that environmental heterogeneity may contribute to the maintenance of GSL variation observed within Arabidopsis thaliana.

Genetic variation in the nuclear and organellar genomes modulates stochastic variation in the metabolome, growth, and defense.

Recent studies are starting to show that genetic control over stochastic variation is a key evolutionary solution of single celled organisms in the face of unpredictable environments. This has been expanded to show that genetic variation can alter stochastic variation in transcriptional processes within multi-cellular eukaryotes. However, little is known about how genetic diversity can control stochastic variation within more non-cell autonomous phenotypes. Using an Arabidopsis reciprocal RIL population, we showed that there is significant genetic diversity influencing stochastic variation in the plant metabolome, defense chemistry, and growth. This genetic diversity included loci specific for the stochastic variation of each phenotypic class that did not affect the other phenotypic classes or the average phenotype. This suggests that the organism's networks are established so that noise can exist in one phenotypic level like metabolism and not permeate up or down to different phenotypic levels. Further, the genomic variation within the plastid and mitochondria also had significant effects on the stochastic variation of all phenotypic classes. The genetic influence over stochastic variation within the metabolome was highly metabolite specific, with neighboring metabolites in the same metabolic pathway frequently showing different levels of noise. As expected from bet-hedging theory, there was more genetic diversity and a wider range of stochastic variation for defense chemistry than found for primary metabolism. Thus, it is possible to begin dissecting the stochastic variation of whole organismal phenotypes in multi-cellular organisms. Further, there are loci that modulate stochastic variation at different phenotypic levels. Finding the identity of these genes will be key to developing complete models linking genotype to phenotype.

Meta-analysis of metabolome QTLs in Arabidopsis: trying to estimate the network size controlling genetic variation of the metabolome.

A central goal of systems biology is to develop models that are both predictive and accurately describe the biological system. One complexity to this endeavor is that it is possible to develop models that appear predictive even if they use far fewer components than the biological system itself uses for the same process. This problem also occurs in quantitative genetics where it is often possible to describe the variation in a system using fewer genes than are actually variable due to the complications of linkage between causal polymorphisms and population structure. Thus, there is a crucial need to begin an empirical investigation into the true number of components that are used by biological systems to determine a phenotypic outcome. In this study, we use a meta-analysis of directly comparable metabolomics quantitative studies using quantitative trait locus mapping and genome wide association mapping to show that it is currently not possible to estimate how many genetic loci are truly polymorphic within Arabidopsis thaliana. Our analysis shows that it would require the analysis of at least a 1000 line bi-parental population to begin to estimate how many polymorphic loci control metabolic variation within Arabidopsis. Understanding the base number of loci that are actually involved in determining variation in metabolic systems is fundamental to developing systems models that are truly reflective of how metabolism is modulated within a living organism.