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Association of Burnout and Intention‐To‐Leave the Job With Objective Nursing Workload and Nursing Working Environment: A Cross‐Sectional Study Among Intensive Care Nurses
No full textInternational audienceAim - The objectives of this study were to determine the prevalence of burnout risk and intention-to-leave among intensive care unit (ICU) nurses and analyse the association of these with workload and work environment. Design - A cross-sectional survey of nurses working in ICUs was conducted in France between 15 January 2024 and 15 April 2024 alongside a longitudinal assessment of workload during the same period. Methods - ICU nurse workload was assessed using the Nursing Activities Score (NAS). The risk of burnout was assessed using the Maslach Burnout Inventory scale and intention-to-leave the hospital was assessed with a binary question. A total of 1271 nurses working in 61 intensive care units completed the questionnaire and 14,134 NAS per patient and 1885 NAS per nurse were included in the study. Results - The median overall of burnout by hospital site was 64.7% [P25: 53.3-P75: 72.7] for the broad definition and a median of 20.7% [13.3-27.3] of ICU nurses reported an intent-to-leave their job. The median overall NAS score per nurse was 135.9% [121.4-156.9] and the prevalence of NAS scores exceeding 100% per nurse was 73.9% [62.8-80.3]. A significant association was found between nurses working in an ICU with a better work environment and all dimensions of burnout as well as the intention-to-leave the job. A prevalence in the hospital site of NAS scores exceeding 100% per nurse below the median was associated with a lower burnout (OR = 0.69, 95% CI: 0.50-0.88 for broad definition) and intention-to-leave the job (OR = 0.68, 95% CI: 0.50-0.92). Conclusion - This study found significant associations between burnout and the intention to leave the job for nurses in ICUs, mainly due to a better work environment and, to a lesser extent, a lower workload for nurses. Implications for the profession and/or patient care - In an era of nurse shortages and absenteeism, it is crucial for institutions to retain their nursing staff. Our results should encourage hospital managers to take action to improve the ICU work environment and keep ICU workloads manageable to decrease burnout and the intention-to-leave the job among ICU nurses. Reporting method - This article follows the STROBE guidelines for the reporting of cross-sectional studies. Patient or public contribution - No patient or public contribution
Pre- and post-harvest temperatures influence the germination response to supra-optimal temperature in contrasting tomato (Solanum lycopersicum) MAGIC genotypes
No full textInternational audienceSeeds rely on temperature to adjust their germination timing by modulating primary and secondary dormancy. The knowledge regarding an intraspecific variation in the germination responses to supra-optimal temperatures during imbibition within the Solanum lycopersicon species and its relation with pre-and post-harvest environments is limited. Here, we studied the impact of imbibition at 35°C in 17 genotypes selected from a multiparent advanced generation intercross (MAGIC) population. We discovered a high genetic variability in the germination responses to heat, leading to thermotolerance, thermoinhibition or thermodormancy with different depths. While thermodormancy appeared more profound than primary dormancy, there was no correlation between the deepness of primary and thermodormancy. Post-harvest treatments influenced considerably germination at supra-optimal temperatures. Dry storage beyond the apparent loss of primary dormancy led to an increased proportion of thermotolerant or thermoinhibited seeds at the expense of thermodormancy in a genotype-dependent manner, thereby revealing cryptic genetic variation. Prolonged cold imbibition also led to increased thermodormancy in genotypes that produced thermotolerant and thermoinhibited seeds. The thermal history before and after flowering influenced primary dormancy and the germination response to heat during imbibition in a genotype-dependent manner, with high temperatures leading to increased thermotolerance or thermoinhibition at the expense of thermodormancy, suggesting transgenerational plasticity despite the domestication of the species. The high potential of the MAGIC population for quantitative trait loci mapping and causal polymorphism identification will be helpful in deciphering the regulatory mechanisms that lead to the plasticity of thermoinhibition or thermodormancy, as well as their connection to the parental environment
Research culture influences in health and biomedical research: Rapid scoping review and content analysis
No full textInternational audienceBackground: Research culture is strongly influenced by academic incentives and pressures such as the imperative to publish in academic journals, and can influence the nature and quality of the evidence we produce.Objective: The purpose of this rapid scoping review is to capture the breadth of differential pressures and contributors to current research culture, drawing together content from empirical research specific to the health and biomedical sciences. Study design and setting: PubMed and Web of Science were searched for empirical studies of influences and impacts on health and biomedical research culture, published between January 2012 and April 2024. Data charting extracted the key findings and relationships in research culture from included papers such as workforce composition; equitable access to research; academic journal trends, incentives, and reproducibility; erroneous research; questionable research practices; biases vested interests; and misconduct. A diverse author network was consulted to ensure content validity of the proposed framework of i) inclusivity, ii) transparency, iii) rigor, and iv) objectivity.Results: A growing field of studies examining research culture exists ranging from the inclusivity of the scientific workforce, the transparency of the data generated, the rigor of the methods used and the objectivity of the researchers involved. Figurative diagrams are presented to storyboard the links between research culture content and findings. Conclusion: The wide range of research culture influences in the recent literature indicates the need for coordinated and sustained research culture conversations. Core principles in effective research environments should include inclusive collaboration and diverse research workforces, rigorous methodological approaches, transparency, data sharing, and reflection on scientific objectivity
A Survey on Recent Advances in Self-Organizing Maps
No full textSelf-organising maps are a powerful tool for cluster analysis in a wide range of data contexts. From the pioneer work of Kohonen, many variants and improvements have been proposed. This review focuses on the last decade, in order to provide an overview of the main evolution of the seminal SOM algorithm as well as of the methodological developments that have been achieved in order to better fit to various application contexts and users' requirements. We also highlight a specific and important application field that is related to commercial use of SOM, which involves specific data management
Hospital outbreak of NDM-producing Klebsiella pneumoniae in a surgical intensive care unit: sink traps as the causing source of epidemic strain resurgence
No full textInternational audienceWe report the management of a New Delhi metallo-β-lactamase-producing Klebsiella pneumoniae outbreak in a surgical intensive care unit over 1 year. New Delhi metallo-β-lactamase-producing Enterobacterales were isolated from sink traps. The installation of new sink traps closed the outbreak. Environmental reservoirs should be considered for any persistent carbapenemase-producing Enterobacterales outbreak
Modélisation des pollutions diffuses d’origine agricole sur le bassin Seine-Normandie: Actualisation sur la période 2015-2023 de la base de données ARSEINE caractérisant les dynamiques des systèmes de cultureEvolution des systèmes de production agricoles de 2000 à 2020
No full textFactors affecting investments in environmental assets by agricultural machinery cooperatives (CUMAs): Evidence from France
No full textInternational audienceAlthough cooperatives are major actors in the transformation of agricultural systems, very little attention has been paid to the conditions that facilitate or hinder their involvement in the sustainable transition. Drawing on theoretical and empirical approaches, we analyze the effect of social capital on the propensity and proportion of investment in environmental assets in the case of agricultural machinery cooperatives (CUMAs) in France. The number of producers within their CUMA is used as a proxy of the bonding social capital and the CUMA's relationships with external organizations as a proxy of the bridging social capital. Our results show a nonmonotonic relationship between the proxies of social capital and investment in environmental assets by CUMAs. However, the effect differs depending on the subdimension of social capital considered. Interestingly, our results show that the effect of social capital within CUMAs remains even when the cooperatives carry out investment renewals that involve less risk for members
Results of AFU-GETUG-20: A randomised phase 3 trial of adjuvant androgen deprivation therapy with leuprorelin acetate after radical prostatectomy in patients with high-risk localized prostate cancer
No full textInternational audienceBackground: After radical prostatectomy (RP), men with an undetectable PSA and specific features (extracapsular extension, seminal vesicle involvement, high Gleason score) are at risk of recurrence. No randomized prospective study has been published with LH-RH agonists in the PSA era. AFU-GETUG-20 is a phase III randomised, open, multicenter trial, designed to evaluate the benefit of adjuvant ADT with leuprorelin acetate for 24 months after radical prostatectomy in patients with high risk of recurrence. Methods: Patients with high-risk features (postoperative Gleason score > 7, or ≥ 7 with presence of high-grade Gleason patterns, or pT3b), R0, N0 or Nx, M0, and postoperative PSA < 0.1 ng/mL after RP were eligible. Patients were randomized 1:1 to leuprorelin acetate for 24 months vs observation. The primary endpoint was metastases-free survival (MFS). Secondary endpoints included overall survival, disease-specific survival, PSA recurrence-free survival, and quality of life. Originally 700 patients (350 in each arm) and 250 events were required to detect an improvement of MFS with a HR of 0.80 with a bilateral Logrank test with α= 0.05 and β= 0.20. An interim analysis was planned to test the null hypotheses at the 125th event (50% of events) but was eventually held given the low accrual rate and the accrual was stopped after 325 patients had been accrued. Results: Of 325 patients enrolled, 322 are included in the ITT population. 160 were randomized to the Leuprorelin arm and 162 to the observation arm. The median age was 64.7 years [range, 46-77 years]. The median follow-up is 96.1 months [93.6-106.1] IC95% in the leuprorelin arm and 97.2 months [91.8-101.4] IC95% in the surveillance arm. There was no statistically significant difference between arms for MFS (HR = 0.63 [0.30-1.30] 95%CI; p-= 0.204). Similar results were found for PSA relapse-free survival (HR = 0.74 [0.47-1.16]; p = 0 .187), overall survival (HR = 1.24 [0.56-2.76; p = 0.596), and specific survival (HR = 0.57 [0.10-3.17]; p = 0.512). Patients in the leuprorelin arm reported poorer HRQoD on EORTC QLQ-C30 global health scales, social function scale, and specific symptoms (fatigue, pain, dyspnoea, and insomnia). Post-hoc contrast analysis showed a difference between the groups during the treatment period. The two groups returned to comparable levels during follow-up (M36 and M48). Conclusions: Using 2 years of ADT after RP in high-risk patients with an undetectable post-operative PSA did not significantly improve MFS in AFU-GETUG-20. That the trial only accrued about half of the planned patients is the main limitation. The limited number of observed metastatic events in this population, although with a long follow-up, emphasizes the need to identify better biomarkers predicting for relapse to select candidate patients for the next generation of trials. Clinical trial information: EudraCT #:2010-022037-29 UC-0160/100
Genome-wide identification of novel flagellar motility genes in Pseudomonas syringae pv. tomato DC3000
No full textInternational audiencePseudomonas syringae pv. tomato DC3000 ( Pst DC3000) is a plant pathogenic bacterium that possesses complicated motility regulation pathways including a typical chemotaxis system. A significant portion of our understanding about the genes functioning in Pst DC3000 motility is based on comparison to other bacteria. This leaves uncertainty about whether gene functions are conserved, especially since specific regulatory modules can have opposite functions in sets of Pseudomonas . In this study, we used a competitive selection to enrich for mutants with altered swimming motility and used random barcode transposon-site sequencing (RB-TnSeq) to identify genes with significant roles in swimming motility. Besides many of the known or predicted chemotaxis and motility genes, our method identified PSPTO_0406 ( dipA ), PSPTO_1042 ( chrR ) and PSPTO_4229 (hypothetical protein) as novel motility regulators. PSPTO_0406 is a homolog of dipA , a known cyclic di-GMP degrading enzyme in P. aeruginosa . PSPTO_1042 is part of an extracytoplasmic sensing system that controls gene expression in response to reactive oxygen species, suggesting that PSPTO_1042 may function as part of a mechanism that enables Pst DC3000 to alter motility when encountering oxidative stressors. PSPTO_4229 encodes a protein containing an HD-related output domain (HDOD), but with no previously identified functions. We found that deletion and overexpression of PSPTO_4229 both reduce swimming motility, suggesting that its function is sensitive to expression level. We used the overexpression phenotype to screen for nonsense and missense mutants of PSPTO_4229 that no longer reduce swimming motility and found a pair of conserved arginine residues that are necessary for motility suppression. Together these results provide a global perspective on regulatory and structural genes controlling flagellar motility in Pst DC3000