Workplace violence and intentions to quit: results from a survey of London nurses

Study Objective: Work-place violence, harassment and abuse is an increasing feature of nurses’ experience of work in many countries. There is some evidence that the experience of workplace violence affects levels of job satisfaction (Hesketh et al 2003) and career decisions (e.g. Mayer et al 1999, Fernandes et al 1999). This paper reports on verbal and physical abuse by patients, relatives and carers, as well as racial and sexual harassment in Acute Hospitals in London and investigates whether workplace violence affects nurses’ intentions to leave either their current job or the nursing profession, controlling for a number of other factors that are known to affect career decisions, such as workload, pay and own health. Method: A questionnaire designed by two of the authors (Reeves and West) to assess many different aspects of nurses work life was used in a postal survey of nurses grades A to I practising in twenty London acute trusts in 2002. A total of 6,160 clinical nurses were mailed the questionnaires and 2,880 returned completed questionnaires, resulting in an overall response rate of 47%, discounting undelivered questionnaires. Respondents worked in a wide variety of clinical settings but mainly in acute medical and surgical wards. In addition to descriptive statistics, results were analysed using logistic regression with robust standard errors: the appropriate test when the dependent variable is dichotomous and the individual respondents clustered within units (nurses working within hospitals are not statistically independent). Results: Our results show high levels of racial (%), sexual (%) and other, unspecified forms of harassment (%), as well as verbal and physical abuse (14% had been physically assaulted with 5% being assaulted more than once), over the previous 6 months. A very small number (1%) reported experiencing all three forms of harassment; 12% two forms and 29% one form. Only 45% of this sample intended to stay in nursing for at least 3 years; 40% were undecided and 15% intended to leave. Logistic regression estimates showed that reported levels of abuse and harassment had a significant impact on respondents’ career intentions, even in models that controlled for known factors affecting career decisions. About 70% of our respondents reported that they had had too little training in dealing with aggressive behaviour—or none at all—but there was no statistical relationship between lack of training and reported assaults. Conclusions: The international shortage of health care workers is due at least in part to low retention rates. It is crucial to investigate nurses’ experiences of work to identify the factors that shape their career decisions. Workplace violence is increasingly acknowledged as an international, service-wide, health care problem. This paper adds to the literature that shows that workplace violence has an impact on nurses’ career decisions. The implications for managers and policy makers are that strengthening systems of security and providing nurses with training in interpersonal relationships including dealing with aggressive patients could slow nurse turnover.

The emotional structure of the advertising message in radio

Radio advertising is suffering from a remarkable crisis of creativity as it has yet not found its role in a radio model based on voice locution and information genres. This article suggests the need for implementing a peripheral or heuristic strategy to attract and hold listeners’ attention. Within this framework, the narration and scene representation are proposed as suitable persuasion techniques. The objective is to design a useful conceptual tool for an efficient creative conception of narration at the service of certain commercial strategy. First, the concept of narrative persuasion is grounded according to the possibilities of the sound code. Second, the keys of scene representation and commercial strategy (brand, product, advantage, benefit and target) within the sound message are presented. And third, these keys are articulated in a model. This model is pre-tested by means of analyzing eight different case-radio ads.

Impact of persistent substance misuse on 1-year outcome in first-episode psychosis

Background: Substance misuse is a common comorbid problem in people presenting with first-episode psychosis and is associated with a poor short-term outcome.

Aims: The aim of this study is to examine differences in baseline characteristics and 1-year outcome between individuals with first-episode psychosis who have never misused substances, those who stop misusing substances after initial presentation and those who persistently misuse substances over the 1-year assessment period.

Method: Patients were recruited to the Northern Ireland First Episode Psychosis Study (n=272). Clinical assessments were performed at baseline and at 1 year (n=194) and data were collected from the case notes.

Results: Individuals with persistent substance misuse had more severe depression, more positive symptoms, poorer functional outcome and greater rates of relapse at 1 year than those who stopped and those who had never misused substances. There were no differences in outcome between people who had never misused substances and those who stopped misusing after presentation.

Conclusions: These results support assertive intervention targeted at comorbid substance misuse in individuals with first-episode psychosis.

Bacterial polysaccharide synthesis and gene nomenclature

Gene nomenclature for bacterial surface polysaccharides is complicated by the large number of structures and genes. We propose a scheme applicable to all species that distinguishes different classes of genes, provides a single name for all genes of a given function and greatly facilitates comparative studies.

Stable Isotope Dietary Analysis of Prehistoric Populations from the Minusinsk Basin, Southern Siberia, Russia: A new chronological framework for the introduction of millet to the eastern Eurasian steppe

We report the results of stable carbon and nitrogen isotope analysis of 354 human and faunal samples from five archaeological cultures of the Minusinsk Basin, Southern Siberia – Afanasyevo, Okunevo, Andronovo, Karasuk and Tagar (ca. 2700–1 BC) – a key location in Eurasia due to its position on a northern corridor linking China and central Eurasia. The results indicate that the diet of Eneolithic to Middle Bronze Age (Afanasyevo to Andronovo) populations was primarily C3-based, with C4 plants only becoming an important component of the diet in the Late Bronze Age Karasuk and Early Iron Age Tagar cultures. Freshwater fish seems to have been an important constituent of the diets in all groups. The findings constitute the earliest concrete evidence for the substantial use of millet in the eastern Eurasian steppe. We propose that it was probably introduced from Northwestern China during the Karasuk culture at the start of the Late Bronze Age, ca. 1500 BC. We conclude with a discussion of the implications for the nature of pastoralist economies on the steppes.