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Background: The 16-item Vitamin D Status Predictor (VDSP) questionnaire helps to identify, without resorting to a blood test, older adults with low vitamin D concentrations. Our objective was to determine whether a self-administered VDSP was concordant with the VDSP administered by a physician, and to examine the concordance of every single item of the VDSP. Methods: A total of 349 older in- and outpatients (mean, 83.2±7.2years; 59% female) were consecutively recruited in the geriatric ward of the University Hospital of Angers, France. All participants completed a self-administered VDSP questionnaire (self-VDSP) in paper format composed of 17 items exploring age, gender, general condition, nutrition, vision, mood, cognition, gait and falls, and osteoporosis. All participants underwent subsequently a full clinical examination by a physician exploring the same areas (rater-VDSP). Results: The agreement between the self-VDSP and the rater-VDSP was almost perfect for the probability of having low vitamin D concentrations, regardless of the definition used (i.e., ≤25, ≤50 or ≤75 nmol/L). The agreements between physicians’ and patients’ responses were significant for every single VDSP item. The agreement was fair to perfect for all items, except for cognitive disorders, undernutrition and polymorbidity (poor agreement). Conclusions: Older adults are able to evaluate their own probabilities of severe vitamin D deficiency, deficiency and insufficiency. A self-questionnaire may promote the use of the VDSP tool in this population, and help clinicians in decisions to supplement their patients in a reasoned way. [ABSTRACT FROM AUTHOR]

The study investigated two followership behaviors, followers’ active engagement and followers’ independent critical thinking, and their relationship with job satisfaction in a sample of nurses. In addition, the study also considered a number of control variables and classical job demands and job resources—workload and emotional dissonance for job demands, and meaningful work for job resources—which have an impact on well-being at work. A paper-and-pencil questionnaire was administered to 425 nurses in an Italian hospital, and a hierarchical multiple regression was used to test the hypotheses. In addition to the job demands and job resources considered, followers’ active engagement had a significant impact on job satisfaction. Moreover, it showed a significant linear and curvilinear relationship with the outcome variable. Followers’ independent critical thinking has a non significant relationship with job satisfaction, confirming the mixed results obtained in the past for this dimension. These findings bore out the importance of analyzing followers’ behaviors as potential resources that people can use on the job to increase their own well-being. Looking at followers not just as passive recipients but as active and proactive employees can also benefit the organization. [ABSTRACT FROM AUTHOR]

In this paper we address the problem of automated grading of invasive breast carcinoma through the encoding of histological images as VLAD (Vector of Locally Aggregated Descriptors) representations on the Grassmann manifold. The proposed method considers each image as a set of multidimensional spatially-evolving signals that can be efficiently modeled through a higher-order linear dynamical systems analysis. Subsequently, each H&E (Hematoxylin and Eosin) stained breast cancer histological image is represented as a cloud of points on the Grassmann manifold, while a vector representation approach is applied aiming to aggregate the Grassmannian points based on a locality criterion on the manifold. To evaluate the efficiency of the proposed methodology, two datasets with different characteristics were used. More specifically, we created a new medium-sized dataset consisting of 300 annotated images (collected from 21 patients) of grades 1, 2 and 3, while we also provide experimental results using a large dataset, namely BreaKHis, containing 7,909 breast cancer histological images, collected from 82 patients, of both benign and malignant cases. Experimental results have shown that the proposed method outperforms a number of state of the art approaches providing average classification rates of 95.8% and 91.38% with our dataset and the BreaKHis dataset, respectively. [ABSTRACT FROM AUTHOR]

Introduction: Globally, life expectancy together with multimorbidity and chronic diseases are increasing. This leads to a growing demand for care and hence for healthcare personnel and nurses. To meet this demand, healthcare workers from abroad are increasingly hired. The nurses’ workplace in general is characterized by physically and psychologically demanding tasks, while that of migrant and minority nurses is additionally characterized by discriminatory practices. The present knowledge about the health of migrant and minority nurses and the terminology in this context are diverse. Thus, the purpose of this review is to systematically identify and synthesize international publications that explicitly focus on migrant nurses’ health. Materials and methods: A systematic review of relevant studies was undertaken using the databases Medline, PsycINFO, CINAHL and Web of Science. The screening process was conducted in several phases. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines while the methodological quality assessment of the included papers was performed with the Mixed Method Appraisal Tool (MMAT). Results: Out of 11,599 citations initially obtained, 14 empirical studies were included in the final synthesis. The methodological quality of the empirical studies and reviews was diverse. The majority of the studies were conducted in the US and the nurses under study migrated from countries like the Philippines, India, Europe, and Africa. Among migrant nurses of different origins, there are differences in their physiological responses to stress. Migrant nurses and native nurses differ in reporting work-related injuries. Discussion: Migrant and minority nurses are at high risk of work-related injuries and discrimination than native or majority nurses. However, mixed results were obtained, namely that the reported health of migrant nurses either improves over time or it decreases. This review revealed that discrimination is the leading cause of impaired health amongst migrant and minority nurses. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is highly infectious and one of the leading killers globally. Several studies from sub-Saharan Africa highlight health systems challenges that affect ability to cope with existing disease burden, including TB, although most of these employ survey-type approaches. Consequently, few address community or patient perspectives and experiences. At the same time, understanding of the mechanisms by which the health systems challenges translate into seeking or avoidance of formal health care remains limited. This paper applies the notion of human agency to examine the ways people who have symptoms suggestive of TB respond to and deal with the symptoms vis-à-vis major challenges inherent within health delivery systems. Empirical data were drawn from a qualitative study exploring the ways in which notions of masculinity affect engagement with care, including men’s well-documented tendency to delay in seeking care for TB symptoms. The study was carried out in three high-density locales of urban Blantyre, Malawi. Data were collected in March 2011 –March 2012 using focus group discussions, of which eight (mixed sex = two; female only = three; male only = three) were with 74 ordinary community members, and two (both mixed sex) were with 20 health workers; and in-depth interviews with 20 TB patients (female = 14) and 20 un-investigated chronic coughers (female = eight). The research process employed a modified version of grounded theory. Data were coded using a coding scheme that was initially generated from the study aims and subsequently progressively amended to incorporate concepts emerging during the analysis. Coded data were retrieved, re-read, and broken down and reconnected iteratively to generate themes. A myriad of problems were described for health systems at the primary health care level, centring largely on shortages of resources (human, equipment, and drugs) and unprofessional conduct by health care providers. Participants consistently pointed out how the problems could drive patients from promptly reporting symptoms at primary healthcare centres. The accounts suggest that in responding to illness symptoms including those suggestive of TB, patients navigate their options taking into cognisance past and current experiences with formal health systems. Understanding and factoring in the mediating role of such ‘agency’ is critical when implementing efforts to promote timely response to TB-suggestive symptoms. [ABSTRACT FROM AUTHOR]