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Objective: Compassion and physician well-being are two key components related to quality care in health including emergency medicine. The objective of this study was to explore the impact of compassion in care on the well-being of emergency physicians. We conducted a scoping review to explore the impact of provision of compassionate care by emergency physicians on their well-being and subconcepts. Methods: Four electronic databases and grey literature were searched to find evidence related to compassion, empathy, self-compassion, and their impact on emergency physicians’ well-being. Following title and abstract review, two reviewers independently screened full-text articles, and extracted data. Data were presented using descriptive statistics and a narrative analysis. Results: A total of 803 reports were identified in databases. Three articles met eligibility criteria for data extraction. None directly examined compassion and well-being. Included studies addressed empathy and burnout in emergency medicine professionals. Conclusion: No high-quality evidence could be found on the topic in the population of interest. Literature related to the topic of compassion in physicians, especially in emergency physicians, a field known for its high demand and stress levels, is currently scarce and additional evidence is needed to better describe and understand the association between physicians’ compassion and well-being.

The COVID-19 crisis has substantial consequences for entrepreneurs. Specifically, our model assumes that the task environment turbulence – changing employment rates within industries and geographic locations – forces entrepreneurs to adapt and change their work organization which, in turn, increases their stress and reduces their wellbeing. In building on the conservation of resource theory, we posit that resources will have a positive effect on stress and wellbeing, whereas coping strategies will have either positive or negative effects depending on the type of strategy used. We tested our model on a sample of 496 entrepreneurs. Our results demonstrate the strong effect of environmental turbulence on changes in work organization and, ultimately, the stress and wellbeing of entrepreneurs. Avoidance-oriented and task-oriented coping strategies are both important in reducing stress and improving wellbeing, while emotion-oriented coping has a negative impact on stress. Having access to relational resources reduces stress and improves wellbeing, and access to organizational resources reduces stress and positively moderates the negative effect of stress on wellbeing.

Diversity within microglia, the resident brain immune cells, is reported. Whether microglial subsets constitute different subtypes with intrinsic properties and unique functions has not been fully elucidated. Here, we describe a microglial subtype characterized by the expression of the enzyme Arginase-1, i.e.Arg1+microglia, which is found predominantly in the cholinergic neuron-rich forebrain region during early postnatal development. Arg1+microgliacontain cellular inclusions and exhibit a distinct molecular signature including upregulation of genes such as Apoe, Clec7a, Igf1, Lgals3and Mgl2. Arg1-knockout in microglia results in a deficient cholinergic innervation along with impaired dendritic spine maturation in the hippocampus where cholinergic neurons project, impaired long-term potentiation and cognitive behavioural deficiencies in female mice. Our results expand on microglia diversity and provide insights into distinctive spatiotemporal functions exerted by microglial subtypes.

Introduction Indigenous peoples in Canada face a disproportionate burden of diabetes-related foot complications (DRFC), such as foot ulcers, lower extremity amputations (LEA), and peripheral arterial disease. This scoping review aimed to provide a comprehensive understanding of DRFC among First Nations, Métis, and Inuit peoples in Canada, incorporating an equity lens Methods A scoping review was conducted based on Arksey and O’Malley refined by the Joanna Briggs Institute. The PROGRESS-Plus framework was utilized to extract data and incorporate an equity lens. A critical appraisal was performed, and Indigenous stakeholders were consulted for feedback. We identified the incorporation of patient-oriented/centered research (POR). Results Of 5,323 records identified, 40 studies were included in the review. The majority of studies focused on First Nations (92%), while representation of the Inuit population was very limited populations (< 3% of studies). LEA was the most studied outcome (76%). Age, gender, ethnicity, and place of residence were the most commonly included variables. Patient-oriented/centered research was mainly included in recent studies (16%). The overall quality of the studies was average. Data synthesis showed a high burden of DRFC among Indigenous populations compared to non-Indigenous populations. Indigenous identity and rural/remote communities were associated with the worse outcomes, particularly major LEA. Discussion This study provides a comprehensive understanding of DRFC in Indigenous peoples in Canada of published studies in database. It not only incorporates an equity lens and patient-oriented/centered research but also demonstrates that we need to change our approach. More data is needed to fully understand the burden of DRFC among Indigenous peoples, particularly in the Northern region in Canada where no data are previously available. Western research methods are insufficient to understand the unique situation of Indigenous peoples and it is

Evidence points out that increasing plant productivity associated with greater erect shrub abundance alters soil organic carbon (SOC) stocks in the Arctic. However, the underlying plant economic traits remain poorly examined, which limits our understanding of plant–environment interactions driving tundra carbon cycling. We explored how erect shrub abundance leads to SOC variation in a High Arctic tundra (Bylot Island, Nunavut, Canada), where the only erect shrub, Salix richardsonii, has settled along currently active and abandoned channel zones of alluvial fans. The effects of vegetation and local environmental changes on SOC were evaluated through a paired sampling of soil materials and plant aboveground functional traits associated with plant carbon supply and nutrient demand processes. The occurrence of S. richardsonii, characterized by a tenfold increase in aboveground biomass, induced a 28% increase in SOC compared to adjacent plots dominated by prostrate shrubs and graminoids. Yet, this vegetation effect was solely observed along active channels, where higher SOC was associated with greater leaf and stem biomass. A path analysis showed that shrub leaf area index and total leaf nutrient content best represented plant carbon supply and nutrient demand dynamics, respectively, and jointly regulated SOC variation. This study underscores that vegetation structural changes associated with increasing erect shrub abundance in the Arctic can promote soil organic carbon storage, but that this pattern may be mediated by strong plant–environment interactions. Accounting for changes in functional traits driving plant carbon supply and nitrogen demand proves important for a better mechanistic understanding of how shrubification impacts tundra carbon cycling.

BACKGROUND: The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs. METHODS: The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity. RESULTS: Among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients' needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in

Background Most research on the Personality Inventory for DSM-5 (PID-5) was conducted with self-reports. One of the specific areas for which a multimethod design has yet to be implemented is for the PID-5's associations with aggression. The main objectives of this study were to (a) compare the PID-5 associations with self-reported and file-rated aggression, (b) compare these associations between women and men, and (c) identify the relative importance of PID-5 facet predictors. Methods A sample of outpatients with personality disorder (N = 285) was recruited in a specialized public clinic to complete questionnaires, and a subsample was assessed for file-rated aggression (n = 227). Multiple regression analyses were performed with PID-5 facets as statistical predictors but using distinct operationalizations of aggression (self-reported vs. file-rated). Moderation analyses were performed to identify the moderating effect of biological sex. Dominance analyses were computed to identify the relative importance of predictors. Results PID-5 facet predictors of self-reported and file-rated aggression were very consistent in both conditions. However, the amount of explained variance was reduced in the latter case (from 39% to 14%), especially for women (from 40% to 2%). The most important predictors were Hostility, Risk Taking, and Callousness. Conclusion Pertaining to the statistically significant facets associated with aggression, strong evidence of multimethod replication was found. The women-men discrepancies were not most obvious in their specific associations with aggression, but rather in their amount of explained variance, maybe reflecting examiners' or patients' implicit biases, and/or different manifestations of aggression between women and men.

Purpose A career in entrepreneurship is stressful, especially during the start-up phase. Training programs for these nascent entrepreneurs are designed to improve entrepreneurial competencies and, more generally to generate learnings. Although learning outcomes can reduce stress, the conditions under which this can happen are not fully understood. The study looks particularly at the effect of learning, interaction with other participants and gender. Design/methodology/approach A six-month three-wave longitudinal study of 120 nascent entrepreneurs has been conducted to investigate the before-and-after effects of training on stress reduction. The training is specially designed to develop competencies, share knowledge about business creation and support the development of the project, not to reduce per se stress. Findings The training has no direct effect on stress levels. However, results indicate that interacting with others has a positive moderating effect on training as stress reduction, just as gender has. Specifically, women reduce their stress through training while men see theirs increasing. The authors conclude that breaking isolation through training is a relevant way to reduce entrepreneurial stress for nascent entrepreneurs. Research limitations/implications Training programs offer different ways to deliver the learning content (online, in cohorts, in the continuous entrance, etc.). The findings of this study suggest ensuring that the participants will have opportunities to interact with others as it reduces the stress on nascent entrepreneurs. Nevertheless, the authors cannot demonstrate that this has a long-term effect as our timeframe is limited to six months. Originality/value This research investigates the stress-reduction effect of training, which is not a common outcome studied related to training. This highlights the importance of looking at other more distal outcomes as nascent entrepreneurs may seek other peripheral outcomes from training, like se

The Alternative Model for Personality Disorders (AMPD), included in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) and the World Health Organization's International Classification of Diseases (11th ed.; ICD-11) are, respectively, hybrid categorical-dimensional and dimensional frameworks for personality disorders (PDs). Both models emphasize personality dysfunction and personality traits. Previous studies investigating the links between the AMPD and ICD-11, and self-reported physical aggression have mostly focused on traits and did not take into account the potential interaction between personality dysfunction and traits. Thus, the aim of this study is to identify dysfunction*trait interactions using regression-based analysis. Outpatients with personality disorder from a specialized public clinic (N = 285) and community participants (N = 995) were recruited to complete self-report questionnaires. Some small-size, albeit significant and clinically/conceptually meaningful personality dysfunction*trait interactions were found to predict physical aggression in both samples. Interaction analyses might further inform, to some degree, about the current discussion pertaining to the potential redundancy between dysfunction and traits, the optimal personality dysfunction structure (in the case of the AMPD), as well as clinical assessment based on AMPD/ICD-11 PD frameworks.

Background: There have been multiple attempts to try to parse out heterogeneity within borderline pathology by identifying patient subtypes; thus far, these works have yielded few consistent results. Recent developments in the operationalization of borderline pathology may provide new opportunities to identify clinically and conceptually meaningful subgroups of patients. The Alternative DSM-5 Model for Personality Disorders (AMPD) offers a categorical-dimensional operationalization of Borderline personality disorder (BPD) that has yet to be tested for identification of patient subgroups. The purpose of the present study is to test whether the combination of the Criterion A elements (pertaining to level of severity) and the seven pathological facets from Criterion B that define BPD in the AMPD can yield meaningful patient profiles. Methods: A total of 211 outpatients from a specialized PD treatment program (133 women, Mage = 33.66, SD = 10.97) were selected based on the presence of at least moderate borderline pathology according to cutoffs recently proposed for the Borderline Symptom List-23. Valid Criterion A (Self and Interpersonal Functioning Scale) and B (Personality Inventory for DSM-5 Faceted Brief Form) self-reports were administered to measure elements and facets that define BPD in the AMPD model; these variables were used as indicators in a latent profile analysis (LPA). Results: The optimal solution generated by LPA yielded four distinct profiles: (a) Borderline traits; (b) Moderate pathology with Impulsivity; (c) Moderate pathology with Identity problems and Depressivity; and (d) Severe pathology. Clinically meaningful distinctions emerged among profiles on AMPD indicators and external variables relevant to PD, especially aggression and impulsivity. Conclusions: Profiles reflected both the “severity” and “style” components imbedded within Criterion A and B of the AMPD, as they were mainly distinguished by a continuum of severity but also by some meaningfu

Background: The 11th version of the World Health Organization's International Classification of Diseases (ICD-11) has adopted a dimensional approach to personality disorder (PD) nosology. Notably, it includes an assessment of PD degree of severity, which can be classified according to five categories. To date, there is no gold standard measure for assessing degree of PD severity based on the ICD-11 model, and there are no empirically-based anchor points to delineate the proposed categories. With the operationalization of PD degrees of severity in the ICD-11 PD model now being closely aligned with Criterion A of the DSM-5 Alternative Model for Personality Disorders (AMPD), sharing a focus on self and interpersonal dysfunction, self-report instruments developed for the latter model might prove useful as screening tools to determine degrees of severity in the former.Methods: The Self and Interpersonal Functioning Scale, a brief validated self-report questionnaire originally designed to assess level of personality pathology according to the AMPD framework, was used to derive anchor points to delineate the five severity degrees from the ICD-11 PD model. Data from five clinical and non-clinical samples (total N = 2,240) allowed identifying anchor points for classification, based on Receiver Operating Characteristic curve analysis, Latent Class Analysis, and data distribution statistics. Categories were validated using multiple indices pertaining to externalizing and internalizing symptoms relevant to PD.Results: Analyses yielded the following anchor points for PD degrees of severity: No PD = 0–1.04; Personality Difficulty = 1.05–1.29; Mild PD = 1.30–1.89; Moderate PD = 1.90–2.49; and Severe PD = 2.50 and above. A clear gradient of severity across the five categories was observed in all samples. A high number of significant contrasts among PD categories were also observed on external variables, consistent with the ICD-11 PD degree of severity operationalization.Conclusions

The majority of variation in six traits critical to the growth, survival and reproduction of plant species is thought to be organised along just two dimensions, corresponding to strategies of plant size and resource acquisition. However, it is unknown whether global plant trait relationships extend to climatic extremes, and if these interspecific relationships are confounded by trait variation within species. We test whether trait relationships extend to the cold extremes of life on Earth using the largest database of tundra plant traits yet compiled. We show that tundra plants demonstrate remarkably similar resource economic traits, but not size traits, compared to global distributions, and exhibit the same two dimensions of trait variation. Three quarters of trait variation occurs among species, mirroring global estimates of interspecific trait variation. Plant trait relationships are thus generalizable to the edge of global trait-space, informing prediction of plant community change in a warming world.

This study focuses on whether a mentor can facilitate the development of entrepreneurial self-efficacy particularly with regard to opportunity recognition (ESE-OR) for novice entrepreneurs and whether their level of learning goal orientation (LGO) has a moderating effect. Based on a sample of 219 mentees and a longitudinal follow-up for 106 of these respondents, the results show that mentoring supports the development of ESE-OR, but only for low LGO mentees. Furthermore, the effect of mentoring on ESE-OR for low LGO mentees is ephemeral as it decreases once the relationship ends. This suggests the need for long-term support in order to maintain their ESE-OR high throughout the entrepreneurial endeavour. At the opposite end, high-LGO mentees see their ESE-OR slightly decline in an intense mentoring relationship suggesting that mentoring helps to adjust ESE-OR to a more appropriate level for novice entrepreneurs. © The Author(s) 2020.

BACKGROUND: Frontotemporal dementia is a heterogenous neurodegenerative disorder, with about a third of cases being genetic. Most of this genetic component is accounted for by mutations in GRN, MAPT, and C9orf72. In this study, we aimed to complement previous phenotypic studies by doing an international study of age at symptom onset, age at death, and disease duration in individuals with mutations in GRN, MAPT, and C9orf72. METHODS: In this international, retrospective cohort study, we collected data on age at symptom onset, age at death, and disease duration for patients with pathogenic mutations in the GRN and MAPT genes and pathological expansions in the C9orf72 gene through the Frontotemporal Dementia Prevention Initiative and from published papers. We used mixed effects models to explore differences in age at onset, age at death, and disease duration between genetic groups and individual mutations. We also assessed correlations between the age at onset and at death of each individual and the age at onset and at death of their parents and the mean age at onset and at death of their family members. Lastly, we used mixed effects models to investigate the extent to which variability in age at onset and at death could be accounted for by family membership and the specific mutation carried. FINDINGS: Data were available from 3403 individuals from 1492 families: 1433 with C9orf72 expansions (755 families), 1179 with GRN mutations (483 families, 130 different mutations), and 791 with MAPT mutations (254 families, 67 different mutations). Mean age at symptom onset and at death was 49·5 years (SD 10·0; onset) and 58·5 years (11·3; death) in the MAPT group, 58·2 years (9·8; onset) and 65·3 years (10·9; death) in the C9orf72 group, and 61·3 years (8·8; onset) and 68·8 years (9·7; death) in the GRN group. Mean disease duration was 6·4 years (SD 4·9) in the C9orf72 group, 7·1 years (3·9) in the GRN group, and 9·3 years (6·4) in the MAPT group. Individual age at onset and at

Résumé Les problèmes de santé mentale en milieu de travail représentent un enjeu important pour les organismes publics, particulièrement pour les personnes travaillant dans le secteur de la santé, confrontées à de multiples changements suite à la récente réforme du système de santé québécois. Les gestionnaires doivent prendre en considération la santé mentale des employés au sein de leur organisation afin d’assurer leur santé et productivité. Ils sont donc appelés à assumer un rôle incluant la prévention (p. ex. détecter des signes avant-coureurs des problèmes de santé mentale), la gestion d’équipe (p. ex. travailler à la reconnaissance au travail) et l’accompagnement des employés dans leurs tâches lors du retour au travail après une absence maladie due à un trouble mental courant (p. ex. dépression). Bien qu’il existe une littérature foisonnante sur le rôle du gestionnaire dans la prévention des problèmes de santé mentale en milieu de travail et dans le champ de la réadaptation au travail à la suite d’une absence maladie due à un trouble mental courant, à notre connaissance peu de recherches ont été menées sur ces enjeux perçus par les gestionnaires de grandes organisations de santé. En outre, les solutions possibles n’ont pas été explorées dans ce contexte. Objectif L’objectif de l’étude est de documenter, du point de vue des gestionnaires d’une grande organisation de santé au Québec, les enjeux liés à la santé mentale et travail (de la prévention à la réadaptation) ainsi que les solutions pour y faire face. Méthode Cette recherche de nature participative consistait en des groupes de discussion avec des gestionnaires sur le thème « santé mentale et travail : enjeux et solutions ». Une analyse thématique a été réalisée. Au total, 83 gestionnaires répartis dans 10 groupes de discussion ont participé à cette étude. Résultats Des groupes de discussion, 6 grandes catégories conceptuelles ont émergé : 1) le cadre de gestion ; 2) la gestion des ressources humaines, finan

The majority of variation in six traits critical to the growth, survival and reproduction of plant species is thought to be organised along just two dimensions, corresponding to strategies of plant size and resource acquisition. However, it is unknown whether global plant trait relationships extend to climatic extremes, and if these interspecific relationships are confounded by trait variation within species. We test whether trait relationships extend to the cold extremes of life on Earth using the largest database of tundra plant traits yet compiled. We show that tundra plants demonstrate remarkably similar resource economic traits, but not size traits, compared to global distributions, and exhibit the same two dimensions of trait variation. Three quarters of trait variation occurs among species, mirroring global estimates of interspecific trait variation. Plant trait relationships are thus generalizable to the edge of global trait-space, informing prediction of plant community change in a warming world.

The majority of variation in six traits critical to the growth, survival and reproduction of plant species is thought to be organised along just two dimensions, corresponding to strategies of plant size and resource acquisition. However, it is unknown whether global plant trait relationships extend to climatic extremes, and if these interspecific relationships are confounded by trait variation within species. We test whether trait relationships extend to the cold extremes of life on Earth using the largest database of tundra plant traits yet compiled. We show that tundra plants demonstrate remarkably similar resource economic traits, but not size traits, compared to global distributions, and exhibit the same two dimensions of trait variation. Three quarters of trait variation occurs among species, mirroring global estimates of interspecific trait variation. Plant trait relationships are thus generalizable to the edge of global trait-space, informing prediction of plant community change in a warming world.

© 2020 Elsevier Inc. The many theoretical and empirical studies of work motivation to date have not fully clarified how it develops and evolves over time. We therefore investigated profiles of employees to identify their self-determination trajectories, and we examined differences among these profiles with respect to diverse predictors and outcomes. We gathered data (at 0, 6, 12, and 24 months over a two-year period) from a sample of 660 nurses employed in public health care establishments. Longitudinal growth mixture analyses (GMA) revealed three distinct trajectory profiles, characterized by Increasing, Slightly Decreasing, and Decreasing global levels of self-determination at work. Importantly, when employees perceived supervisors' transformational leadership behaviors and task-level socialization more positively, they were more likely to belong to the Increasing profile. Moreover, higher levels of affective commitment to the occupation and the organization and lower levels of intentions to leave the occupation and the organization were also associated with the Increasing profile.