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A decline in servant leadership was also demonstrated in nurses in practice greater than 10 years. Spirituality scores declined slightly in nurses' early years of practice, then rebounded and continued to progress with increased years of practice. The authors concluded that students that select nursing as a professional career may inherently possess characteristics of servant leadership and spirituality.Moral injury is a complex phenomenon characterized by spiritual, psychological, and moral distress caused by actions or acts of omission inconsistent with an individual's moral and ethical values. We present two cases from an ongoing randomized controlled trial of a spiritually integrated structured intervention delivered by chaplains for individuals suffering from moral injury. Chaplains met with Veterans for twelve 50-min sessions that each focused on a specific domain of moral injury. Participants were asked to complete validated scales assessing symptoms of moral injury and PTSD, including the PTSD Checklist for DSM-5 (PCL-5), Moral Injury Symptom Scale-Military Version Short Form, and Moral Injury Symptom Scale-Military Version Long Form. We report on two Veterans who completed the intervention and demonstrated significant improvement in moral injury and PTSD symptoms.At admission, unintentional medication discrepancies (UMDs) can occur and may led to severe adverse events. Some of them are preventable through medication reconciliation (MR). As MR is a time-consuming activity, a better identification of high-risk patients of UMDs is mandatory. The objective was to identify risk factors associated with UMDs at admission in an internal medicine department. This prospective observational study was conducted from April 2017 to June 2019. At admission, inpatients had MR to obtain a complete list of home medications. This list was compared to prescriptions made at admission. All discrepancies were classified as intentional or UMDs. Univariate and multivariate analyses to identify the risk factors associated with UMDs were performed. MR was performed on 1157 patients (70.1 ± 16.8 years old); 550 MR (47.5%) contained at least one UMD. More than half of the UMDs (n = 892, 65.6%) corresponded to drug omission. The univariate analysis showed that age (> 60 years old), "living at home", medication preparation not performed by patient, medication-intake difficulties, number of sources consulted, MR duration, presence of a high-risk drug and the number of home medications were associated with UMDs. In the multivariate analysis, adjusted on the number of sources consulted, independent risk factors were "living at home" and the number of home medications. At admission to an internal medicine department, UMDs were frequent and associated with "living at home" and poly-medication. Our findings might help physicians to identify high-risk patients of UMDs since their admission.Physical examination (PE) has always been a corner stone of medical practice. The recent advances in imaging and fading of doctors' ability in performing it, however, raised doubts on PE usefulness. Point-of-care ultrasonography (POCUS) is gaining ground in medicine with the detection of free fluids being one of its main applications. To estimate physicians' confidence and use of PE and POCUS for the detection of abdominal or pleural free fluid, we conducted a cross-sectional survey. In all, 246 internal and emergency medicine physicians answered to the survey (197 in-hospital physicians and 49 general practitioners; response rate 28.5%). Almost all declared to perform PE in case of suspected ascites or pleural effusion (88% and 90%, respectively). The highest rates of confidence were observed in conventional PE signs (91% for diminished breath sounds, 80% for dullness to thorax percussion, and 66% for abdominal flank dullness). For the remaining signs, rates of confidence were less than 53%. Physicians with > 15 years of experience and POCUS-naïve doctors reported higher confidence in PE. Most of emergency and almost half of internal medicine physicians (78% and 44%, respectively) attended a structured POCUS course. POCUS use was higher among trained physicians for both ascites (84% vs 50%, p  less then  0.001) and pleural effusion (80% vs 34%, p  less then  0.001). Similarly, higher POCUS use was observed in younger physicians. In conclusion, PE is frequently performed and rates of confidence are low for most PE signs, especially among young doctors and POCUS users. Adenosine disodium triphosphate solubility dmso This detailed inventory suggests an ongoing shift towards POCUS integration in clinical practice.Resilient readers comprehend written language despite word reading deficits. The reading resiliency framework specifies candidate protective factors hypothesized to mitigate adverse effects on reading comprehension arising from phonological decoding deficiencies and, consequently, illuminates how some individuals exhibit relative reading resiliency. A focus on relative reading resiliency involves an examination of individual strengths and weaknesses because areas of relative strength can bolster one's abilities. The ability for morphological awareness and vocabulary to be strengths or protective factors contributing to reading resiliency was explored in a sample of university students. Morphological awareness is predicted to be a particularly important skill for university students due to the complexity of texts encountered in their coursework. A measure of word-level morphological awareness was positively associated with relative reading resiliency. Furthermore, across norm-referenced and standardized high-stakes testing measures of reading comprehension, vocabulary mediated the impact of morphological awareness on comprehension after controlling for phonological decoding ability. These findings suggest that morphological awareness and vocabulary skills are important contributing factors to reading comprehension and reading resilience.

The impact of carotenoid intake on the risk of mental disorders and poor sleep quality is unclear. Thus, we sought to examine the association between carotenoid intake, mental health, and sleep quality among university students.

A total of 368 healthy university students (181 men, 49%), aged 18 to 43years, volunteered for this study. Dietary intake, physical activity, sleep quality, mental health, and body mass index (BMI) were evaluated. A multivariable logistic regression analysis test was used to estimate the odds ratio (OR) and 95% confidence interval (CI).

The mean age of the participants was 22.9 ± 3.9years and mean BMI was23.1 ± 3.8kg/m

. The students in the highest quartile of carotenoid intake had a significantly lower risk of poor sleep quality (OR = 0.19, 95% CI 0.09 to 0.40; P  < 0.001) and depression (OR = 0.27, 95% CI 0.12 to 0.59; P = 0.001). In the sex-stratified subgroup analysis, the depression risk was significant for men (OR = 0.28, 95% CI 0.07 to 0.59; P = 0.007), but not for women.