BackgroundHigh levels of work-related stress, burnout, job dissatisfaction, and poor health are common within the nursing profession. A comprehensive understanding of nurses’ psychosocial work environment is necessary to respond to complex patients’ needs. The aims of this study were threefold: (1) To retest and confirm two structural equation models exploring associations between practice environment and work characteristics as predictors of burnout (model 1) and engagement (model 2) as well as nurse-reported job outcome and quality of care; (2) To study staff nurses’ and nurse managers’ perceptions and experiences of staff nurses’ workload; (3) To explain and interpret the two models by using the qualitative study findings.MethodThis mixed method study is based on an explanatory sequential study design. We first performed a cross-sectional survey design in two large acute care university hospitals. Secondly, we conducted individual semi-structured interviews with staff nurses and nurse managers assigned to medical or surgical units in one of the study hospitals. Study data was collected between September 2014 and June 2015. Finally, qualitative study results assisted in explaining and interpreting the findings of the two models.ResultsThe two models with burnout and engagement as mediating outcome variables fitted sufficiently to the data. Nurse-reported job outcomes and quality of care explained variances between 52 and 62%. Nurse management at the unit level and workload had a direct impact on outcome variables with explained variances between 23 and 36% and between 12 and 17%, respectively. Personal accomplishment and depersonalization had an explained variance on job outcomes of 23% and vigor of 20%. Burnout and engagement had a less relevant direct impact on quality of care (≤5%). The qualitative study revealed various themes such as organisation of daily practice and work conditions; interdisciplinary collaboration, communication and teamwork; staff nurse personal characteristics and competencies; patient centeredness, quality and patient safety. Respondents’ statements corresponded closely to the models’ associations.ConclusionA deep understanding of various associations and impacts on studied outcome variables such as risk factors and protective factors was gained through the retested models and the interviews with the study participants. Besides the softer work characteristics — such as decision latitude, social capital and team cohesion — more insight and knowledge of the hard work characteristic workload is essential.

Introduction First aid is a factor that reduces damage to health and loss of life in traffic accidents. It is therefore necessary to make even the lay population ready to give at least basic first aid. Czech driving schools offer only 4-h first-aid trainings that do not provide the appropriate level of competencies. Our team has designed a new conception of a 16-h experience-based first-aid course and compared its efficacy with the standard 4-h training. Methods Thirty participants were randomly divided into two groups of 15 participants each. The first group went through the standard training; the second group went through the new experience-based training. Three levels of competencies were tested: 1. Knowledge; 2. Skills; 3. Performance in a simulated situation. The competencies were evaluated by a trained observer.Results A pilot test showed a remarkable difference in knowledge and skills, as well as the competency to act in a simulated situation between the group of people that had gone through the experience-based training and those that had gone through the standard first-aid course. Conclusions Experience-based first-aid training, focused on knowledge and skills, as well as the psychological set-up, is an effective part of a driver's education that can help to reduce the numbers of fatalities and serious damage to health caused by traffic accidents. It is an important factor of traffic safetyuseful for all drivers -and should become an integral part of all driving (improvement) courses. Further research is still necessary.

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The first aid is an important tool to save people’s lives after traffic accidents. Drivers are the most-likely bystanders, who might help injured people at the traffic accident site. The current research aims to explore Czech learner drivers‘ knowledge and attitudes towards the first aid and to evaluate whether the first aid education increases the likelihood that a driver will provide the first aid for injuries resulting from traffic accidents. A questionnaire survey was conducted in 2015 among a sample of 370 Czech learner drivers at driving schools. The two groups of student drivers were compared - those who had attended the first aid classes (FAC) and those who had not. The learner drivers who had attended an FAC are more likely to know how to treat burns and serious injuries, contain external bleeding, and unblock the respiratory track. Those who had not attended an FAC would more often hesitate to provide the first aid because they resisted taking a leadership role to organize the scene, or they did not have suitable equipment. This supports the idea that increasing the quality of the first aid training for Czech student drivers would improve the traffic safety in the Czech Republic.

An alarming number of traffic-related deaths occur each year on European roads alone. Figures reveal that the vast majority of road-traffic accidents are caused by drivers themselves, and so further improvements in road safety require developments in driver training and rehabilitation. This study evaluated a novel approach to driver rehabilitation-specifically, empathy induction as a means of changing attitudes towards risky driving. To assess the effectiveness of this method, the present study employed functional magnetic resonance imaging (fMRI) to compare brain function before and after a short program of empathy induction in 27 drivers whose licenses had been revoked after serious traffic offences (rehabilitated drivers [RDs]). In an extension of our previous research, we first assessed whether neural responses to empathy-eliciting social stimuli changed in these RDs. In order to isolate the neurophysiological effects of empathy induction from any other potential influences, we compared these RDs to a sample of 27 age-, handedness-and driving experience-matched control drivers (CDs) who had no exposure to the program. We then performed dual-fMRI "hyperscanning" to evaluate whether empathy induction changed brain responses during real-world social interactions among drivers; namely, during cooperative and/or competitive exchanges. Our data reveal that RDs exhibited weaker brain responses to socio-emotional stimuli compared with CDs prior to the program, but this difference was reversed after empathy induction. Moreover, we observed differences between pre-and post-program assessments in patterns of brain responses in RDs elicited during competitive social exchanges, which we interpret to reflect a change in their proclivity to react to the perceived wrongdoing of other road users. Together, these findings suggest that empathy induction is an effective form of driver rehabilitation, and the utility of neuroscientific techniques for evaluating and improving rehabilitation programs.