Patient–Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction

In healthcare settings, nurses’ workload, burnout, and job satisfaction are associated to the patient–nurse ratio. Whether this ratio also affects their intention to leave the nursing profession, along with the underlying stress pathway, remains unclear. This study aimed to investigate the effects of the patient–nurse ratio on nurses’ intention to leave and considering the mediating roles of burnout and job dissatisfaction. The study analyzed the data of two pooled cross-sectional surveys collected in 2013 and 2014. Measures were obtained by a structure questionnaire, which queried the average daily patient–nurse ratio (ADPNR), nurses’ personal burnout, client-related burnout, job dissatisfaction, intention to leave, and other demographics. ADPNRs were standardized according to hospital levels. Multiple regression models examined mediation hypotheses, and a percentile bootstrap confidence interval was applied to determine the significance of indirect effects. A total of 1409 full-time registered nurses in medical and surgical wards of 24 secondary or tertiary hospitals in Taiwan completed self-administered questionnaires. Most of the participants were female (97.2%), and the mean age was 29.9 years. The association between the standardized ADPNR and intention to leave their job was significantly mediated by personal burnout, client-related burnout, and job dissatisfaction. Higher standardized ADPNRs predicted higher levels of personal burnout, client-related burnout, and job dissatisfaction, each of which resulted in higher levels of intention to leave the current job. The results highlight that appropriate patient–nurse ratio standards may be further discussed by selecting personal burnout, client-related burnout, and job dissatisfaction as indicators.

Allometric correction of peak VO2 in obese adults undergoing cardiopulmonary exercise testing

We hypothesised that the reduction in cardiorespiratory fitness (CRF) of individuals with less severe obesity is small or non-existent when the allometric rather than the ratio standard is used for the comparison. We aimed to evaluate the influence of obesity on CRF, and to compare peak VO2 using allometric corrections in asymptomatic adults with a wide range of body mass index. The results of 780 adults (age 41±13 years) who underwent cardiopulmonary exercise testing (CPET) were evaluated. Participants were stratified according to body mass index (BMI): normal weight (n=227), overweight (n=198), and obese class 1 (n=155), 2 (n=131), and 3 (n=69). After cardiovascular risk assessment, the participants underwent CPET on a treadmill ramp protocol. The allometric exponents calculated were 0.60 and 0.62 for obese and non-obese groups respectively, with no significant differences. After using BMI strata in a multivariate analysis of covariance, we found an allometric exponent of 0.65. Peak VO2 using ratio standards significantly declined among all stratified groups. After allometric correction, peak VO2 remained significantly reduced only in women with obesity class 3 and men with obesity classes 2 and 3. When ratio standards were used to compare peak VO2, the effect of obesity on CRF was overestimated. Allometric correction of peak VO2 is more reasonable, and should be adopted as a routine for CPET.

Microstructural analysis of the quality of forcemeat in smoked sausages

Sausage products are the main type of meat products due to their high nutritional value and energy content, high gustatory qualities, long storage conditions and the possibility of their consumption without heat treatment. The main condition for the possibility of meat products commercialization is to achieve their safety when consumed by people. Microstructural analysis of smoked sausages was carried out using the samples of high-grade quality smoked sausages «Moskovksa» and «Braunschweigska» that were selected by means of control purchases in the retail chains of Dnipro city (Ukraine) from various manufacturers. The veterinary and sanitary examination of smoked sausages included the identification of five organoleptic and four techno-chemical criteria to identify the quality of raw materials and the product itself. Histological studies of the samples of sausages and analysis of sausage mince were carried out. The study of microstructural analysis found that all samples of sausages are produced in compliance with organoleptic control standards and formulations prescribed in corresponding requirements documentation. It was established that the best sausage samples were «Moskovskaya» produced by meat-processing and packing plant of «Myasnaya Guildiya» trademark in Zhytomyr and «Braunschweigska» produced by «Alan» trademark. The analysis of sausage meat mass showed that manufacturers did not meet quantitative state ratio standards of aforementioned raw materials and the high-grade meat was replaced by low-grade canned or frozen meat. The smoked sausage forcemeat produced by «Alan» Ltd. mainly consist of rubbed meat, which may point to an attempt by the manufacturer to conceal the use of low-quality or low-grade raw materials. The smoked sausage samples of «Moskovskaya» produced by «Premia» trademark and «Braunschweigska» produced by «Farro» trademark exceeded the standard rate of fat tissue, while smoked sausages of «Dobrov» trademark exceeded the allowed content of the dense fibrous connective tissue.