Mental health practitioners in many developing countries are faced with high job demands and a lack of institutional support. Given their high levels of work-related stress, it is important to identify mechanisms that help them to maintain psychological well-being and job satisfaction. Recent research has focused on the role that positive orientation (POS) may play in mediating the negative impact of stress on individual well-being. The present study investigated whether POS predicts mental health practitioners' perceived levels of stress, mental health and job satisfaction. If POS measures a person's tendency to take a positive attitude to life and their ability to cope with difficulties, a high POS could be linked to reduced levels of stress and increased levels of job satisfaction and well-being. This study examined associations between self-reported POS and psychological outcomes in a sample of 100 Malaysian mental health practitioners. The results showed that POS significantly predicted job satisfaction positively and mental health issues and perceived stress negatively, even when socio-demographic variables were controlled. Overall, we found a strong effect of POS on individual functioning across the sample of mental health practitioners. Our results have implications for improving practitioner wellbeing and job satisfaction.
Echocardiography is essential for the diagnosis and management of infective endocarditis (IE). However, the reproducibility for the echocardiographic assessment of variables relevant to IE is unknown. Objectives of this study were: (1) To define the reproducibility for IE echocardiographic variables and (2) to describe a methodology for assessing quality in an observational cohort containing site-interpreted data. IE reproducibility was assessed on a subset of echocardiograms from subjects enrolled in the International Collaboration on Endocarditis registry. Specific echocardiographic case report forms were used. Intra-observer agreement was assessed from six site readers on ten randomly selected echocardiograms. Inter-observer agreement between sites and an echocardiography core laboratory was assessed on a separate random sample of 110 echocardiograms. Agreement was determined using intraclass correlation (ICC), coverage probability (CP), and limits of agreement for continuous variables and kappa statistics (κweighted) and CP for categorical variables. Intra-observer agreement for LVEF was excellent [ICC = 0.93 ± 0.1 and all pairwise differences for LVEF (CP) were within 10 %]. For IE categorical echocardiographic variables, intra-observer agreement was best for aortic abscess (κweighted = 1.0, CP = 1.0 for all readers). Highest inter-observer agreement for IE categorical echocardiographic variables was obtained for vegetation location (κweighted = 0.95; 95 % CI 0.92-0.99) and lowest agreement was found for vegetation mobility (κweighted = 0.69; 95 % CI 0.62-0.86). Moderate to excellent intra- and inter-observer agreement is observed for echocardiographic variables in the diagnostic assessment of IE. A pragmatic approach for determining echocardiographic data reproducibility in a large, multicentre, site interpreted observational cohort is feasible.
Staphylococcus aureus left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in S aureus LNVIE is unknown.