Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review

Objective To determine whether there is an association between healthcare professionals’ wellbeing and burnout, with patient safety. Design Systematic research review. Data Sources PsychInfo (1806 to July 2015), Medline (1946 to July 2015), Embase (1947 to July 2015) and Scopus (1823 to July 2015) were searched, along with reference lists of eligible articles. Eligibility Criteria for Selecting Studies Quantitative, empirical studies that included i) either a measure of wellbeing or burnout, and ii) patient safety, in healthcare staff populations. Results Forty-six studies were identified. Sixteen out of the 27 studies that measured wellbeing found a significant correlation between poor wellbeing and worse patient safety, with six additional studies finding an association with some but not all scales used, and one study finding a significant association but in the opposite direction to the majority of studies. Twenty-one out of the 30 studies that measured burnout found a significant association between burnout and patient safety, whilst a further four studies found an association between one or more (but not all) subscales of the burnout measures employed, and patient safety. Conclusions Poor wellbeing and moderate to high levels of burnout are associated, in the majority of studies reviewed, with poor patient safety outcomes such as medical errors, however the lack of prospective studies reduces the ability to determine causality. Further prospective studies, research in primary care, conducted within the UK, and a clearer definition of healthcare staff wellbeing are needed. Implications This review illustrates the need for healthcare organisations to consider improving employees’ mental health as well as creating safer work environments when planning interventions to improve patient safety

Ambient Stable Quantitative PCR Reagents for the Detection of Yersinia pestis

Plague, caused by Yersinia pestis, is one of the oldest and most dangerous diseases in human history, and has claimed millions of lives in the three major historical pandemics. Although panic caused by the Black Death is fading, the threat of the reemergence of plague pandemics still exists, with the additional potential of misuse in biowarfare or bioterrorism. Rapid on-site detection and identification of the pathogen is of paramount significance for timely implementation of effective countermeasures. TaqMan probe-based real-time PCR assays can give quick and accurate identification; however, the need for cold delivery and storage prevents its potential on-site application. The objective of this study was to develop a stable PCR system for easy delivery and storage under room temperature, which is vital for conventional plague surveillance and for preparedness in public health emergencies. We present a solution to this particular issue, hoping that it is helpful to future applications

What is damaging the kidney in lupus nephritis?

Despite marked improvements in the survival of patients with severe lupus nephritis over the past 50 years, the rate of complete clinical remission after immune suppression therapy i

Integrating teamwork, clinician occupational well-being and patient safety – development of a conceptual framework based on a systematic review

BACKGROUND: There is growing evidence that teamwork in hospitals is related to both patient outcomes and clinician occupational well-being. Furthermore, clinician well-being is associated with patient safety. Despite considerable research activity, few studies include all three concepts, and their interrelations have not yet been investigated systematically. To advance our understanding of these potentially complex interrelations we propose an integrative framework taking into account current evidence and research gaps identified in a systematic review. METHODS: We conducted a literature search in six major databases (Medline, PsycArticles, PsycInfo, Psyndex, ScienceDirect, and Web of Knowledge). Inclusion criteria were: peer reviewed papers published between January 2000 and June 2015 investigating a statistical relationship between at least two of the three concepts; teamwork, patient safety, and clinician occupational well-being in hospital settings, including practicing nurses and physicians. We assessed methodological quality using a standardized rating system and qualitatively appraised and extracted relevant data, such as instruments, analyses and outcomes. RESULTS: The 98 studies included in this review were highly diverse regarding quality, methodology and outcomes. We found support for the existence of independent associations between teamwork, clinician occupational well-being and patient safety. However, we identified several conceptual and methodological limitations. The main barrier to advancing our understanding of the causal relationships between teamwork, clinician well-being and patient safety is the lack of an integrative, theory-based, and methodologically thorough approach investigating the three concepts simultaneously and longitudinally. Based on psychological theory and our findings, we developed an integrative framework that addresses these limitations and proposes mechanisms by which these concepts might be linked. CONCLUSION: Knowledge about the mechanisms underlying the relationships between these concepts helps to identify avenues for future research, aimed at benefiting clinicians and patients by using the synergies between teamwork, clinician occupational well-being and patient safety. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-016-1535-y) contains supplementary material, which is available to authorized users

Fungal G-protein-coupled receptors::mediators of pathogenesis and targets for disease control

G-protein signalling pathways are involved in sensing the environment, enabling fungi to coordinate cell function, metabolism and development with their surroundings, thereby promoting their survival, propagation and virulence. G-protein-coupled receptors (GPCRs) are the largest class of cell surface receptors in fungi. Despite the apparent importance of GPCR signalling to fungal biology and virulence, relatively few GPCR–G-protein interactions, and even fewer receptor-binding ligands, have been identified. Approximately 40% of current pharmaceuticals target human GPCRs, due to their cell surface location and central role in cell signalling. Fungal GPCRs do not belong to any of the mammalian receptor classes, making them druggable targets for antifungal development. This Review Article evaluates developments in our understanding of fungal GPCR-mediated signalling, while substantiating the rationale for considering these receptors as potential antifungal targets. The need for insights into the structure–function relationship of receptor–ligand interactions is highlighted, which could facilitate the development of receptor-interfering compounds that could be used in disease control

Structural comparisons of the species of recognition of Ni2+, Cu2+, Zn2+, Cd2+, Hg2+ and Ag+ with 1,3-di-conjugates of calix[4]arene by DFT computations

Calixarenes are versatile macromolecular systems, which would exhibit better host-guest chemistry upon appropriate derivatization. Our group has been involved in the synthesis of a variety of calix[4]arene conjugates, which were found to selectively recognize metal ions. Though such recognitions have been demonstrated, based on different experimental studies, the qualitative and semi-quantitative understanding of the coordination aspects are still lacking owing to the non-availability of the crystal structures of the species of recognition. Hence, in order to understand the coordination chemistry of the interactions between the host calix[4]arene receptor and the guest metal ion species, computational modelling studies have been carried out. In this regard, five conjugates of calix[4]arene, which are 1,3-di-O-derivised at the lower-rim and appended over an amide as well as Schiff base linker have been studied. The computational modelling studies have been carried out at the level of density functional theory to yield coordination geometries, which are intune with the experimental observations and comparable to those reported in the literature in the case of similar receptor systems. The species of recognition obtained with the metal ions are found to have some structural resemblances with the metal sites present in metalloproteins. The modelling studies and the coordination geometries are discussed in this article

1-(D-Glucopyranosyl-2 '-deoxy-2 '-iminomethyl)-2-hydroxynaphthalene as chemo-sensor for Fe(3+) in aqueous HEPES buffer based on colour changes observable with the naked eye

A new glucose-based C2-derivatized colorimetric chemo-sensor (L(1)) has been synthesized by a one-step condensation of glucosamine and 2-hydroxy-1-naphthaldehyde for the recognition of transition metal ions. Among the eleven metal ions studied, viz., Mg(2+), Ca(2+), Mn(2+), Fe(2+), Fe(3+), Co(2+), Ni(2+), Cu(2+) Zn(2+), Cd(2+) and Hg(2+), L(1) results in visual colour change only in the presence of Fe(2+), Fe(3+) and Cu(2+) in methanol. However, in an aqueous HEPES buffer (pH 7.2) it is only the Fe(3+) that gives a distinct visual colour change even in the presence of other metal ions, up to a concentration of 280 ppb. The changes have been explained based on the complex formed, and the composition has been determined to be 2:1 between L, and Fe(3+) based on job's plot as well as ESI MS. The structure of the proposed complex has been derived based on HF/6-31G calculations. (C) 200

Lower rim 1,3-di-amide-derivative of calix[4]arene possessing bis-[N-(2,2 '-dipyridylamide)} pendants: a dual fluorescence sensor for Zn2+ and Ni2+

Single crystal XRD structure of the lower rim 1,3-di-amide-derivative of calix[4]arene possessing bis-{N(2,2 '-dipyridylamide)} pendants (L) exhibit two distinct binding cores, viz., N-4 and O-6. L was found to be selective for Zn2+ by switch-on and for Ni2+ by switch-off fluorescence by forming 1: 1 complexes. The binding and the composition of the complex formed have been addressed based on steady state and time-resolved fluorescence spectroscopy in addition to the absorption and ESI MS. As L can detect Zn2+ and Ni2+ to a concentration as low as 142 and 203 ppb, respectively, L can be a very sensitive molecular probe for these ions. The coordination details of the metal ion-bound complexes have been addressed based on ab initio calculations showing that the stabilization energies are commensurate with the coordination formed. (C) 200

1,3-Diamido-calix[4]arene Conjugates of Amino Acids: Recognition of -COOH Side Chain Present in Amino Acids, Peptides, and Proteins by Experimental and Computational Studies

Lower rim 1,3-diamido conjugates of calix[4]arene have been synthesized and characterized, and the structures of some of these have been established by single crystal XRD. The amido-calix conjugates possessing a terminal -COOH moiety have been shown to exhibit recognition toward guest molecules possessing -COOH moiety, viz., Asp, Glu, and reduced and oxidized glutathione (GSH, GSSG), by switch-on fluorescence in aqueous acetonitrile and methanol solutions when compared to the control molecules via forming a 1:1 complex. The complex formed has been shown by mass spectrometry, and the structural features of the complexes were derived on the basis of DFT computations. The association constants observed for the recognition of Asp/Glu by Phe-calix conjugate, viz., 532/676 M(-1), are higher than that reported for the recognition of Val, Leu, Phe, His, and Trp (16-63 M(-1)) by a water-soluble calixarene (Arena, G., et al. Tetrahedron Lett. 1999, 40, 1597). For this recognition, there should be a free -COOH moiety from the guest molecule. AFM, SEM, and DLS data exhibited spherical particles with a hundred-fold reduction in the size of the complexes when compared to the particles of the precursors. These spherical particles have been computationally modeled to possess hexameric species reminiscent of the hexameric micellar structures shown for a Ag(+) complex of a calix[6]arene reported in the literature (Houmadi, S., et al. Langmuir 2007, 23, 4849). Both AFM and TEM studies demonstrated the formation of nanospheres in the case of GSH-capped Ag nanoparticles in interaction with the amido-calix conjugate that possesses terminal -COOH moiety. The AFM studies demonstrated in this paper have been very well applied to albumin proteins to differentiate the aggregational behavior and nanostructural features exhibited by the complexes of proteins from those of the uncomplexed ones. To our knowledge, this is the first report wherein a amido-calix[4]arene conjugate and its amino acid/peptide/protein complexes have been differentiated on the basis of spectroscopy and microscopy studies followed by species modeling by computations

Nanofibers Formed Through pi ... pi Stacking of the Complexes of Glucosyl-C2-salicyl-imine and Phenylalanine: Characterization by Microscopy, Modeling by Molecular Mechanics, and Interaction by alpha-Helical and beta-Sheet Proteins

This paper deals with the self-assembly of the 1:1 complex of two different amphiphiles, namely, a glucosyl-salicyl-imino conjugate (L) and phenylalanine (Phe), forming nanofibers over a period of time through pi ... pi interactions. Significant enhancement observed in the fluorescence intensity of L at similar to 423 nm band and the significant decrease observed in the absorbance of the similar to 215 nm band are some characteristics of this self-assembly. Matrix-assisted laser desorption ionization/time of flight titration carried out at different time intervals supports the formation of higher aggregates. Atomic force microscopy (AIM), transmission electron microscopy, and scanning electron miscroscopy results showed the formation of nanofibers for the solutions of L with phenylalanine. In dynamic light scattering measurements, the distribution of the particles extends to a higher diameter range over time, indicating a slow kinetic process of assembly. Similar spectral and microscopy studies carried out with the control molecules support the role of the amino acid moiety over the simple - COOH moiety as well as the side chain phenyl moiety in association with the amino acid, in the formation of these fibers. All these observations support the presence of pi ... pi interactions between the initially formed 1:1 complexes leading to the fiber formation. The aggregation of 1:1 complexes leading to fibers followed by the formation of bundles has been modeled by molecular mechanics studies. Thus the fiber formation with L is limited to phenylalanine and not to any other naturally occurring amino acid and hence a polymer composed of two different biocompatible amphiphiles. AFM studies carried out between the fiber forming mixture and proteins resulted in the observation that only BSA selectively adheres to the fiber among the three alpha-helical and two beta-sheet proteins studied and hence may be of use in some medical applications