Nursing Perception on Patient Safety Culture: The Latest Methodological Approaches

Safety culture can be defined as “the values shared among organization members about what is important, their beliefs about how things operate in the organization, and the interaction of these with work unit and organizational structures and systems, which together produce behavioral norms in the organization that promote safety”. This literature review aimed to identify the latest methodological approaches quantifying patient safety culture perception among nurses. The available literature was searched from January 2018 to today . Eleven eligible works were found and analyzed and the main key concepts highlighted were: the research approaches to assess patient safety culture, the development of quantitative survey tools for data collection for further reproducibility and the levels of data aggregation for conducting data analyses. A cohesive body of literature of evaluation tools is requiring on patient safety culture among nurses which is still limited in the current literature. Keywords: Health Safety; Methodological Approach; Nursing Perception; Patient Safety; Safety Culture; Safety Survey. DOI: 10.7176/JHMN/62-12 Publication date:May 31st 201

Assessment of Correlations among Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and Cumulative Illness Rating Index (CI) Scores in the Elderly Patients with Femur Fractures: A Prospective Study

Background: The World Health Organization (WHO) has established that injury will be the second principal cause of the world disease onerous by the year 2020. Purpose: In this study comorbidity was evaluated with the Cumulative Illness Rating Index, (CI) and studied in relation to the functional status of the elderly participants, by considering: Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL), scores. Method: Ninety-five elderly patients with femur fracture were recruited for this study. A prospective investigation and evaluation of their comorbidity and their physical activity conditions was performed. Results: Correlations were evaluated between: ADL and CIRS values (r = 0.23); CIRS and IADL values (r = 0.24), and finally correlations between patients age and CIRS values (r = 0.09).Conclusion: No significant correlations were assessed to standardize the different score levels. Keywords: Activities of Daily Living (ADL), Cumulative Illness Rating Index (CI), Instrumental Activities of Daily Living (IADL), Elderly Patients. DOI: 10.7176/JHMN/63-05 Publication date:June 30th 2019

How Patients and Nurses defined Advocacy in Nursing? A Review of the Literature

Objectives: Advocacy is an important aspect in current professional nursing care and it is a relatively new role for nursing, emerged in the United States in 1980s. This article aimed to explore the basis of advocacy concept viewed by both nurses and patients.Design: A computerized search in PubMed, Medline, Embase databases was conducted to highlight the relevance of nursing advocacy by nurses and patients. This review included qualitative studies which explained better advocacy concept in nursing practice and analyzed the concept of nursing advocacy. Data sources: Fifteen articles were found. Of these, only six met all the requirements of the inclusion criteria Review methods: Articles were compared by considering for each paper the purpose, the design, the methodology, the finding, in order to define advocacy concept by both patients and nurses.Results: Six articles were found, which were published between 1996 and 2018.Conclusions: It was found that the concept and the practice of the nursing advocacy was still enshrouded in confusion, conflict and change. Keywords: Advocacy; Nursing Advocacy; Literature Review; Patient Advocacy. DOI: 10.7176/JHMN/63-08 Publication date:June 30th 201

Associations between sampling characteristics, nutritional supplemental taking and the SARS-CoV-2 infection onset in a cohort of Italian nurses

Background: The aim of the present study was to analyze any relations existed between sampling characteristics and the onset of the SARS-CoV-2 infection, also by considering the number of times that it occurred in a cohort of Italian nurses interviewed. Additionally, by considering the nutritional supplemental taking, this research wanted to assess any differences both in the onset and in the number of times which the infection occurred among participants. Method: An observational cohort study was carried out thorough all Italian nurses by advertising the questionnaire through some professional internet pages. Results: Work typology (p=0.021), ward Covid-19 (p=0.002) and regular meal assumption (p=0.019) significantly associated to the onset of the SARS-CoV-2 infection. Most of nurses who contracted the SARS-CoV-2 infection worked during the night shift (53.7%), 44.3% worked in a no-Covid-19 ward and 53% declared to have a regular meals' assumption. Ward typology significantly associated to the times of the SARS-CoV-2 onset (p=0.003), as most of nurses who contracted almost one time the SARS-CoV-2 infection were employed in a no-Covid-19 ward (55.5%) and 54.1% of them declared to have a regular meals' assumption. The onset of the Sars-CoV-2 infection seemed to be more present in the most part of the sample collect. Conclusion: The present study could be considered as pilot in this sense and also more studies will be performed in order to better relate the function of supplemental food intakes with a better functioning of the immune system

Body mass index conditions and eating attitudes in young nurses: a pilot psycho-immune-endocrine investigation

Purpose. To investigate a cohort of young Italian nurses to identify whether the body mass index (BMI) and eating flexibility differed and were associated according to the basic characteristics of sex, smoking behavior, or shift activity, the levels of neutrophils, lymphocytes, or platelets in blood, and the psychological conditions of anxiety, depression, stress, or insomnia. Materials and Methods. The data include sex, BMI, smoking behavior, shift activity, neutrophil, lymphocyte, and platelet levels, eating flexibility [measured using the eating disorder flexibility index (EDFLIX) and the subdimensions EDFLIX-GF for general flexibility, EDFLIX-FoEx for food and exercise flexibility, and EDFLIX-WeSh for weight and shape flexibility], and mental health [assessed using the depression, anxiety, and stress scale (DASS-21) and the insomnia severity index (ISI)]. Results. Differences in BMI with shift work (P=0.042) and anxiety with total EDFLIX (P<0.001), EDFLIX-GF (P<0.001), and EDFLIX-WeSh (P=0.044) scores were significant. Having depression was associated with significant differences in total EDFLIX (P<0.001), EDFLIX-GF (P=0.005), and EDFLIX-WeSh (P<0.001) scores. Nurses with moderate stress reported high total EDFLIX (P<0.001), EDGLIX-FoEx (P<0.001), and EDFLIX-WeSh (P=0.013) scores. Nurses with mild stress reported high EDFLIX-GF scores (P<0.001). Nurses without insomnia symptoms reported significantly high EDFLIX- FoEx scores (P<0.001). Associations between lymphocyte levels and EDFLIX-FoEx (β=-0.264; P=0.003), stress and EDFLIX-total (β=-0.436; P<0.001), EDFLIX-GF (β=-0.466; P<0.001) and EDFLIX-WeSh (P=0.022), and also between insomnia and EDFLIX-FoEx (β=-0.245; P<0.001) were significant. Conclusions. Nurses, from the beginning of their careers, should be monitored and encouraged to avoid adverse health practices that negatively influence their quality of life

Comparison of pain perception between open and minimally invasive surgery in total knee arthroplasty

Total knee arthroplasty (TKA) was a well-established procedure that had shown excellent long-term results in terms of reduced pain and increased mobility. Pain was one of the most important outcome measures that contributed to patient dissatisfaction after TKA. After a computerized search of the Medline and Embase databases, we considered articles from January 1st, 1997 to October 31st, 2009 that underlined the impact on patient pain perception of either standard open total knee arthroplasty or minimally invasive total knee arthroplasty. We included articles that used the visual analog scale (VAS), Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC), Knee Score, Hospital for Special Surgery Score (HSS), Oxford Knee Score (OKS) as postoperative pain indicators, and we included studies with a minimum follow-up period of two months. We excluded studies that monitored only functional postoperative knee activities. It was shown that TKA with the open technique was a better treatment for knees with a positive effect on pain and function than the minimally invasive technique

Russell-like bodies in plant seeds share common features with prolamin bodies and occur upon recombinant protein production

Although many recombinant proteins have been produced in seeds at high yields without adverse effects on the plant, endoplasmic reticulum (ER) stress and aberrant localization of endogenous or recombinant proteins have also been reported. The production of murine interleukin-10 (mIL-10) in Arabidopsis thaliana seeds resulted in the de novo formation of ER-derived structures containing a large fraction of the recombinant protein in an insoluble form. These bodies containing mIL-10 were morphologically similar to Russell bodies found in mammalian cells. We confirmed that the compartment containing mIL-10 was enclosed by ER membranes, and 3D electron microscopy revealed that these structures have a spheroidal shape. Another feature shared with Russell bodies is the continued viability of the cells that generate these organelles. To investigate similarities in the formation of Russell-like bodies and the plant-specific protein bodies formed by prolamins in cereal seeds, we crossed plants containing ectopic ER-derived prolamin protein bodies with a line accumulating mIL-10 in Russell-like bodies. This resulted in seeds containing only one population of protein bodies in which mIL-10 inclusions formed a central core surrounded by the prolamin-containing matrix, suggesting that both types of protein aggregates are together removed from the secretory pathway by a common mechanism. We propose that, like mammalian cells, plant cells are able to form Russell-like bodies as a self-protection mechanism, when they are overloaded with a partially transport-incompetent protein, and we discuss the resulting challenges for recombinant protein production

Biological effects of thermal water-associated hydrogen sulfide on human airways and associated immune cells: Implications for respiratory diseases

Natural mineral (thermal) waters have been used for centuries as treatment for various diseases. However, the scientific background of such therapeutic action is mostly empiric and based on knowledge acquired over time. Among the various types of natural mineral waters, sulfurous thermal waters (STWs) are the most common type in the center of Portugal. STWs are characterized by high pH, poor mineralization, and the presence of several ions and salts, such as bicarbonate, sodium, fluoride, silica, and carbonate. Furthermore, these waters are indicated as a good option for the treatment of various illnesses, namely respiratory diseases (e.g., allergic rhinitis, asthma, and chronic obstructive pulmonary disease). From the sulfide species present in these waters, hydrogen sulfide (H2S) stands out due to its abundance. In healthy conditions, H2S-related enzymes (e.g., cystathionine β-synthase and cystathionine γ-lyase) are expressed in human lungs, where they have mucolytic, antioxidant, anti-inflammatory, and antibacterial roles, thus contributing to airway epithelium homeostasis. These roles occur mainly through S-sulfhydration, a post-translational modification through which H2S is able to change the activity of several targets, such as ion channels, second messengers, proteins, among others. However, in respiratory diseases the metabolism of H2S is altered, which seems to contribute somehow to the respiratory deterioration. Moreover, H2S has been regarded as a good biomarker of airway dysfunction and severity, and can be measured in serum, sputum, and exhaled air. Hence, in this review we will recapitulate the effects of STWs on lung epithelial-immune crosstalk through the action of its main component, H2S

Can innovations in traditional pork products help thriving EU untapped pig breeds? A non-hypothetical discrete choice experiment with hedonic evaluation

The EU is supporting measures that stimulate enhanced value-added products in order to conserve local and threatened livestock breeds. Several Traditional Pork Products (TPP) and Innovative Traditional Pork Products (ITPP) with health innovations from four untapped pig breeds in Spain (Porc Negre Mallorquí), Croatia (Turopolje), Italy (Cinta Senese) and Slovenia (Krškopolje) were analysed. Consumers' “Non-hypothetical” willingness to pay (WTP) and hedonic evaluation were investigated. An integrated experimental approach using two Non-Hypothetical Discrete Choice Experiment (NH-DCE) was carried out before and after a hedonic evaluation test. Results showed that the health innovative products (ITPP) received similar and even lower WTP than the “control” products (TPP) from the untapped pig breeds. The TPP outperformed products enriched with healthy ingredients or with reduced undesirable compounds. The potential demand for traditional and “unaltered” product from the rustic pig breeds could contribute to their conservation. A market niche exists, where consumers appreciate these high-quality products and where no “add-ons” are required to enhance their uptake.Postprint (updated version

Generation of multi-layered protein bodies in N. benthamiana for the encapsulation of vaccine antigens

The ability of plants to assemble particulate structures such as virus-like particles and protein storage organelles allows the direct bioencapsulation of recombinant proteins during the manufacturing process, which holds promise for the development of new drug delivery vehicles. Storage organelles found in plants such as protein bodies (PBs) have been successfully used as tools for accumulation and encapsulation of recombinant proteins. The fusion of sequences derived from 27-kDa-γ-zein, a major storage protein of maize, with a protein of interest leads to the incorporation of the chimeric protein into the stable and protected environment inside newly induced PBs. While this procedure has proven successful for several, but not all recombinant proteins, the aim of this study was to refine the technology by using a combination of PB-forming proteins, thereby generating multi-layered protein assemblies in N. benthamiana. We used fluorescent proteins to demonstrate that up to three proteinaceous components can be incorporated into different layers. In addition to 27-kDa-γ-zein, which is essential for PB initiation, 16-kDa-γ-zein was identified as a key element to promote the incorporation of a third zein-component into the core of the PBs. We show that a vaccine antigen could be incorporated into the matrix of multi-layered PBs, and the protein microparticles were characterized by confocal and electron microscopy as well as flow cytometry. In future, this approach will enable the generation of designer PBs that serve as drug carriers and integrate multiple components that can be functionalized in different ways