Differential characteristics of young and midlife adult users of psychotherapy, psychotropic medications, or both: information from a population representative sample in São Paulo, Brazil

Mutu pelayanan di rumah sakit tak lepas dari kinerja sumber daya manusia keperawatan. Setiap organisasi memiliki budaya yang merupakan faktor penting yang menentukan keberhasilan organisasi  dalam mencapai tujuannya. Penelitian yang bertujuan untuk mengidentifikasi hubungan antara persepsi perawat pelaksana tentang budaya organisasi dengan kinerjanya di ruang rawat inap sebuah RS di Bogor ini, merupakan penelitian cross sectional yang melibatkan 113 perawat. Instrumen yang digunakan adalah instrumen budaya organisasi dan kinerja yang telah dimodifikasi. Sebanyak 79.6% perawat pelaksana mempersepsikan kinerjanya baik dan 85% mempersepsikan budaya organisasinya baik. Perawat pelaksana yang berpersepsi baik terhadap organisasinya, mereka juga berkinerja lebih baik. Karakteristik perawat pelaksana dan persepsi perawat pelaksana terhadap budaya organisasi tidak berhubungan dengan kinerja. Budaya organisasi yang sudah baik dankinerja yang optimalperlu dipertahankan dengan selalu mengevaluasi tiap komponennya,baik oleh manajemen maupun individu keperawatan. Abstract The Nurse Practitioners’ Perception on OrganizationalCulture and Work Performance. The quality of hospital services is supported by several aspects, including the work performance of human resources in nursing. Every organization has a culture which is an important factor that determines the success of the organization in achieving its goals. The research aimed to identify the relationship between the perceptions of nurses about the organizational culture with theirwork performance in inpatient ward at a hospital in Bogor, a cross-sectional study involving 113 nurses. The instrument used was the modified instrument of organizational culture and work performance. A total of 79.6% of nurses perceiving good performance and 85% perceive the organizational culture good. Nurses who have good perception for the organizational cultura, they also perform better. Characteristics of nurses and nurses’ perceptions of the organizational culture is not related to the work performance.Good organizational and optimum work performance need to maintain with evaluating each its component. Keyword: nurse practitioners, organizational culture, work performanceMutu pelayanan di rumah sakit tak lepas dari kinerja sumber daya manusia keperawatan. Setiap organisasi memiliki budaya yang merupakan faktor penting yang menentukan keberhasilan organisasi dalam mencapai tujuannya. Penelitian yang bertujuan untuk mengidentifikasi hubungan antara persepsi perawat pelaksana tentang budaya organisasi dengan kinerjanya di ruang rawat inap sebuah Rumah Sakit di Bogor ini, merupakan penelitian cross sectional yang melibatkan 113 perawat. Instrumen yang digunakan adalah instrumen budaya organisasi dan kinerja yang telah dimodifikasi. Sebanyak 79.6% perawat pelaksana mempersepsikan kinerjanya baik dan 85% mempersepsikan budaya organisasinya baik. Perawat pelaksana yang berpersepsi baik terhadap organisasinya, mereka juga berkinerja lebih baik. Karakteristik perawat pelaksana dan persepsi perawat pelaksana terhadap budaya organisasi tidak berhubungan dengan kinerja. Budaya organisasi yang sudah baik dankinerja yang optimal perlu dipertahankan dengan selalu mengevaluasi tiap komponennya,baik oleh manajemen maupun individu keperawatan. Abstract The Nurse Practitioners’ Perception on Organizational Culture and Work Performance. The quality of hospital services is supported by several aspects, including the work performance of human resources in nursing. Every organization has a culture which is an important factor that determines the success of the organization in achieving its goals. The research aimed to identify the relationship between the perceptions of nurses about the organizational culture with theirwork performance in inpatient ward at a hospital in Bogor, a cross-sectional study involving 113 nurses. The instrument used was the modified instrument of organizational culture and work performance. A total of 79,6% of nurses perceiving good performance and 85% perceive the organizational culture good. Nurses who have good perception for the organizational cultura, they also perform better. Characteristics of nurses and nurses’ perceptions of the organizational culture is not related to the work performance. Good organizational and optimum work performance need to maintain with evaluating each its component. Keyword: nurse practitioners, organizational culture, work performanc

Multi-model seascape genomics identifies distinct environmental drivers of selection among sympatric marine species

Background As global change and anthropogenic pressures continue to increase, conservation and management increasingly needs to consider species’ potential to adapt to novel environmental conditions. Therefore, it is imperative to characterise the main selective forces acting on ecosystems, and how these may influence the evolutionary potential of populations and species. Using a multi-model seascape genomics approach, we compare putative environmental drivers of selection in three sympatric southern African marine invertebrates with contrasting ecology and life histories: Cape urchin (Parechinus angulosus), Common shore crab (Cyclograpsus punctatus), and Granular limpet (Scutellastra granularis). Results Using pooled (Pool-seq), restriction-site associated DNA sequencing (RAD-seq), and seven outlier detection methods, we characterise genomic variation between populations along a strong biogeographical gradient. Of the three species, only S. granularis showed significant isolation-by-distance, and isolation-by-environment driven by sea surface temperatures (SST). In contrast, sea surface salinity (SSS) and range in air temperature correlated more strongly with genomic variation in C. punctatus and P. angulosus. Differences were also found in genomic structuring between the three species, with outlier loci contributing to two clusters in the East and West Coasts for S. granularis and P. angulosus, but not for C. punctatus. Conclusion The findings illustrate distinct evolutionary potential across species, suggesting that species-specific habitat requirements and responses to environmental stresses may be better predictors of evolutionary patterns than the strong environmental gradients within the region. We also found large discrepancies between outlier detection methodologies, and thus offer a novel multi-model approach to identifying the principal environmental selection forces acting on species. Overall, this work highlights how adding a comparative approach to seascape genomics (both with multiple models and species) can elucidate the intricate evolutionary responses of ecosystems to global change

Researching COVID to Enhance Recovery (RECOVER) Adult Study Protocol: Rationale, Objectives, and Design

IMPORTANCE: SARS-CoV-2 infection can result in ongoing, relapsing, or new symptoms or other health effects after the acute phase of infection; termed post-acute sequelae of SARS-CoV-2 infection (PASC), or long COVID. The characteristics, prevalence, trajectory and mechanisms of PASC are ill-defined. The objectives of the Researching COVID to Enhance Recovery (RECOVER) Multi-site Observational Study of PASC in Adults (RECOVER-Adult) are to: (1) characterize PASC prevalence; (2) characterize the symptoms, organ dysfunction, natural history, and distinct phenotypes of PASC; (3) identify demographic, social and clinical risk factors for PASC onset and recovery; and (4) define the biological mechanisms underlying PASC pathogenesis. METHODS: RECOVER-Adult is a combined prospective/retrospective cohort currently planned to enroll 14,880 adults aged ≥18 years. Eligible participants either must meet WHO criteria for suspected, probable, or confirmed infection; or must have evidence of no prior infection. Recruitment occurs at 86 sites in 33 U.S. states, Washington, DC and Puerto Rico, via facility- and community-based outreach. Participants complete quarterly questionnaires about symptoms, social determinants, vaccination status, and interim SARS-CoV-2 infections. In addition, participants contribute biospecimens and undergo physical and laboratory examinations at approximately 0, 90 and 180 days from infection or negative test date, and yearly thereafter. Some participants undergo additional testing based on specific criteria or random sampling. Patient representatives provide input on all study processes. The primary study outcome is onset of PASC, measured by signs and symptoms. A paradigm for identifying PASC cases will be defined and updated using supervised and unsupervised learning approaches with cross-validation. Logistic regression and proportional hazards regression will be conducted to investigate associations between risk factors, onset, and resolution of PASC symptoms. DISCUSSION: RECOVER-Adult is the first national, prospective, longitudinal cohort of PASC among US adults. Results of this study are intended to inform public health, spur clinical trials, and expand treatment options

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Factors associated with antidepressant, anxiolytic, and other psychotropic medication use to treat psychiatric symptoms in the city of São Paulo, Brazil

The objective of this study was to examine the prevalence and characteristics of adult psychotropic medication use in São Paulo, Brazil. Information on lifetime and 12-month psychotropic medication use, and psychiatric status was obtained from a representative sample of 2000 adults aged 18-65 years in São Paulo, Brazil. Lifetime and 12-month use of psychotropic medications was 16.8 and 7.1%, respectively. of the 22.8% of patients with current psychiatric problems, 29.5% reported lifetime use and 15.8% (5.6% of the sample) reported 12-month use (anxiolytics: 2.7%, antidepressants: 1.8%, alternative medicines: 0.9%, antipsychotics: 0.4%, mood stabilizers: 0.4%, hypnotics: 0.3%; multiple class use occurred). the most frequent prescribers were psychiatrists and general practitioners. Determinants of use included identification as a psychiatric case (four-fold increased odds), being female (three-fold increase), age (4-5% per additional year), and lower odds if married. Education, employment status, and birth in São Paulo were not associated with use. Income did not affect anxiolytic use, but antidepressant and alternative medicine use was associated with higher income. These results show that psychotropic drug use was comparatively low. Only 15.8% of patients with psychiatric problems reported recent psychotropic use. Comparable with other studies, use was greater among women and increased with age.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Bolsista de Produtividade em PesquisaNational Institute on AgingUniversidade Federal de São Paulo, Paulista Sch Med UNIFESP, Dept Psychiat, São Paulo, BrazilUniv Bandeirante São Paulo, São Paulo, BrazilDuke Univ, Med Ctr, Ctr Study Aging & Human Dev, Durham, NC 27710 USAUniversidade Federal de São Paulo, Paulista Sch Med UNIFESP, Dept Psychiat, São Paulo, BrazilFAPESP: 01/03423-0Bolsista de Produtividade em Pesquisa: 306156/2011-3National Institute on Aging: 1P30 AG028716Web of Scienc

Researching COVID to Enhance Recovery (RECOVER) adult study protocol: Rationale, objectives, and design.

ImportanceSARS-CoV-2 infection can result in ongoing, relapsing, or new symptoms or other health effects after the acute phase of infection; termed post-acute sequelae of SARS-CoV-2 infection (PASC), or long COVID. The characteristics, prevalence, trajectory and mechanisms of PASC are ill-defined. The objectives of the Researching COVID to Enhance Recovery (RECOVER) Multi-site Observational Study of PASC in Adults (RECOVER-Adult) are to: (1) characterize PASC prevalence; (2) characterize the symptoms, organ dysfunction, natural history, and distinct phenotypes of PASC; (3) identify demographic, social and clinical risk factors for PASC onset and recovery; and (4) define the biological mechanisms underlying PASC pathogenesis.MethodsRECOVER-Adult is a combined prospective/retrospective cohort currently planned to enroll 14,880 adults aged ≥18 years. Eligible participants either must meet WHO criteria for suspected, probable, or confirmed infection; or must have evidence of no prior infection. Recruitment occurs at 86 sites in 33 U.S. states, Washington, DC and Puerto Rico, via facility- and community-based outreach. Participants complete quarterly questionnaires about symptoms, social determinants, vaccination status, and interim SARS-CoV-2 infections. In addition, participants contribute biospecimens and undergo physical and laboratory examinations at approximately 0, 90 and 180 days from infection or negative test date, and yearly thereafter. Some participants undergo additional testing based on specific criteria or random sampling. Patient representatives provide input on all study processes. The primary study outcome is onset of PASC, measured by signs and symptoms. A paradigm for identifying PASC cases will be defined and updated using supervised and unsupervised learning approaches with cross-validation. Logistic regression and proportional hazards regression will be conducted to investigate associations between risk factors, onset, and resolution of PASC symptoms.DiscussionRECOVER-Adult is the first national, prospective, longitudinal cohort of PASC among US adults. Results of this study are intended to inform public health, spur clinical trials, and expand treatment options.RegistrationNCT05172024

Researching COVID to Enhance Recovery (RECOVER) adult study protocol: Rationale, objectives, and design.

IMPORTANCE: SARS-CoV-2 infection can result in ongoing, relapsing, or new symptoms or other health effects after the acute phase of infection; termed post-acute sequelae of SARS-CoV-2 infection (PASC), or long COVID. The characteristics, prevalence, trajectory and mechanisms of PASC are ill-defined. The objectives of the Researching COVID to Enhance Recovery (RECOVER) Multi-site Observational Study of PASC in Adults (RECOVER-Adult) are to: (1) characterize PASC prevalence; (2) characterize the symptoms, organ dysfunction, natural history, and distinct phenotypes of PASC; (3) identify demographic, social and clinical risk factors for PASC onset and recovery; and (4) define the biological mechanisms underlying PASC pathogenesis. METHODS: RECOVER-Adult is a combined prospective/retrospective cohort currently planned to enroll 14,880 adults aged ≥18 years. Eligible participants either must meet WHO criteria for suspected, probable, or confirmed infection; or must have evidence of no prior infection. Recruitment occurs at 86 sites in 33 U.S. states, Washington, DC and Puerto Rico, via facility- and community-based outreach. Participants complete quarterly questionnaires about symptoms, social determinants, vaccination status, and interim SARS-CoV-2 infections. In addition, participants contribute biospecimens and undergo physical and laboratory examinations at approximately 0, 90 and 180 days from infection or negative test date, and yearly thereafter. Some participants undergo additional testing based on specific criteria or random sampling. Patient representatives provide input on all study processes. The primary study outcome is onset of PASC, measured by signs and symptoms. A paradigm for identifying PASC cases will be defined and updated using supervised and unsupervised learning approaches with cross-validation. Logistic regression and proportional hazards regression will be conducted to investigate associations between risk factors, onset, and resolution of PASC symptoms. DISCUSSION: RECOVER-Adult is the first national, prospective, longitudinal cohort of PASC among US adults. Results of this study are intended to inform public health, spur clinical trials, and expand treatment options. REGISTRATION: NCT05172024