Stres na radu i zdravlje medicinskih sestara u jedinicama intenzivne njege u Srbiji

The aim of this study was to identify and analyse professional stressors, evaluate the level of stress in nurses in Intensive Care Units (ICU), and assess the correlation between the perception of stress and psychological and somatic symptoms or diseases shown by nurses. The research, designed as a crosssectional study, was carried out in the Intensive Care Units (ICU), in health centres in Serbia. The sample population encompassed 1000 nurses. Expanded Nursing Stress Scale (ENSS) was used as the research instrument. ENSS revealed a valid metric characteristic within our sample population. Nurses from ICUs rated situations involving physical and psychological working environments as the most stressful ones, whereas situations related to social working environment were described as less stressful; however, the differences in the perception of stressfulness of these environments were minor. Socio-demographic determinants of the participants (age, marital status and education level) significantly affected the perception of stress at work. Significant differences in the perception of stressfulness of particular stress factors were observed among nurses with respect to psychological and somatic symptoms (such as headache, insomnia, fatigue, despair, lower back pain, mood swings etc.) and certain diseases (such as hypertension, myocardial infarction, stroke, diabetes mellitus etc). In view of permanent escalation of professional stressors, creating a supportive working environment is essential for positive health outcomes, prevention of job-related diseases and better protection of already ill nurses.Cilj je ovoga rada bio identifi cirati i analizirati profesionalne stresore, procijeniti razinu stresa kod medicinskih sestara u jedinicama intenzivne njege te procijeniti korelaciju između percepcije stresa i prisutnosti psiholoških i somatskih simptoma ili bolesti kod medicinskih sestara. Istraživanje je provedeno u obliku studije presjeka u Jedinicama intenzivne njege u zdravstvenim centrima u Srbiji. Uzorak se sastojao od 1000 medicinskih sestara-tehničara. Za procjenu i analizu profesionalnih stresora korišten je upitnik Expanded Nursing Stress Scale (ENSS), koji je pokazao validne metrijske karakteristike na našoj ispitanoj populaciji. Medicinske sestre u Jedinicama intenzivne njege ocijenile su situacije iz fizičkoga i psihološkoga radnog okruženja kao izrazito opterećujuće, a situacije iz socijalnoga radnog okruženja kao manje opterećujuće. Razlika u percepciji stresogenosti navedenih radnih okruženja nije bila statistički značajna. Sociodemografske determinante ispitanika (dob, bračno stanje i stupanj obrazovanja) značajno utječu na percepciju stresa na radnom mjestu. Utvrđena je statistički značajna razlika u opažanju stresogenosti pojedinih stresnih situacija na radnom mjestu između medicinskih sestara u odnosu na postojanje psihosomatskih simptoma (kao što su glavobolja, nesanica, umor, očaj, bol u leđima, česte promjene raspoloženja) ili određenih bolesti (kao što su povišena hipertenzija, infarkt miokarda, cerebrovaskularni inzult, šećerna bolest). Zbog sve izraženije prisutnosti profesionalnih stresora nužno je poduzeti određene strateške mjere kod medicinskih sestara u Jedinicama intenzivne njege. Strateške mjere podrazumijevaju unaprjeđenje psihosocijalne radne klime, što bi unaprijedilo njihovo zdravlje i spriječilo nastanak bolesti u svezi s radom, ali i omogućilo bolju zaštitu već oboljelim medicinskim sestrama

Prognostic significance of urokinase plasminogen activator and plasminogen activator inhibitor-1 mRNA expression in lymph node- and hormone receptor-positive breast cancer

BACKGROUND: One of the most thoroughly studied systems in relation to its prognostic relevance in patients with breast cancer, is the plasminogen activation system that comprises of, among others, the urokinase Plasminogen Activator (uPA) and its main inhibitor, the Plasminogen Activator Inhibitor-1 (PAI-1). In this study, we investigated the prognostic value of uPA and PAI-1 at the mRNA level in lymph node- and hormone receptor-positive breast cancer. METHODS: The study included a retrospective series of 87 patients with hormone-receptor positive and axillary lymph node-positive breast cancer. All patients received radiotherapy, adjuvant anthracycline-based chemotherapy and five years of tamoxifen treatment. The median patient age was 54 and the median follow-up time was 79 months. Distant relapse occurred in 30 patients and 22 patients died from breast cancer during follow-up. We investigated the prognostic value of uPA and PAI-1 at the mRNA level as measured by real-time quantitative RT-PCR. RESULTS: uPA and PAI-1 gene expression was not found to be correlated with any of the established clinical and pathological factors. Metastasis-free Survival (MFS) and Breast Cancer specific Survival (BCS) were significantly shorter in patients expressing high levels of PAI-1 mRNA (p < 0.0001; p < 0.0001; respectively). In Cox multivariate analysis, the level of PAI-1 mRNA appeared to be the strongest prognostic factor for MFS (Hazard Ratio (HR) = 10.12; p = 0.0002) and for BCS (HR = 13.17; p = 0.0003). Furthermore, uPA gene expression was not significantly associated neither with MFS (p = 0.41) nor with BCS (p = 0.19). In a Cox-multivariate regression analysis, uPA expression did not demonstrate significant independent prognostic value. CONCLUSION: These findings indicate that high PAI-1 mRNA expression represents a strong and independent unfavorable prognostic factor for the development of metastases and for breast cancer specific survival in a population of hormone receptor- and lymph node-positive breast cancer patients

Determination of c-myc amplification and overexpression in breast cancer patients: evaluation of its prognostic value against c-erbB-2, cathepsin-D and clinicopathological characteristics using univariate and multivariate analysis

C-myc and c-erbB-2 amplification and/or overexpression as well as total cathepsin-D (CD) concentration have been reported to be associated with poor prognosis in breast cancer. The prognostic significance, however, remains somewhat controversial, partly because of discrepancies among the different methodologies used. We determined the amplification and overexpression of c-myc oncogene in 152 breast cancer patients and examined its prognostic value in relation to c-erbB-2 amplification and overexpression, high concentration of CD (≥ 60 pmol mg–1 protein) and standard clinicopathological prognostic factors of the disease. High CD concentration, as well as c-myc amplification and overexpression, proved to be the best of the new variables examined for prediction of early relapse (ER; before 3 years). After multivariate analysis only CD remained significant, which suggests that the prognostic power of these variables is similar. Using univariate analysis we proved that c-myc amplification and overexpression were highly significant for disease-free survival (DFS) (P = 0.0016 and P = 0.0001 respectively) and overall survival (OS) (P < 0.0001 and P = 0.0095 respectively), although by multivariate analysis c-myc overexpression was statistically significant only for DFS (P = 0.0001) and c-myc amplification only for OS (P = 0.0006). With regard to c-erbB-2, only its overexpression appeared to be significant for DFS and OS, although after multivariate analysis its prognostic power was weaker (P = 0.030 and P = 0.024 respectively). c-myc amplification and overexpression exhibited a tendency for locoregional recurrence (LRR) (P = 0.0024 and P = 0.0075 respectively), however, their prognostic value was lower after multivariate analysis and only CD remained significant. © 1999 Cancer Research Campaig

Declining Sleep Quality among Nurses: A Population-Based Four-Year Longitudinal Study on the Transition from Nursing Education to Working Life

Background: Several studies have established impaired sleep is a common problem among nurses. Overworked, fatigued and stressed nurses are at a higher risk of making mistakes that threaten patient safety as well as their own health. The aim of the present study was to longitudinally monitor the development of sleep quality in nurses, starting from the last semester at the university, with three subsequent annual follow-ups once the nurses had entered working life. Methodology/Principal Findings: Nationwide, longitudinal questionnaire study of nursing students and newly qualified nurses in Sweden. The results imply a continuous decline in sleep quality among nurses during the three years of follow-up, starting from their last semester of nursing education and continuing for three years into their working life. The most pronounced short-term decline in sleep quality seems to occur in the transition between student life and working life. Conclusion/Significance: This finding is important since it may affect the quality of care and the health of nurses negatively

Intra-regional transportation of a tugboat fouling community between the ports of recife and natal, northeast Brazil

This study aimed to identify the incrusting and sedentary animals associated with the hull of a tugboat active in the ports of Pernambuco and later loaned to the port of Natal, Rio Grande do Norte. Thus, areas with dense biofouling were scraped and the species then classified in terms of their bioinvasive status for the Brazilian coast. Six were native to Brazil, two were cryptogenic and 16 nonindigenous; nine of the latter were classified as established (Musculus lateralis, Sphenia fragilis, Balanus trigonus, Biflustra savartii, Botrylloides nigrum, Didemnum psammatodes, Herdmania pallida, Microscosmus exasperatus, and Symplegma rubra) and three as invasive (Mytilopsis leucophaeta, Amphibalanus reticulatus, and Striatobalanus amaryllis). The presence of M. leucophaeata, Amphibalanus eburneus and A. reticulatus on the boat's hull propitiated their introduction onto the Natal coast. The occurrence of a great number of tunicate species in Natal reflected the port area's benthic diversity and facilitated the inclusion of two bivalves - Musculus lateralis and Sphenia fragilis - found in their siphons and in the interstices between colonies or individuals, respectively. The results show the role of biofouling on boat hulls in the introduction of nonindigenous species and that the port of Recife acts as a source of some species.Este trabalho objetivou identificar os animais incrustantes e sedentários associados ao casco de um rebocador que atuava nos Portos de Pernambuco e foi cedido para o Porto de Natal, Rio Grande do Norte. Áreas com densa bioincrustação foram raspadas e as espécies foram posteriormente classificadas em relação ao status de bioinvasão no litoral brasileiro. Dentre as espécies identificadas, seis eram nativas do Brasil, duas criptogênicas e 16 exóticas. Destas, oito foram classificadas como estabelecidas (Musculus lateralis, Sphenia fragilis, Balanus trigonus, Biflustra savartii, Botrylloides nigrum, Didemnum psammatodes, Herdmania pallida, Microscosmus exasperatus, Symplegma rubra) e três como invasoras (Mytilopsis leucophaeta, Amphibalanus reticulatus e Striatobalanus amaryllis). A presença de M. leucophaeata, Amphibalanus eburneus e A. reticulatus no casco da embarcação, propiciou sua introdução na costa de Natal. A ocorrência de grande número de espécies de tunicados em Natal refletiu a biodiversidade bêntica da área portuária e facilitou a inclusão de dois bivalves, Musculus lateralis e Sphenia fragilis, encontrados em seus sifões e nos interstícios entre colônias ou indivíduos, respectivamente. Os dados obtidos indicam que a incrustação em cascos de embarcações tem um papel preponderante na introdução de espécies exóticas, e que o Porto do Recife atuou como fonte de algumas destas espécies

Analyses of a 426-Day Record of Seafloor Gravity and Pressure Time Series in the North Sea

International audienceContinuous gravity observations of ocean and solid tides are usually done with land-based gravimeters. In this study we analyze a 426-day record of time-varying gravity acquired by an ocean-bottom Scintrex spring gravimeter between August 2005 and November 2006 at the Troll A site located in the North Sea at a depth of 303 m. Sea-bottom pressure changes were also recorded in parallel with a Paroscientific quartz pressure sensor. From these data, we show a comparison of the noise level of the sea-floor gravimeter with respect to two standard land-based relative gravimeters: a Scintrex CG5 and a GWR Superconducting Gravimeter that were recording at the J9 gravimetric observatory of Strasbourg (France). We also compare the analyzed gravity records with the predicted solid and oceanic tides. The oceanic tides recorded by the seafloor barometer are also analyzed and compared to the predicted ones using FES2014b ocean model. Observed diurnal and semi-diurnal components are in good agreement with FES2014b predictions. Smallest constituents reflect some differences that may be attributed to non-linearity occurring at the Troll A site. Using the barotropic TUGO-m dynamic model of sea level response to ECMWF atmospheric pressure and winds forcing, we show a good agreement with the detided ocean-bottom pressure residuals. About 4-hPa of standard deviation of remaining sea-bottom pressure are however not explained by the TUGO-m dynamic model

Second generation biofuels: Thermochemistry of glucose and fructose

International audienc

[Instrumental extractions using Thierry's spatulas: evaluation of the risk of perineal laceration according to occiput position in operative deliveries]

International audienceOBJECTIVE: Risk factors for severe perineal lacerations are nowadays well-known and they include operative vaginal deliveries and extractions in occiput posterior (OP) positions. The aim of this study was to assess whether OP position increases the risk for anal sphincter injury when compared with occiput anterior (OA) positions in operative deliveries using Thierry's spatulas. METHODS: Retrospective study of 163 extractions with Thierry's spatulas over a five-year period (January 2000 to December 2005) performed in a general hospital. Singleton cephalic pregnancies at term were studied and the incidence of severe perineal lacerations was noted in deliveries in OP and OA positions. RESULTS: In these 163 cases, the varieties of presentation obtained by vaginal examination were 129 in anterior and 34 in posterior positions. Eleven posterior positions rotated anteriorly on delivery and 23 remained in a posterior position. The OA group (n=140) and the OP group (n=23) were constituted. Anal sphincter injury occurred significantly more often in the OP group compared with the OA group (17.4% versus 2.9%, p=0.014) with an odds ratio of 7.1 (95% CI 1.6-31). Only one fourth-degree laceration was noted. Within the OP group, the incidence of vaginal lacerations was increased compared to the OA group, but without any significant difference (43.5% versus 27.9%, p=0.20). In a logistic regression model, the OP position was 6.4 times (95% CI 1.3-31.5) more likely to be associated with anal sphincter injury than OA position. The incidence of OP position was 14.1% within the whole population studied and Thierry's spatulas permit anterior rotations of occipito posterior presentation in only 32.4% of cases. CONCLUSION: The efficiency of Thierry's spatulas is proven. As with forceps and vacuum extractors, extraction with Thierry's spatulas is a risk factor for perineal laceration compared to a spontaneous delivery. In deliveries with spatulas, OP head positions further increase this perineal risk against OA positions. OP positions before fetal extractions do not seem to be an ideal situation for using spatulas, even if an anterior rotation is achieved in one-third of cases