Factors Contributing to Nurses’ Intention to Leave the Profession: A Qualitative Study in Catalonia, Spain, following the Latest Waves of COVID-19

Introduction. The COVID-19 pandemic has had a significant impact on healthcare professionals globally, with nurses facing diverse challenges at the forefront. Despite their resilience, nurses are experiencing emotional burdens, which have contributed to a growing intention to abandon the profession. Understanding these factors is crucial for addressing the global nursing shortage. Methods. A qualitative descriptive approach was utilized for this study. Nurses who were actively working during the last waves of the pandemic in Catalonia, Spain, were intentionally recruited through social media and personal contacts, and data were collected through online semistructured interviews until data saturation was reached. Data were analyzed using Braun and Clarke’s thematic analysis method. Results. Fourteen nurses, with an average of 22.8 years of work experience, were interviewed. Thematic analysis revealed three main themes: (1) the impact of COVID-19 on health, (2) factors influencing the decision to stay, and (3) recommendations to improve crisis management. Conclusion. Nurses faced significant emotional impacts but demonstrated dedication and resilience. Their decision to persevere was influenced by factors such as responsibility, guilt, and economic stability. Urgent measures are necessary to provide tailored mental health support and recognize emotional challenges in crisis preparedness.Open access funding was enabled and organized by CRUE-CSUC 2024

Sexuality in people living with a serious mental illness: a meta‐synthesis of qualitative evidence

Introduction: Sexuality-related nursing care is scarce and mainly focuses on biological issues. There is also a lack of knowledge about how serious mental illnesses affect sexuality.Aim: To explain how people with a serious mental illness perceive and experience their sexuality. Method: A meta-synthesis was conducted to integrate qualitative studies. Four databases were used to perform the search, focused in the last ten years. Nine articles were included, and their results analysed thematically. Results: Four categories were identified: 'Pathologized sexuality', which explains how the disorder and treatment affect sexuality; 'Not my sexuality anymore", which describes feelings emerging from the perceived limitations and the role of selfacceptance; "Learning to manage intimate relationships", which explains the desire to establish intimate personal relationships and define their meaning; and 'Reconstructing my sexuality', which elucidates the influence of the environment on sexuality. Discussion: Sexuality is influenced by several factors, the main ones being: the clinical complications, the side effects of drug treatment, the social support, the relationship with the health sector, and stigma. Implications for Practice: Having a serious mental illness affects sexuality and can provoke suffering and social isolation. Mental health services should address this issue and carry out community interventions to reduce stigma. RELEVANCE STATEMENT: This study shows that having a serious mental illness affects sexuality and can provoke suffering and social isolation. Also, people living with a serious mental illness have not lost interest in maintaining an active sex life and, therefore, mental health services must respond to this need. Nurses can develop their role as health educators and should receive training on affective and sexual education to allow them to advise on options to develop the sexual dimension of these people. Additionally, mental health services should address this issue and carry out community interventions to reduce stigma

Sexuality in people living with a serious mental illness: A meta-synthesis of qualitative evidence

"Introduction: Sexuality-related nursing care is scarce and mainly focuses on biological issues. There is also a lack of knowledge about how serious mental illnesses affect sexuality. Aim: To explain how people with a serious mental illness perceive and experience their sexuality Method: A meta-synthesis was conducted to integrate qualitative studies. Four databases were used to perform the search, focused in the last ten years. Nine articles were included, and their results analysed thematically. Results: Four categories were identified: ""Pathologized sexuality,"" which explains how the disorder and treatment affect sexuality; ""Not my sexuality anymore,” which describes feelings emerging from the perceived limitations and the role of self-acceptance; “Learning to manage intimate relationships,” which explains the desire to establish intimate personal relationships and define their meaning; and ""Reconstructing my sexuality,"" which elucidates the influence of the environment on sexuality. Discussion: Sexuality is influenced by several factors, the main ones being: the clinical complications, the side effects of drug treatment, the social support, the relationship with the health sector and stigma. Implications for practice: Having a serious mental illness affects sexuality and can provoke suffering and social isolation. Mental health services should address this issue and carry out community interventions to reduce stigma.

Hunger and Satiety Peptides: Is There a Pattern to Classify Patients with Prader-Willi Syndrome?

Hyperphagia is one of the main problems of patients with Prader-Willi syndrome (PWS) to cope with everyday life. The underlying mechanisms are not yet well understood. Gut-brain hormones are an interrelated network that may be at least partially involved. We aimed to study the hormonal profile of PWS patients in comparison with obese and healthy controls. Thirty adult PWS patients (15 men; age 27.5 ± 8.02 years; BMI 32.4 ± 8.14 kg/m2 ), 30 obese and 30 healthy controls were studied before and after eating a hypercaloric liquid diet. Plasma brain-derived neurotrophic factor (BDNF), leptin, total and active ghrelin, peptide YY (PYY), pancreatic polypeptide (PP), Glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and amylin were determined at times 00 , 300 , 600 and 1200 . Cluster analysis was used. When considering all peptides together, two clusters were established according to fasting hormonal standardized concentrations. Cluster 1 encompassed most of obese (25/30) and healthy controls (28/30). By contrast, the majority of patients with PWS were located in Cluster 2 (23/27) and presented a similar fasting profile with hyperghrelinemia, high levels of leptin, PYY, GIP and GLP-1, compared to Cluster 1; that may reflect a dysfunction of these hunger/satiety hormones. When peptide behavior over the time was considered, PP concentrations were not sustained postprandially from 60 min onwards in Cluster 2. BDNF and amylin did not help to differentiate the two clusters. Thus, cluster analysis could be a good tool to distinguish and characterize the differences in hormone responses between PWS and obese or healthy controls

Immunological response against SARS-CoV-2 following full-dose administration of Comirnaty® COVID-19 vaccine in nursing home residents

Objectives: The current study was aimed at examining SARS-CoV-2 immune responses following two doses of Comirnaty® COVID-19 vaccine among elderly people in nursing homes. Methods: A prospective cohort study in a representative sample from nursing homes in Valencia (n ¼ 881; males: 271, females 610; median age, 86 years) recruited residents using a random one-stage cluster sampling approach. A lateral flow immunochromatography device (LFIC) (OnSite COVID-19 IgG/ IgM Rapid Test; CTK BIOTECH, Poway, CA, USA) was used as the front-line test for detecting SARS-CoV-2- Spike (S)-specific antibodies in whole blood obtained using a fingerstick. Residents returning negative LFIC results underwent venipuncture and testing for presence of SARS-CoV-2-S-reactive antibodies and T cells using the Roche Elecsys® Anti-SARS-CoV-2 S (Roche Diagnostics, Pleasanton, CA, USA), the LIAISON® SARS-CoV-2 TrimericS IgG assay (Diasorin S.p.A, Saluggia, Italy) and by flow cytometry, respectively. Results: The SARS-CoV-2-S antibody detection rate in nursing home residents was 99.6% (283/284) and 98.3% (587/597) for SARS-CoV-2 recovered and naïve residents, respectively, within a median of 99 days (range 17e125 days) after full vaccination. Three out of five residents lacking SARS-CoV-2-S antibodies had detectable S-reactive CD8þ and/or CD4þ T cells. In addition, 50/50 and 40/50 participants with detectable SARS-CoV-2 antibodies also had SARS-CoV-2-S-reactive interferon-g-producing CD4þ and CD8þ T cells, respectivelyMedicin

SARS-CoV-2 adaptive immunity in nursing home residents following a third dose of the Comirnaty® COVID-19 vaccine

A third Comirnaty® vaccine dose increased SARS-CoV-2-receptor binding domain antibody levels (median of 93-fold) and neutralizing antibody titers against Wuhan-Hu-1 (median, 57-fold), Beta (median, 22-fold), Delta, (median, 43-fold) and Omicron (median, 8-fold) variants, particularly in SARS-CoV-2-naïve individuals, but had a negligible impact on S-reactive T-cell immunity in nursing home residents.Peer reviewe

Cumulative incidence of SARS-CoV-2 infection in the general population of the Valencian Community (Spain) after the surge of the Omicron BA.1 variant

Background Studies investigating the cumulative incidence of and immune status against SARS-CoV-2 infection provide valuable information for shaping public health decision-making. Methods The current cross-sectional, population-based study, conducted in April 2022 in the Valencian Community (VC), recruited 935 participants of all ages. Anti-SARS-CoV-2-Receptor Binding Domain-RBD-total antibodies and anti-Nucleocapsid (N)- IgGs were measured by electrochemiluminescence assays. To account for past SARS-CoV-2 infection the VC microbiology registry (RedMiVa) was interrogated. |Quantitation of neutralizing antibodies (NtAb) against the ancestral and Omicron BA.1 and BA.2 (sub)variants by an S-pseudotyped neutralization assay and for enumeration of SARS-CoV-2-S specific-IFNγ-producing CD4+ and CD8+ T cells by Intracellular Cytokine Staining assay was performed in a subset of participants (n=100 and 137, respectively). Findings The weighted cumulative incidence was 51□9% (95% CI, 48□7–55□1), and was inversely related to age. Anti-RBD total antibodies were detected in 906/931 (97□3%) participants, those vaccinated and SARS-CoV-2-experienced (VAC-ex;=442) displaying higher levels (P<0.001) than vaccinated/naïve (VAC-n;(n=472) and non-vaccinated/experienced (UNVAC-ex; n(n=63). Antibody levels correlated inversely with the time elapsed since receipt of last vaccine dose in VAC-n (Rho, -0□52; 95% CI, -0□59 to -0□45; P<0.001) but not in VAC-ex. NtAbs against Omicron BA.1 were detected in 94%, 75% and 50% of VAC-ex, VAC-n and UNVAC-ex groups, respectively, while in 97%, 84% and 40%, against Omicron BA.2. SARS-CoV-2-S-reactive IFN-γ T cells were detected in 73%, 75%, and 64% for VAC-ex, VAC-n, UNVAC-ex, respectively. Interpretation By April 2022 around half of the VC population had been infected with SARS-CoV-2 and due to extensive vaccination display hybrid immunity. The large percentage of participants with detectable functional antibody and T-cell responses against SARS-CoV-2, which may be cross-reactive to some extent, points towards lower expected severity than in previous waves.We also thank Ana Berenguer, General Director of Analysis and Public Policies of the Presidency of the Generalitat. Eliseo Albert (Juan Rodés Contract; JR20/00011) Estela Giménez (Juan Rodés Contract, JR18/00053) and Ignacio Torres (Río Hortega Contract; CM20/00090) hold contracts funded by the Carlos III Health Institute (co-financed by the European Regional Development Fund, ERDF/FEDER). Ron Geller holds a Ramon y Cajal fellowship from the Spanish Ministry of Economics and Competitiveness (RYC-2015-17517).N

SARS-CoV-2 Omicron BA.1 variant breakthrough infections in nursing home residents after an homologous third dose of the Comirnaty® COVID-19 vaccine: Looking for correlates of protection

8 páginas, 2 figuras. Texto completo en PubMedCentral: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9348298/pdf/JMV-94-4216.pdfWe investigated whether peripheral blood levels of SARS-CoV-2 Spike (S) receptor binding domain antibodies (anti-RBD), neutralizing antibodies (NtAb) targeting Omicron S, and S-reactive-interferon (IFN)-γ-producing CD4+ and CD8+ T cells measured after a homologous booster dose (3D) with the Comirnaty® vaccine was associated with the likelihood of subsequent breakthrough infections due to the Omicron variant. An observational study including 146 nursing home residents (median age, 80 years; range, 66-99; 109 female) evaluated for an immunological response after 3D (at a median of 16 days). Anti-RBD total antibodies were measured by chemiluminescent immunoassay. NtAb were quantified by an Omicron S pseudotyped virus neutralization assay. SARS-CoV-2-S specific-IFNγ-producing CD4+ and CD8+ T cells were enumerated by whole-blood flow cytometry for intracellular cytokine staining. In total, 33/146 participants contracted breakthrough Omicron infection (symptomatic in 30/33) within 4 months after 3D. Anti-RBD antibody levels were comparable in infected and uninfected participants (21 123 vs. 24 723 BAU/ml; p = 0.34). Likewise, NtAb titers (reciprocal IC50 titer, 157 vs. 95; p = 0.32) and frequency of virus-reactive CD4+ (p = 0.82) and CD8+ (p = 0.91) T cells were similar across participants in both groups. anti-RBD antibody levels and NtAb titers estimated at around the time of infection were also comparable (3445 vs. 4345 BAU/ml; p = 0.59 and 188.5 vs. 88.9; p = 0.70, respectively). Having detectable NtAb against Omicron or SARS-CoV-2-S-reactive-IFNγ-producing CD4+ or CD8+ T cells after 3D was not correlated with increased protection from breakthrough infection (OR, 1.50; p = 0.54; OR, 0.0; p = 0.99 and OR 3.70; p = 0.23, respectively). None of the immune parameters evaluated herein, including NtAb titers against the Omicron variant, may reliably predict at the individual level the risk of contracting COVID-19 due to the Omicron variant in nursing home residents.Ignacio Torres (Río Hortega Contract; CM20/00090), Estela Giménez (Juan Rodés Contract, JR18/00053), and Eliseo Albert (Juan Rodés Contract; JR20/00011) hold contracts funded by the Carlos III Health Institute (cofinanced by the European Regional Development Fund, ERDF/FEDER). Ron Geller holds a Ramon y Cajal fellowship from the Spanish Ministerio de Economía y Competitividad (RYC‐2015‐17517). This study work was supported by Instituto de Salud Carlos III, Madrid, Spain (FIS, PI21/00563) to David Navarro, and by the European Commission NextGenerationEU fund (EU 2020/2094), through CSIC's Global Health Platform (PTI Salud Global) to Ron Geller.Peer reviewe

Prospective individual patient data meta-analysis of two randomized trials on convalescent plasma for COVID-19 outpatients

Data on convalescent plasma (CP) treatment in COVID-19 outpatients are scarce. We aimed to assess whether CP administered during the first week of symptoms reduced the disease progression or risk of hospitalization of outpatients. Two multicenter, double-blind randomized trials (NCT04621123, NCT04589949) were merged with data pooling starting when = 50 years and symptomatic for <= 7days were included. The intervention consisted of 200-300mL of CP with a predefined minimum level of antibodies. Primary endpoints were a 5-point disease severity scale and a composite of hospitalization or death by 28 days. Amongst the 797 patients included, 390 received CP and 392 placebo; they had a median age of 58 years, 1 comorbidity, 5 days symptoms and 93% had negative IgG antibody-test. Seventy-four patients were hospitalized, 6 required mechanical ventilation and 3 died. The odds ratio (OR) of CP for improved disease severity scale was 0.936 (credible interval (CI) 0.667-1.311); OR for hospitalization or death was 0.919 (CI 0.592-1.416). CP effect on hospital admission or death was largest in patients with <= 5 days of symptoms (OR 0.658, 95%CI 0.394-1.085). CP did not decrease the time to full symptom resolution