Compassion Fatigue among Healthcare Personnel in Acute Care Contexts: An Integrative Review

Healthcare workers in acute care settings experience considerable emotional exhaustion on a daily basis, which might lead to the manifestation of compassion fatigue that adversely impacts their wellbeing. There has been an increasing awareness in understanding compassion fatigue on healthcare workers recently, but the literature within this area remains ambiguous due to the use of different terminology. This integrative review aims to synthesize the existing research knowledge of the manifestation of compassion fatigue and the related concepts in acute care contexts. A total of 27 full-text research articles were retrieved for analysis. The interpretation of the selected articles yielded four main categories, which included the prevalence, risk factors, protective factors, and consequences regarding compassion fatigue among healthcare workers. These findings provide an outline for decision makers of healthcare organizations to formulate a strategic plan for helping healthcare workers to cope with compassion fatigue in everyday work and disaster events

The transition challenges faced by new graduate nurses in their first year of professional experience

Though nurses form the largest group of healthcare professionals in most of the healthcare systems, the transition from an academic to a real-world setting is characterized by high stress and reality shock, which contributes to a high turnover rate during the first year of practice. This qualitative study aimed to illustrate the transition experience of new graduate nurses and to identify the factors affecting their adaptation processes. Registered nurses who had completed university nursing training program and possessed about a year of professional nursing experience in Hong Kong were recruited for semi-structured, face-to-face individual interviews. The data was saturated after 14 new graduate nurses had been interviewed. The participants experienced complicated perceptions with fluctuating feelings ranging from frustration to a sense of accomplishment during the transition period. Four interrelated human and work related factors were illuminated to influence their adaptation to transition: 1) professional accountability and competency, 2) personal adaptation attitude and ability, 3) interpersonal relationships with colleagues and 4) institutional/workplace support and orientation. The findings demonstrated a close link between perceptions and the interrelated factors affecting transition experiences and adaptation processes. Education and healthcare institutions should provide more training and support in the promotion of emotional well-being, the improvement of professional knowledge and skills, and in-service adaptation enhancement programs before and during the transition. Further comprehensive studies with longitudinal designs are recommended to explore the perceptions of new graduate nurses. Keyword

Emergency Nurses’ Experience on End-of-life Care: An Integrative Review

Emergency nurses are regarded as the key healthcare professional (HCP) in the emergency department endof-life (ED-EOL) care. The emergency nurses encountered the dying and death on a regular base. Still, they find the EOL care is another aspect and caring from their usual practice. With the successful ED-EOL care delivery, it can help to meet the needs of the imminent patients and families. Emergency nurses admired the pain and symptoms management helping the ED-EOL patients. This paper reviewed the existing literature on the emergency nurses’ perception of ED-EOL care. A systematic search of the literature published between January 2005 and January 2016 was conducted to identify published studies concerning emergency nurses’ practice and the influencing factors in EOL care provision. The final sample for this integrative review was comprised of 23 studies. It is suggested in the results of the included studies that emergency nurses’ EOL care in the clinical context could involve the care of the dying patients and their families in both physical, psychosocial and spiritual aspects. Further study of the emergency nurses and different ED-HCPs are encouraged which could make the ED-EOL care more fruitful and bright in the future

Knowledge, Attitude and Practice of Breast Selfexamination among Nursing Students in Hong Kong: A Cross-sectional Study

Breast cancer is a global public health concern. Currently, the crude incidence rate of breast cancer in Hong Kong is increasing. Although breast self-examination (BSE) is an effective screening method which able to reduce mortality rates, only a few women perform it monthly. As nurses play a significant role in promoting BSE, this study aims to study the knowledge, attitude, and practice of BSE for nursing students. A crosssectional design was employed, and 372 nursing students participated in this study. Results reveal that even BSE are compulsory in nursing curriculum, poor knowledge (“don’t know” 46.9%, incorrect 9.4%.), poor attitude (mean = 24.29, SD = 3.49) and limited practice (mean = 7.69, SD = 4.66) were found. Regression analysis support that knowledge and attitude predict practice of BSE. It is important to promote and build up the awareness of BSE to nursing students by enhancing their knowledge and attitude

Stage-Specific Generation of Human Pluripotent Stem Cell Derived Lung Models to Measure CFTR Function

Human embryonic stem cells (ES) and induced pluripotent stem cells (iPSC) are powerful tools that have the potential to generate in vitro human lung epithelial cells. However, challenges in efficiency and reproducibility remain in utilizing the cells for therapy discovery platforms. Here, we optimize our previously published protocols to efficiently generate three developmental stages of the lung model (fetal lung epithelial progenitors, fLEP; immature airway epithelial spheroid, AES; air-liquid interface culture, ALI), and demonstrate its potential for cystic fibrosis (CF) drug discovery platforms. The stepwise approach directs differentiation from hPSC to definitive endoderm, anterior ventral foregut endoderm, and fetal lung progenitor cells. The article also describes the generation of immature airway epithelial spheroids in Matrigel with epithelial cells sorted by a magnetic-activated cell sorting system, and the generation of adult-like airway epithelia through air-liquid interface conditions. We demonstrate that this optimized procedure generates remarkably higher cystic fibrosis transmembrane conductance regulator (CFTR) expression and function than our previous method, and thus is uniquely suitable for CF research applications. © 2022 The Authors. Current Protocols published by Wiley Periodicals LLC. Basic Protocol 1: hESC/hiPSC differentiation to fetal lung progenitors Basic Protocol 2: Formation of airway epithelial spheroids Alternate Protocol 1: Cryopreservation of airway epithelial spheroids Basic Protocol 3: Differentiation and maturation in air-liquid interface culture Alternate Protocol 2: Differentiation and maturation of epithelial progenitors from airway epithelial spheroids in ALI culture

Knowledge, practices, compliance and beliefs of university nursing students’ toward hand hygiene: A cross-sectional survey

Nursing students can contribute to healthcareassociated infections if having inadequate knowledge and noncompliance of hand hygiene. Effective hand hygiene is considered the most effective measure for preventing healthcare-associated infections. This study investigated the knowledge, practices, compliance, and beliefs of university nursing students toward hand hygiene. By using a well-validated, self-report hand hygiene questionnaire, a cross-sectional survey was performed. In the convenience sampling, 421 out of 506 questionnaires were returned (83.2%). There were 169 (40.14%), 170 (40.38%) and 82 (19.48%) nursing students from Years 1, 2 and 3, respectively. The respondents’ overall mean score for hand hygiene knowledge was 7.33/10 (SD = 1.52) with an increasing trend of knowledge performance along study year was observed. The hand hygiene practice inventory was 4.76/5 (SD = 0.303). The mean scores for respondents from Years 1, 2 and 3 were 4.75 (SD = 0.367), 4.82 (SD = 0.20) and 4.69 (SD = 0.290), respectively. The self-reported hand hygiene compliance rate was 88.17% (SD = 11.922) and the mean score on the health beliefs scale was 4.03/5 (SD = 0.34). The university nursing students demonstrated moderate knowledge, good practices, a high compliance rate and positive beliefs toward hand hygiene. More effort on educating healthcare professionals about alcohol-based hand rubs and the promotion of hand cream usage to prevent hand-hygiene-induced skin irritations are suggested. Regular training workshops or seminars could be arranged to maintain knowledge levels and cultivate a positive attitude toward hand hygiene

What are the obligations of pharmaceutical companies in a global health emergency?

All parties involved in researching, developing, manufacturing, and distributing COVID-19 vaccines need guidance on their ethical obligations. We focus on pharmaceutical companies' obligations because their capacities to research, develop, manufacture, and distribute vaccines make them uniquely placed for stemming the pandemic. We argue that an ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability. All parties' obligations should be coordinated and mutually consistent. For instance, companies should not be obligated to provide host countries with additional booster shots at the expense of fulfilling bilateral contracts with countries in which there are surges. Finally, any satisfactory approach should include mechanisms for assurance that all parties are honouring their obligations. This assurance enables countries, pharmaceutical companies, global organisations, and others to verify compliance with the chosen approach and protect ethically compliant stakeholders from being unfairly exploited by unethical behaviour of others

Genetic polymorphisms in AH receptor and cytochrome P450 drug-metabolizing enzymes in relation to estradiol metabolism and breast cancer susceptibility

grantor: University of TorontoBioactivation of environmental procarcinogens and prolonged exposure to 17ß-estradiol and catechol estrogens have been implicated in the etiology of mammary carcinogenesis. Endogenous 17ß-estradiol is oxidized to catechol estrogens by cytochrome P450 CYP1A2 and CYP1B1 enzymes which are transcriptionally regulated by the AH receptor. These enzymes are also involved in the bioactivation of numerous environmental procarcinogens such as benzo['a']pyrene. Consequently, those genetic polymorphisms in 'CYP1A2, CYP1B1' and 'AHR' that result in changes of enzyme or receptor function may affect 17ß-estradiol clearance and metabolic activation of procarcinogens. I genotyped two populations for a total of 7 polymorphisms in the 'AHR, CYP1A2' and ' CYP1B1' genes to examine whether these gene polymorphisms modify estrogen metabolism (Project 1) and breast cancer susceptibility (Project 2). Data of our estrogen metabolism study (Project 1) suggest that the 'AHR ' 554 polymorphism is related to alterations in 17ß-estradiol metabolism. Results of our Quebec French Canadian breast cancer case-control study (Project 2) indicate that the 'AHR' 554, 'CYP1A2*1F, CYP1B1*3' and 'CYP1B1*4' polymorphisms may modify breast cancer susceptibility.M.Sc

College students' knowledge and attitudes toward bystander cardiopulmonary resuscitation: A cross-sectional survey ABOUT THE AUTHORS

Abstract: Background: Sudden cardiac arrest attracts global attention because it is a fatal public health concern. Early implementation of high-quality cardiopulmonary resuscitation (CPR) can significantly improve chances of survival. The significance of CPR training is well recognized by the American Heart Association. College students are potential bystanders who could perform CPR in the community. Aim: This study purpose is to explore college students' knowledge and attitudes toward CPR. Methods: A cross-sectional survey with convenience sampling was conducted in a tertiary college. From September to October 2015, 506 hard-copies of a well-validated questionnaire were distributed. Results: Of 351 respondents, 73 (21.8%) were male and 278 (79.2%) were female. The mean knowledge score was 4.97 out of 10 with a standard deviation of 1.61. Over half of the respondents (n = 194, 55.3%) had attended a CPR course before. The mean attitude score was 26.53 out of 30, and the standard deviation was 2.68. Most of the respondents (87.0%) showed a willingness to perform CPR. The reasons for attending CPR training were mainly "interest" (n = 106, 46.5%), followed by "extra-curricular activity" (n = 37, 16.2%), "to help PUBLIC INTEREST STATEMENT Sudden cardiac arrest attracts global attention because it is a fatal public health concern worldwide. Early implementation of cardiopulmonary resuscitation (CPR) is vital to increase the survival chances and improve the neurologic and health outcomes for outof-hospital cardiac arrest victims. This positive association among bystander CPR and beneficial functional outcomes enhances the significance of promoting community CPR programs. Colleges and Universities have been shown to be ideal settings for CPR training, and their students are one of the most suitable potential bystanders trained for CPR in the community. This study explored Hong Kong college students' knowledge, attitudes and related factors affecting bystander CPR, and compared CPR knowledge and attitudes between students who have and have not been trained in CPR. The results provide directions for future planning and training. Incorporation of CPR training into the tertiary education curricula could be a long-term strategy to expand CPR benefits to the wider community. family and friends in need" (n = 37, 16.2%) and "others" (n = 29, 12.7%) such as to fulfill job or academic requirement. The most frequently reported inhibitors of performing bystander CPR were a lack of confidence due to forgetting CPR procedures (28.8%) and lack of confidence due to not having received any CPR training (19.1%). Conclusions: Although students had a positive attitude toward CPR, inadequate knowledge and training were found. Incorporation of CPR training into the college curricula could be a long-term strategy to enhance CPR benefits to the wider community. Maintaining better knowledge and skills retention, regular and refresher training for students are recommended

Effects of Online Health Promotion Program to Improve the Health and Wellbeing of Healthcare Students: A Feasibility Study

Background: Healthcare students’ health and wellbeing have been seriously affected worldwide. Research studies highlighted the need to establish health promotion strategies to improve them. Methods: A mixed method feasibility with a randomized controlled trial study followed by qualitative focus-group interviews to evaluate the effect of a 24 h online health promotion program improving healthcare students’ health and wellbeing was performed in mid-2022. The study also illustrated the program’s effect, contents, and activity arrangements. Healthcare students from two large tertiary institutions were randomly assigned to intervention and waitlist-control groups. Outcomes were measured by self-completed online questionnaires at three-time points (baseline, week four, and week eight), and in-depth focus-group interviews followed. Results: Among 70 enrolled and 60 eligible students, 54 completed the study, with a 10% attrition rate. Results demonstrated a significant difference between groups at week eight. Within the intervention group, there were significant differences were found from baseline to week eight for depression (p = 0.001), anxiety (p = 0.004), and stress (p < 0.001). The program also improved certain domains of personal wellbeing and quality of life. Qualitative findings further illustrated the program contents and activities’ feasibility, acceptability, and suitability. Most participants welcomed the online mode’s flexibility and convenience. They enjoyed diversified and complementary content and activities. They had increased self-awareness of health and wellbeing. Besides, mental health knowledge enables them to ‘self-care’ and help those in need in the future. Conclusions: The results indicate the feasibility of performing full-scale research in the future and may provide more support for the students of higher education institutions