Effects of a 12-hour shift on mood states and sleepiness of Neonatal Intensive Care Unit nurses

OBJETIVO Evaluar el efecto de un turno de 12 horas en estados de ánimo y somnolencia al principio y al final del turno. MÉTODO Estudio cuantitativo, transversal y descriptivo.Se realizó con 70 enfermeras de unidades de cuidados intensivos neonatales. Se administró la Escala de Humor Brunel (BRUMS), la Escala de Somnolencia de Karolinska (KSS) y un cuestionario de perfil sociodemográfico. RESULTADOS Cuando se compararon las puntuaciones de KSS y BRUMS al comienzo del turno se encontraron asociaciones con calidad de sueño previa (p ≤ 0,01) y calidad de vida (p ≤ 0,05). Los efectos estadísticos significativos en las puntuaciones de BRUMS también se asociaron con la calidad previa del sueño, la calidad de vida, la ingestión de líquidos, la dieta saludable, el estado civil y el estrés laboral por turnos. Cuando se compararon el comienzo y el final del turno, se observaron diferentes puntuaciones de KSS en el grupo de todos los enfermeros y en el turno de noche. Se observaron puntuaciones significativas de vigor y fatiga dentro de los grupos de turnos. CONCLUSIÓN Dormir bien de noche tiene efectos positivos en los estados de ánimo del individuo tanto al principio como al final del turno. La autopercepción de una buena calidad de vida también influyó positivamente en las puntuaciones KSS y BRUMS al inicio y al final del turno. La ingesta de líquidos adecuada condujo a mejores puntuaciones KSS y BRUMS.OBJECTIVE To assess the effect of a 12-hour shift on mood states and sleepiness at the beginning and end of the shift. METHOD Quantitative, cross-sectional and descriptive study.It was conducted with 70 neonatal intensive care unit nurses. The Brunel Mood Scale (BRUMS), Karolinska Sleepiness Scale (KSS), and a socio-demographic profile questionnaire were administered. RESULTS When the KSS and BRUMS scores were compared at the beginning of the shift associations were found with previous sleep quality (p ≤ 0.01), and quality of life (p ≤ 0.05). Statistical significant effects on BRUMS scores were also associated with previous sleep quality, quality of life, liquid ingestion, healthy diet, marital status, and shift work stress. When the beginning and end of the shift were compared, different KSS scores were seen in the group of all nurses and in the night shift one. Significant vigor and fatigue scores were observed within shift groups. CONCLUSION A good night’s sleep has positive effects on the individual`s mood states both at the beginning and the end of the shift. The self-perception of a good quality of life also positively influenced KSS and BRUMS scores at the beginning and end of the shift. Proper liquid ingestion led to better KSS and BRUMS scores.OBJETIVO Avaliar o efeito de um turno de 12 horas nos estados de humor e na sonolência ao início e ao final do turno. MÉTODO Estudo quantitativo, transversal e descritivo. O estudo foi realizado com 70 profissionais de enfermagem de unidades de terapia intensiva neonatal. A Escala de Humor de Brunel (BRUMS), a Escala de Sonolência de Karolinska (KSS) e oQuestionário Perfil Sociodemográfico foram aplicados. RESULTADOS Quando os escores da KSS e da BRUMS foram comparados no início do plantão, associações foram encontradas entrea qualidade do último sono (p ≤ 0,01) e a qualidade de vida (p ≤ 0,05). Efeitos significativamente estatísticos nos escores da BRUMS também foram associados às variáveis:qualidade do sono, qualidade de vida, ingestão de líquido, dieta saudável, estado civil e estresse no plantão. Quando o início e o fim do turno foram comparados, diferentes escores para sonolência foram vistos no grupo de todos os enfermeiros e no turno da noite. Escores significativos de vigor e de fadiga foram observados intergrupos. CONCLUSÃO Uma boa noite de sono tem efeitos positivos sobre os estados de humor tanto no início quanto ao final do turno. A autopercepção de uma boa qualidade de vida também influenciou positivamente os escores da KSS e da BRUMS no início e ao final do turno. A ingestão adequada de líquidos levou a melhorespontuaçõesKSS e BRUMS

Metabolism and accumulation of the lipophilic deoxynucleoside analogs elacytarabine and CP-4126

Cytarabine (ara-C) and gemcitabine (dFdC) are commonly used anticancer drugs, which depend on the equilibrative (ENT) and concentrative-nucleoside-transporters to enter the cell. To bypass transport-related drug resistance, lipophilic derivatives elacytarabine (CP-4055), ara-C-5′elaidic-acid-ester, and CP-4126, (CO 1.01) gemcitabine-5′elaidic-acid-ester, were investigated for the entry into the cell, distribution, metabolism and retention. The leukemic CEM-cell-line and its deoxycytidine-kinase deficient variant (CEM/dCK-) were exposed for 30 and 60 min to the radiolabeled drugs; followed by culture in drug-free medium in order to determine drug retention in the cell. The cellular fractions were analyzed with thin-layer-chromatography and HPLC. Elacytarabine and CP-4126 were converted to the parent compounds both inside and outside the cell (35–45%). The ENT-inhibitor dipyridamole did not affect their uptake or retention. Inside the cell Elacytarabine and CP-4126 predominantly localized in the membrane and cytosolic fraction, leading to a long retention after removal of the medium. In contrast, in cells exposed to the parent drugs ara-C and dFdC, intracellular drug concentration increased during exposure but decreased to undetectable levels after drug removal. In the dCK- cell line, no metabolism was observed. The concentrations of ara-CTP and dFdCTP reached a peak at the end of the incubation with the drugs, and decreased after drug removal; peak levels of dFdCTP were 35 times higher than ara-CTP and was retained better. In contrast, after exposure to elacytarabine or CP-4126, ara-CTP and dFdCTP levels continued to increase not only during exposure but also during 120 min after removal of the elacytarabine and CP-4126. Levels of ara-CTP and dFdCTP were higher than after exposure to the parent drugs. In conclusion, the lipophilic derivatives elacytarabine and CP-4126 showed a nucleoside-transporter independent uptake, with long retention of the active nucleotides. These lipophilic nucleoside analogues are new chemical entities suitable for novel clinical applications

Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers

PURPOSE: Survivors of acute lung injury (ALI) and their informal caregivers have difficulty coping with the physical and emotional challenges of recovery from critical illness. We aimed to develop and pilot test a telephone-based coping skills training intervention for this population. METHODS: 58 participants were enrolled overall. 21 patients and 23 caregivers participated in a cross-sectional study to assess coping and its association with psychological distress. This also informed the development of an ALI coping skills training intervention in an iterative process involving content and methodological experts. The intervention was then evaluated in 7 patients and 7 caregivers in an uncontrolled, prospective, pre-post study. Outcomes included acceptability, feasibility, and symptoms of psychological distress measured with the Hospital Anxiety and Depression Scale (HADS) and Post-Traumatic Symptom Scale (PTSS). RESULTS: Survivors and their caregivers used adaptive coping infrequently, a pattern that was strongly associated with psychological distress. These findings informed the development of a 12-session intervention for acquiring, applying, and maintaining coping skills. In the evaluation phase, participants completed 77 (92%) of a possible 84 telephone sessions and all (100%) reported that the intervention’s usefulness in their daily routine. Mean change scores reflecting improvements in the HADS (7.8 units) and PTSS (10.3 units) were associated with adaptive coping (r=0.50–0.70) and high self-efficacy (r=0.67–0.79). CONCLUSIONS: A novel telephone-based coping skills training intervention was acceptable, feasible, and may have been associated with a reduction in psychological distress among survivors of ALI and their informal caregivers. A randomized trial is needed to evaluate the intervention