Leadership in Nursing

The nursing literature, until recently presents the phenomenon of leadership as associated with nurse executives and formal leadership roles. That is leadership is defined in terms of an interactive process where followers are motivated and empowered to accomplish specific goals. The purpose of this chapter is to present the phenomena of nursing clinical leadership and leadership at the bedside, which is a new area of research in nursing. This chapter proposes that leadership is not merely linked to top management levels, but it can be developed and implemented at bedside for nurses. Clinical leadership skills focus on patients and healthcare teams rather than formal leadership position. In addition, clinical leadership relates to nursing professional activities, which provide direct care at bedside, which differs from the traditional nursing leadership notion. Thus, acquiring clinical leadership skills is crucial for nurses who provide direct patient care. This allows nurses to direct and support patients and healthcare teams when providing care. Furthermore, it is crucial that nurses develop an effective leadership role to deliver high-quality care and ensure patient safety while engaging in numerous daily leadership roles. Moreover, it emphasized the importance of the cooperation between nursing education programs and healthcare organizations in preparing nurses to be effective leaders by 2020 for the new era of health care

Activation of human endogenous retrovirus K and cellular modifications in human melanoma cell lines: gene expression analysis

Presso i laboratori dell’Università di Tor Vergata è stato sviluppato un sistema in vitro dotato di caratteristiche idonee allo studio dei meccanismi che sono alla base dello sviluppo e della progressione del melanoma. Tale sistema è costituito da una linea cellulare di melanoma umano, isolata da una lesione metastatica di una paziente e caratterizzata dalla capacità di crescere in adesione (linea TVM-A12), da cui sono state ottenute due distinte linee cellulari, dotate invece della caratteristica di crescita in sospensione, derivate l’una mediante tecnica della diluizione limite (Clonesp), e l’altra riducendo la concentrazione di siero dal 10% al 1% nel terreno di coltura (linea TVM-A12sp). Il passaggio dalla fase di crescita in adesione a quella in sospensione, osservato quando le cellule TVM-A12 erano poste in condizione di ridotta concentrazione di siero (1%) era accompagnato da riduzione di espressione dell’antigene melanocitico Melan-A/MART-1 e delle molecole HLA di classe I oltre che dall’aumentata capacità di formare colonie in terreno semisolido. Il cambiamento nella modalità di crescita delle cellule risultava inoltre associata all’aumento dell’espressione di HERV-K, sia a livello di mRNA che di proteine e poteva essere inibito dal blocco dell’espressione di HERV-K, ottenuto mediante RNA interference. Scopo del presente lavoro è stato quello di caratterizzare le linee cellulari TVM-A12, parentale e di derivazione, dotate rispettivamente di capacità di crescita in aderenza ed in sospensione, al fine di chiarire i meccanismi che sono alla base dell’acquisizione del fenotipo dotato di maggiore aggressività ed individuare il ruolo dell’attivazione di HERV-K nella progressione del melanoma. A tale scopo, è stato condotto uno studio dell’espressione genica, mediante microarray, seguito da analisi in Real-Time PCR, che ha mostrato come la transizione fenotipica delle cellule, dalla fase di crescita in adesione a quella di crescita in sospensione, risultava accompagnata dalla modulazione di numerosi geni, che è noto essere coinvolti nell’acquisizione di caratteristiche di malignità. Inoltre il profilo di espressione delle cellule a crescita in sospensione, siano esse originate per diluizione limite o per riduzione della concentrazione di siero nel mezzo di coltura, risultava essere del tutto simile. Lo studio in Real-Time, utilizzato per confermare quanto osservato mediante microarray, ha mostrato che quando le cellule di melanoma iniziavano a distaccarsi dal monostrato, in presenza di FBS all’1%, i geni BHLHB2 e MYC risultavano transitoriamente attivati. Nelle cellule in presenza di bassa concentrazione di siero e durante il passaggio verso la fase definitiva di crescita in sospensione, i geni PTEN, VEFGA, CSK, PITCH1, FOXG1A e TP53 risultavano progressivamente up-regolati. Nelle cellule di melanoma che avevano acquisito la capacità di crescere stabilmente in sospensione, si osservava infine aumento di espressione dei geni WNT3, MYCN, MYCL1, BTK, CCND2, WNT2, TIMP3, IRF3, GTF2I, CTNNB1, E2F1, ARHGAP5, ARHGEF5, GPR39 e ITGB4. Riduzione di espressione dei geni ANXA7, CTNNA1, NME1, RRM1, CDKN1A, XRCC6, HDAC, TRAM1, CD59 e TOB1 veniva riscontrata invece nelle cellule ancora adese, in presenza di 1 % di siero ed in quelle già in sospensione, rispetto alla linea di origine mantenuta in condizioni di coltura standard (10%FBS). In questo studio è stato per la prima volta descritto un sistema cellulare in cui è stata dimostrata la correlazione tra aumento di espressione di HERV-K e acquisizione di un fenotipo più aggressivo, nonché la modulazione dei geni che in tali processi risultano coinvolti. Tale modello può fornire pertanto un utile strumento per la comprensione dei meccanismi che regolano lo sviluppo e la progressione del melanoma, nonché per la valutazione di agenti farmacologici e modulatori di geni attivi nei confronti dell’espressione di HERV-K e nella progressione del melanoma

Activation of human endogenous retrovirus K and cellular modifications in human melanoma cell lines: gene expression analysis

Presso i laboratori dell’Università di Tor Vergata è stato sviluppato un sistema in vitro dotato di caratteristiche idonee allo studio dei meccanismi che sono alla base dello sviluppo e della progressione del melanoma. Tale sistema è costituito da una linea cellulare di melanoma umano, isolata da una lesione metastatica di una paziente e caratterizzata dalla capacità di crescere in adesione (linea TVM-A12), da cui sono state ottenute due distinte linee cellulari, dotate invece della caratteristica di crescita in sospensione, derivate l’una mediante tecnica della diluizione limite (Clonesp), e l’altra riducendo la concentrazione di siero dal 10% al 1% nel terreno di coltura (linea TVM-A12sp). Il passaggio dalla fase di crescita in adesione a quella in sospensione, osservato quando le cellule TVM-A12 erano poste in condizione di ridotta concentrazione di siero (1%) era accompagnato da riduzione di espressione dell’antigene melanocitico Melan-A/MART-1 e delle molecole HLA di classe I oltre che dall’aumentata capacità di formare colonie in terreno semisolido. Il cambiamento nella modalità di crescita delle cellule risultava inoltre associata all’aumento dell’espressione di HERV-K, sia a livello di mRNA che di proteine e poteva essere inibito dal blocco dell’espressione di HERV-K, ottenuto mediante RNA interference. Scopo del presente lavoro è stato quello di caratterizzare le linee cellulari TVM-A12, parentale e di derivazione, dotate rispettivamente di capacità di crescita in aderenza ed in sospensione, al fine di chiarire i meccanismi che sono alla base dell’acquisizione del fenotipo dotato di maggiore aggressività ed individuare il ruolo dell’attivazione di HERV-K nella progressione del melanoma. A tale scopo, è stato condotto uno studio dell’espressione genica, mediante microarray, seguito da analisi in Real-Time PCR, che ha mostrato come la transizione fenotipica delle cellule, dalla fase di crescita in adesione a quella di crescita in sospensione, risultava accompagnata dalla modulazione di numerosi geni, che è noto essere coinvolti nell’acquisizione di caratteristiche di malignità. Inoltre il profilo di espressione delle cellule a crescita in sospensione, siano esse originate per diluizione limite o per riduzione della concentrazione di siero nel mezzo di coltura, risultava essere del tutto simile. Lo studio in Real-Time, utilizzato per confermare quanto osservato mediante microarray, ha mostrato che quando le cellule di melanoma iniziavano a distaccarsi dal monostrato, in presenza di FBS all’1%, i geni BHLHB2 e MYC risultavano transitoriamente attivati. Nelle cellule in presenza di bassa concentrazione di siero e durante il passaggio verso la fase definitiva di crescita in sospensione, i geni PTEN, VEFGA, CSK, PITCH1, FOXG1A e TP53 risultavano progressivamente up-regolati. Nelle cellule di melanoma che avevano acquisito la capacità di crescere stabilmente in sospensione, si osservava infine aumento di espressione dei geni WNT3, MYCN, MYCL1, BTK, CCND2, WNT2, TIMP3, IRF3, GTF2I, CTNNB1, E2F1, ARHGAP5, ARHGEF5, GPR39 e ITGB4. Riduzione di espressione dei geni ANXA7, CTNNA1, NME1, RRM1, CDKN1A, XRCC6, HDAC, TRAM1, CD59 e TOB1 veniva riscontrata invece nelle cellule ancora adese, in presenza di 1 % di siero ed in quelle già in sospensione, rispetto alla linea di origine mantenuta in condizioni di coltura standard (10%FBS). In questo studio è stato per la prima volta descritto un sistema cellulare in cui è stata dimostrata la correlazione tra aumento di espressione di HERV-K e acquisizione di un fenotipo più aggressivo, nonché la modulazione dei geni che in tali processi risultano coinvolti. Tale modello può fornire pertanto un utile strumento per la comprensione dei meccanismi che regolano lo sviluppo e la progressione del melanoma, nonché per la valutazione di agenti farmacologici e modulatori di geni attivi nei confronti dell’espressione di HERV-K e nella progressione del melanoma

Prevalence of Mouse Mammary Tumor Virus (MMTV)-like sequences in human breast cancer tissues and adjacent normal breast tissues in Saudi Arabia

Abstract Background Breast cancer is considered the most common cancer in women worldwide and is the leading cause of cancer mortality. Sequences similar to Mouse Mammary Tumor Virus (MMTV) were detected in human breast cancer in several studies from different geographical areas. However, the role played by this virus in breast cancer tumorigenesis is not completely understood. These MMTV-like sequences were found to be associated with breast cancer of more malignant types. The aim of this study is to determine the prevalence of MMTV-like envelope gene (env) positivity in breast cancer and non-cancerous breast tissue from Saudi Arabia. Methods Detection of MMTV-like env proviral sequences was done using newly designed primers for conventional polymerase chain reaction (PCR). One hundred nighty four samples were collected from 103 females with breast cancer in addition to 51 control breast tissue obtained from individuals without cancer. We additionally investigated the association of proviral positivity with age of the patients, grade of breast cancer and presence of lymph node metastasis. The results were confirmed by sequencing. Results The prevalence of MMTV-like env proviral positivity was 8.7% (9/103). MMTV env proviral sequences were detected in 5.9% (6/101) of breast cancer tissues and 9.7% (9/93) of non-cancerous adjacent tissues obtained from the same patients. None of the 51 control sample showed positive result for the MMTV env gene. No significant association was found between detection of the virus and the age of the patient, grade of the cancer or presence of metastasis. Conclusion We document the presence of low frequency of MMTV env provirus sequence among breast cancer patients from Saudi Arabia. Further studies are needed to explore the role of the MMTV in breast cancer

AWARENESS, ATTITUDES, PREVENTION, AND PERCEPTIONS OF COVID-19 OUTBREAK AMONG NURSES IN SAUDI ARABIA

he newly discovered coronavirus (COVID-19) has become a pandemic, infecting thousands of people around the world. This study examines nurses’ demographic information (age, gender, marital status, area of practice, total years of experience in the current hospital, work region, monthly salary, educational level, workplace, nationality, working hours per day, total nursing experience, and the respondents’ main source of information on COVID-19), awareness, attitudes, prevention, and perceptions of COVID-19 during the outbreak in Saudi Arabia. A cross-sectional descriptive design of 500 nurses working at government and non-governmental hospitals in five regions in Saudi Arabia were selected using convenience sampling. The Kruskal–Wallis test was applied and the Mann–Whitney test was utilized as a post hoc test. The majority of nurses in this study, 96.85%, had excellent knowledge of COVID-19. Some (83.2%) of nurses reported significant prevention knowledge and treatment skills about COVID-19, while 7.6% had little knowledge about prevention. More than half of the nurses (60.4%) had high positive attitudes toward caring for COVID-19 patients. In conclusion, female nurses, married nurses, and bachelor’s degree nurses had greater awareness, better attitude, and prevention clinical experience towards COVID-19. Meanwhile, non-Saudi nurses had higher self-reported awareness, positive attitudes, optimal prevention, and positive perceptions compared to Saudi nurses. This study provides baseline information immediately needed to enable health authorities to prioritize training programs that support nurses during the COVID-19 pandemic. Keywords: COVID-19; nurses; outbreak; pandemic; Saudi Arabi

Experimental Analysis to Detect Corona COVID-19 Virus Symptoms in Male Patients through Breath Pattern Using Machine Learning Algorithms

In the fourth quarter of the year 2019, the planet became overwhelmed by the pandemic caused by the coronavirus disease (COVID-19). This virus imperiled human life and have affected a considerable percentage of the world population much before its early stage detection mechanisms were discovered and made available at the grassroots level. As there is no specific drug available to treat this infection, the vaccine was intended to serve as the ultimate weapon in the war against this species of coronavirus, but like other viruses, being an RNA virus, this virus also mutates continuously while it passes from one human to the other, making the development of highly potent vaccines even more challenging. This work is being sketched at the juncture when a huge percentage of the human population is already affected by this virus globally. In this work, we are proposing an idea to develop an app to detect coronavirus (COVID-19) symptoms at an early stage by self-diagnosis at home or at the clinical level. An experimental study has been performed on a dummy dataset with 11000 entries of various breadth patterns based on the spirometry analysis, lung volume analysis, and lung capacity analysis of normal male subjects and detailed breath patterns of infected male patients. A logistic regression model is trained after using SMOTE oversampling to balance the data and the predictive accuracy levels of 80%, 78%, and 90%. The results accomplished through this study and experiments may not only aid the clinicians in their medical practice but may also bestow a blue chip to the masterminds engaged in the biomedical research for inventing more evolved, sophisticated, user-friendly, miniaturized, portable, and economical medical app/devices in the future

SCOPE OF NURSING PRACTICE AS PERCEIVED BY NURSES WORKING IN SAUDI ARABIA

The absence of scope of practice guidelines may lead to role ambiguity and legal conse quences in nursing practice. This study measures the scope of practice of nurses in Saudi Arabia. The study utilized a descriptive cross-sectional design using an electronic version of the Arabic Actual Scope of Nursing Practice (A-ASCOP) questionnaire among 928 nurses. Descriptive analysis was followed by a t-test and an analysis of variance (ANOVA). Significance was assured through the Bonferroni test; the effect size was measured through partial η2 when appropriate. The A-ASCOP mean score of each dimension ranged from 4.29 to 4.72 (overall mean = 4.59). Significant overall ASCOP score variations were evident, with higher ASCOP among expatriate nurses, females, Hos pital Operation Program (HOP) nurses, and nurses with postgraduate qualifications. Partial η2 showed a small effect of <0.016. Low-complexity nursing tasks showed insignificant differences no matter the nurse’s position, but were less practiced by Bachelor of Science in Nursing (BSN) and advanced-degree nurses than by those with a diploma education. High complexity of ASCOP was practiced significantly more often by postgraduate-prepared nurses than by diploma-educated nurses. The study showed that there is a range of variation in nursing practice, but that the lack of internal regulations (nursing scope of practice) has no effect on nursing duties. In a country such as Saudi Arabia, where massive national improvement initiatives are frequent, clearly defining the scope of practice for nurses is essential and needs to be done through government mandates. Further studies are essential to define what the scope of practice should include

Nurses&rsquo; Perception of Safety Culture in Medical&minus;Surgical Units in Hospitals in Saudi Arabia

Introduction: Patient safety captures the essence of the primary principle of medical ethics, primum non nocere, first do no harm; this is an important concern in the health care system. Nurses are indispensable members of this system and are the largest group of health care providers involved in the direct delivery of patient care. As an integral part of the health care system, it is important to know nurses&rsquo; opinions on patient safety culture. Objectives: First, to evaluate and measure the existing safety culture and safety of patients in medical&minus;surgical wards (MSW) in hospitals located in the Qassim region, in the Kingdom of Saudi Arabia. Second, to survey the opinion of registered nurses and supervisors/managers about safety culture and issues concerned with safety in hospitals in the region. Materials and Methods: A validated cross-sectional survey, namely the Hospital Survey on Patient Safety Culture (HSOPSC), was used. This survey queried 300 nurses in different MSWs in four hospitals in the Qassim Region. Results: Overall, a positive culture of safety exists in MSWs, with 69% of RNs rating their wards as having great/excellent safety culture. Notably, some participants felt it was problematic that blame was assigned to nurses for reported errors. While 55.9% of participants noted that all errors or narrowly avoided errors had been reported, less than half actually reported errors in the last year. Conclusion: The perceived safety culture was largely positive; however, the results also indicated that a culture of safety comes with some risk and blame

Evaluation of the Patient Experience with the Mawid App during the COVID-19 Pandemic in Al Hassa, Saudi Arabia

(1) Introduction: The objective of this study was to evaluate the patient experience with the Mawid application during the COVID-19 pandemic in Al Hassa, Saudi Arabia. (2) Methodology: A quantitative cross-sectional survey was designed to evaluate the patient experience with the Mawid app during the COVID-19 pandemic in Al Hassa, Saudi Arabia. A total of 146 respondents completed the questionnaire. (3) Results: More than half of the participants (65.8%) opined that application was easy to use. Furthermore, 65.1% of the participants considered it to be very easy and easy to search for the required information; and 63.7% of the respondents reflected that it was easy to book an appointment. There was a statistically significant difference between the ease of searching for the required information (p-value = 0.006); the ease of undoing an unwanted move and gender (p-value = 0.049); the ease of searching for the required information and educational level (p-value = 0.048); the ease of booking an appointment and educational level (p = 0.049); and the ease of searching for the required information and the labor sector of the respondents (p value= 0.049) among the genders. No significant differences were identified among the age groups. (4) Conclusions: Overall, most participants suggested that the Mawid app was easy to use and had a potentially useful set of features to help mitigate and manage the COVID-19 pandemic in Al Hassa, Saudi Arabia