The Relationship of Self-Care to Burnout Among Social Workers in Health Care Settings

Self-care is critical in minimizing the symptoms of burnout among human services professionals, but specific information on the role of self-care among social workers in healthcare settings is limited. This correlational study was designed provide a fuller understanding of this relationship. Orem\u27s theory of self-care and the theory of reasoned action and planned behavior served as the theoretical foundations of this study. The sample included 185 members of the National Association of Social Workers, who volunteered to participate in this study. Participants completed online versions of the Maslach Burnout Inventory and Self-Care Assessment Work Sheet. Correlation and analysis of variance (ANOVA) were performed to test research hypotheses concerning associations between self-care and aspects of burnout among social workers in healthcare settings. The results showed that higher levels of self-care were significantly correlated with lower scores on measures of emotional exhaustion and depersonalization and higher scores on measures of personal accomplishment. No significant differences were found by practice setting in mean ratings of specified self-care activities. More years of social work practice were associated with lower burnout. Implications for positive social change include highlighting the need for self-care to prevent burnout, promoting health and wellbeing among social workers, and saving organizations the costs associated with employee burnout. Future research on self-care and burnout will be beneficial to the profession to expand current literature and highlight trends between social work practice and client populations served

Marine CO2 Patterns in the Northern Salish Sea

Marine carbon dioxide (CO2) system data has been collected from December 2014 to June 2018 in the Northern Salish Sea (NSS; British Columbia, Canada) and consisted of continuous measurements at two sites as well as spatially- and seasonally distributed discrete seawater samples. The array of CO2 observing activities included high-resolution CO2 partial pressure (pCO2) and pHT (total scale) measurements made at the Hakai Institute’s Quadra Island Field Station (QIFS) and from an Environment Canada weather buoy, respectively, as well as discrete seawater measurements of pCO2 and total dissolved inorganic carbon (TCO2) obtained during a number of field campaigns. A relationship between NSS alkalinity and salinity was developed with the discrete datasets and used with the continuous measurements to highly resolve the marine CO2 system. Collectively, these datasets provided insights into the seasonality in this historically under-sampled region and detail the area’s tendency for aragonite saturation state (Ωarag) to be at non-corrosive levels (i.e., Ωarag > 1) only in the upper water column during spring and summer months. This depth zone and time period of reprieve can be periodically interrupted by strong northwesterly winds that drive short-lived (∼1 week) episodes of high-pCO2, low-pH, and low-Ωarag conditions throughout the region. Interannual variability in summertime conditions was evident and linked to reduced northwesterly winds and increased stratification. Anthropogenic CO2 in NSS surface water was estimated using data from 2017 combined with the global atmospheric CO2 forcing for the period 1765 to 2100, and projected a mean value of 49 ± 5 μmol kg-1 for 2018. The estimated trend in anthropogenic CO2 was further used to assess the evolution of Ωarag and pHT levels in NSS surface water, and revealed that wintertime corrosive Ωarag conditions were likely absent pre-1900. The percent of the year spent above Ωarag = 1 has dropped from ∼98% in 1900 to ∼60% by 2018. Over the coming decades, winter pHT and spring and summer Ωarag are projected to decline to conditions below identified biological thresholds for select vulnerable species

CTL Responses of High Functional Avidity and Broad Variant Cross-Reactivity Are Associated with HIV Control

Cytotoxic T lymphocyte (CTL) responses targeting specific HIV proteins, in particular Gag, have been associated with relative control of viral replication in vivo. However, Gag-specific CTL can also be detected in individuals who do not control the virus and it remains thus unclear how Gag-specific CTL may mediate the beneficial effects in some individuals but not in others. Here, we used a 10mer peptide set spanning HIV Gag-p24 to determine immunogen-specific T-cell responses and to assess functional properties including functional avidity and cross-reactivity in 25 HIV-1 controllers and 25 non-controllers without protective HLA class I alleles. Our data challenge the common belief that Gag-specific T cell responses dominate the virus-specific immunity exclusively in HIV-1 controllers as both groups mounted responses of comparable breadths and magnitudes against the p24 sequence. However, responses in controllers reacted to lower antigen concentrations and recognized more epitope variants than responses in non-controllers. These cross-sectional data, largely independent of particular HLA genetics and generated using direct ex-vivo samples thus identify T cell responses of high functional avidity and with broad variant reactivity as potential functional immune correlates of relative HIV control

How collective is collective efficacy? The importance of consensus in judgments about community cohesion and willingness to intervene

Existing studies have generally measured collective efficacy by combining survey respondents’ ratings of their local area into an overall summary for each neighborhood. Naturally, this approach results in a substantive focus on the variation in average levels of collective efficacy between neighborhoods. In this article, we focus on the variation in consensus of collective efficacy judgments. To account for differential consensus among neighborhoods, we use a mixed‐effects location‐scale model, with variability in the consensus of judgments treated as an additional neighborhood‐level random effect. Our results show that neighborhoods in London differ, not just in their average levels of collective efficacy but also in the extent to which residents agree with one another in their assessments. In accord with findings for U.S. cities, our results show that consensus in collective efficacy assessments is affected by the ethnic composition of neighborhoods. Additionally, we show that heterogeneity in collective efficacy assessments is consequential, with higher levels of criminal victimization, worry about crime, and risk avoidance behavior in areas where collective efficacy consensus is low

Combined point of care nucleic acid and antibody testing for SARS-CoV-2 following emergence of D614G Spike Variant

Rapid COVID-19 diagnosis in hospital is essential, though complicated by 30-50% of nose/throat swabs being negative by SARS-CoV-2 nucleic acid amplification testing (NAAT). Furthermore, the D614G spike mutant now dominates the pandemic and it is unclear how serological tests designed to detect anti-Spike antibodies perform against this variant. We assess the diagnostic accuracy of combined rapid antibody point of care (POC) and nucleic acid assays for suspected COVID-19 disease due to either wild type or the D614G spike mutant SARS-CoV-2. The overall detection rate for COVID-19 is 79.2% (95CI 57.8-92.9%) by rapid NAAT alone. Combined point of care antibody test and rapid NAAT is not impacted by D614G and results in very high sensitivity for COVID-19 diagnosis with very high specificity

Age-related immune response heterogeneity to SARS-CoV-2 vaccine BNT162b2

Abstract: Although two-dose mRNA vaccination provides excellent protection against SARS-CoV-2, there is little information about vaccine efficacy against variants of concern (VOC) in individuals above eighty years of age1. Here we analysed immune responses following vaccination with the BNT162b2 mRNA vaccine2 in elderly participants and younger healthcare workers. Serum neutralization and levels of binding IgG or IgA after the first vaccine dose were lower in older individuals, with a marked drop in participants over eighty years old. Sera from participants above eighty showed lower neutralization potency against the B.1.1.7 (Alpha), B.1.351 (Beta) and P.1. (Gamma) VOC than against the wild-type virus and were more likely to lack any neutralization against VOC following the first dose. However, following the second dose, neutralization against VOC was detectable regardless of age. The frequency of SARS-CoV-2 spike-specific memory B cells was higher in elderly responders (whose serum showed neutralization activity) than in non-responders after the first dose. Elderly participants showed a clear reduction in somatic hypermutation of class-switched cells. The production of interferon-γ and interleukin-2 by SARS-CoV-2 spike-specific T cells was lower in older participants, and both cytokines were secreted primarily by CD4 T cells. We conclude that the elderly are a high-risk population and that specific measures to boost vaccine responses in this population are warranted, particularly where variants of concern are circulating

Complement lectin pathway activation is associated with COVID-19 disease severity, independent of MBL2 genotype subgroups

IntroductionWhile complement is a contributor to disease severity in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, all three complement pathways might be activated by the virus. Lectin pathway activation occurs through different pattern recognition molecules, including mannan binding lectin (MBL), a protein shown to interact with SARS-CoV-2 proteins. However, the exact role of lectin pathway activation and its key pattern recognition molecule MBL in COVID-19 is still not fully understood.MethodsWe therefore investigated activation of the lectin pathway in two independent cohorts of SARS-CoV-2 infected patients, while also analysing MBL protein levels and potential effects of the six major single nucleotide polymorphisms (SNPs) found in the MBL2 gene on COVID-19 severity and outcome.ResultsWe show that the lectin pathway is activated in acute COVID-19, indicated by the correlation between complement activation product levels of the MASP-1/C1-INH complex (p=0.0011) and C4d (p<0.0001) and COVID-19 severity. Despite this, genetic variations in MBL2 are not associated with susceptibility to SARS-CoV-2 infection or disease outcomes such as mortality and the development of Long COVID.ConclusionIn conclusion, activation of the MBL-LP only plays a minor role in COVID-19 pathogenesis, since no clinically meaningful, consistent associations with disease outcomes were noted

Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission

Funder: Addenbrooke's Charitable Trust, Cambridge University Hospitals; FundRef: http://dx.doi.org/10.13039/501100002927Significant differences exist in the availability of healthcare worker (HCW) SARS-CoV-2 testing between countries, and existing programmes focus on screening symptomatic rather than asymptomatic staff. Over a 3 week period (April 2020), 1032 asymptomatic HCWs were screened for SARS-CoV-2 in a large UK teaching hospital. Symptomatic staff and symptomatic household contacts were additionally tested. Real-time RT-PCR was used to detect viral RNA from a throat+nose self-swab. 3% of HCWs in the asymptomatic screening group tested positive for SARS-CoV-2. 17/30 (57%) were truly asymptomatic/pauci-symptomatic. 12/30 (40%) had experienced symptoms compatible with coronavirus disease 2019 (COVID-19)>7 days prior to testing, most self-isolating, returning well. Clusters of HCW infection were discovered on two independent wards. Viral genome sequencing showed that the majority of HCWs had the dominant lineage B∙1. Our data demonstrates the utility of comprehensive screening of HCWs with minimal or no symptoms. This approach will be critical for protecting patients and hospital staff

Single-cell multi-omics analysis of the immune response in COVID-19

Funder: Lister Institute of Preventive Medicine; doi: https://doi.org/10.13039/501100001255Funder: University College London, Birkbeck MRC Doctoral Training ProgrammeFunder: The Jikei University School of MedicineFunder: Action Medical Research (GN2779)Funder: NIHR Clinical Lectureship (CL-2017-01-004)Funder: NIHR (ACF-2018-01-004) and the BMA FoundationFunder: Chan Zuckerberg Initiative (grant 2017-174169) and from Wellcome (WT211276/Z/18/Z and Sanger core grant WT206194)Funder: UKRI Innovation/Rutherford Fund Fellowship allocated by the MRC and the UK Regenerative Medicine Platform (MR/5005579/1 to M.Z.N.). M.Z.N. and K.B.M. have been funded by the Rosetrees Trust (M944)Funder: Barbour FoundationFunder: ERC Consolidator and EU MRG-Grammar awardsFunder: Versus Arthritis Cure Challenge Research Grant (21777), and an NIHR Research Professorship (RP-2017-08-ST2-002)Funder: European Molecular Biology Laboratory (EMBL)Abstract: Analysis of human blood immune cells provides insights into the coordinated response to viral infections such as severe acute respiratory syndrome coronavirus 2, which causes coronavirus disease 2019 (COVID-19). We performed single-cell transcriptome, surface proteome and T and B lymphocyte antigen receptor analyses of over 780,000 peripheral blood mononuclear cells from a cross-sectional cohort of 130 patients with varying severities of COVID-19. We identified expansion of nonclassical monocytes expressing complement transcripts (CD16+C1QA/B/C+) that sequester platelets and were predicted to replenish the alveolar macrophage pool in COVID-19. Early, uncommitted CD34+ hematopoietic stem/progenitor cells were primed toward megakaryopoiesis, accompanied by expanded megakaryocyte-committed progenitors and increased platelet activation. Clonally expanded CD8+ T cells and an increased ratio of CD8+ effector T cells to effector memory T cells characterized severe disease, while circulating follicular helper T cells accompanied mild disease. We observed a relative loss of IgA2 in symptomatic disease despite an overall expansion of plasmablasts and plasma cells. Our study highlights the coordinated immune response that contributes to COVID-19 pathogenesis and reveals discrete cellular components that can be targeted for therapy