Toxic Leadership: Conflict Management Style and Organizational Commitment among Intensive Care Nursing Staff

Context: Toxic leadership becomes a real problem in nursing administration. Its toxicity harms the nursing staff's progress and creates a challenging work environment full of struggles that, in turn, produce adverse outcomes on the nursing staff's commitment toward the organization.Aim: This study envisioned to compare toxic leadership among intensive care nursing staff at Tanta University Hospital and El Menshawy hospital and assess its relation to their conflict management style used and organizational commitment at the two hospitals. Methods: A descriptive, comparative, via cross-sectional research design was applied. All intensive care units at Tanta University Hospitals and El-Menshawy General Hospital were included. All available nurses (n=544) at Tanta University hospitals' ICUs (n=301) and El-Menshawy hospital's ICUs (n=243) were incorporated. Toxic leadership, conflict management styles assessment, and organizational commitment scales were utilized to achieve this study's aim. Results: The nursing staff perceived that their leaders had high 10.6%, 11.5%, and moderate 12%, 11.9% overall toxic leadership levels at Tanta University Hospitals, and Elmenshawy Hospital, respectively. 43.9% of the nursing staff had a high level of using compromising style to manage conflict with their supervisors at Tanta University hospitals contrasted to 36.6% using competing style at El Menshawy hospital. 78.4% of the nursing staff had a low level of overall organizational commitment at Tanta University hospital's ICUs compared to 63% at El-Menshawy General hospital's ICUs. Conclusion: Toxic leadership affected the nursing staff's choice of conflict management style used when handling conflict with toxic leaders at two hospitals and had a negative effect on affective and normative dimensions of organizational commitment in both hospitals. Therefore, improving leadership experiences is necessary by conducting a leadership development program to meet the nursing staff's expectations and improve their commitment. Also, adjusting the hospital's policies is vital to permit nursing staff involvement in leadership evaluation as a means for early detection of leaders' toxic behaviors

Experiences of Professionalism Attributes among Undergraduates Nursing Students and Nurses

Context: Professionalism is an essential ingredient in the nursing profession that when the student nurses learn the knowledge, skills, and attitudes and continue during their practices in the real world. Aim: This research aimed to assess the main attributes of professionalism among undergraduates nursing students and nurses. a descriptive comparative correlational designas well as in Intensive Care Units, Neonatal Intensive Care Units, Cardiac Care Units, and Neurology Intensive Care Units at Tanta University Hospital. Subjects. The sample consisted of (897) nursing students and (149) nurses. The data collection tool was the nursing professionalism attributes questionnaire that was developed by the authors. It contains three dimensions, including; professional identity (12 statements), professional ethics (12 statements), and professional behaviors (16 statements).Results: This study suggested that the undergraduate nursing students perceived the high mean score in all professionalism attributes more than the practicing nurses did.Conclusion: This study concluded that the development of professionalism in nursing is an essential feature of the nursing profession and practice. The nurse students were high in areas of patients' and colleagues’ rights, obeying orders, commitment and collaboration, physical appearance, continuing education, and caring of the patient. While the nurses had very low scores in membership in the nursing association, autonomy, and research areas, this study recommended the encouragement of nurses and students' participation in scientific research activities, including; membership in professional organizations or associations, attending nursing conferences/workshops/symposium as a producer or consumer, and fellowship

Relation of Fruiting in Seewy Date Palm Cultivar with Spraying Boric Acid and Calcium Nitrate

The objective of this work to study the influence of foliar application of boric acid (0, 125, 250 and 500 ppm) and calcium nitrate (0, 1%, 2% and 3%) on fruit set and yield as well as fruit quality of Seewy date palm cultivar growing in El Dakhla Oasis, New Valley governorate during two successive seasons (2021, 2022), palms were treated with different rates of boric acid (zero, 125, 250 and 500 ppm) and sprayed with calcium nitrate at rates (zero, 1%, 2% and 4%). Results showed that all studied treatments had significant effect on fruit set and total yield compared with the control treatment in both experimental seasons. Spraying boric acid at 500 ppm with calcium nitrate at 2% in both seasons gave the best results of fruit set and total yield. In addition, this combination gave the highest T.S.S content, total sugars and reducing sugars; in contrast, the lowest values of total acidity in two studied seasons

Fabrication of sulfonated polyethersulfone ultrafiltration membranes with an excellent antifouling performance by impregnating with polysulfopropyl acrylate coated ZnO nanoparticles

Sulfonated polyethersulfone/sulfopropyl methacrylate membranes impregnated with the polysulfopropyl acrylate coated ZnO nanoparticles were developed using a non-solvent-induced phase separation recipe. The composite membranes offered much-enhanced hydrophilicity and improved porosity, which are critical for the excellent antifouling performance and high permeate flux. By adding polysulfopropyl acrylate modified ZnO, it achieved the maximum water flux of 420 Lm−2h−1 while maintained the natural organic matter rejection rate of 99% with an excellent flux recovery ratio up to 99% in the antifouling measurement. The results display that the impregnation of ZnO nanoparticles in the sulfonated polyethersulfone membrane can effectively increase the surface hydrophilicity which is essential for reducing the irreversible fouling with improved long-term performance and excellent recyclability

Rapidly developed, optimized, and applied wastewater surveillance system for real-time monitoring of low-incidence, high-impact MPOX outbreak

Recent MPOX viral resurgences have mobilized public health agencies around the world. Recognizing the significant risk of MPOX outbreaks, large-scale human testing, and immunization campaigns have been initiated by local, national, and global public health authorities. Recently, traditional clinical surveillance campaigns for MPOX have been complemented with wastewater surveillance (WWS), building on the effectiveness of existing wastewater programs that were built to monitor SARS-CoV-2 and recently expanded to include influenza and respiratory syncytial virus surveillance in wastewaters. In the present study, we demonstrate and further support the finding that MPOX viral fragments agglomerate in the wastewater solids fraction. Furthermore, this study demonstrates that the current, most commonly used MPOX assays are equally effective at detecting low titers of MPOX viral signal in wastewaters. Finally, MPOX WWS is shown to be more effective at passively tracking outbreaks and/or resurgences of the disease than clinical testing alone in smaller communities with low human clinical case counts of MPOX

Near real-time determination of B.1.1.7 in proportion to total SARS-CoV-2 viral load in wastewater using an allele-specific primer extension PCR strategy

"The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome corona- virus 2 (SARS-CoV-2) has claimed millions of lives to date. Antigenic drift has resulted in viral variants with putatively greater transmissibility, virulence, or both. Early and near real-time detection of these variants of concern (VOC) and the ability to accurately follow their incidence and prevalence in communities is wanting. Wastewater-based epidemiology (WBE), which uses nucleic acid amplification tests to detect viral fragments, is a reliable proxy of COVID-19 incidence and prevalence, and thus offers the potential to monitor VOC viral load in a given population. Here, we describe and validate a primer extension PCR strategy targeting a signature mutation in the N gene of SARS-CoV-2. This allows quantification of B.1.1.7 versus non-B.1.1.7 allele frequency in wastewater without the need to employ quantitative RT-PCR standard curves. We show that the wastewater B.1.1.7 profile correlates with its clinical counterpart and benefits from a near real-time and facile data collection and reporting pipeline. This assay can be quickly implemented within a current SARS-CoV-2 WBE framework with minimal cost; allowing early and contemporaneous estimates of B.1.1.7 community transmission prior to, or in lieu of, clinical screening and identification. Our study demonstrates that this strategy can provide public health units with an additional and much needed tool to rapidly triangulate VOC incidence/prevalence with high sensitivity and lineage specificity"National Microbiology Laboratory||Water Services at the Cities of Ottawa and Barrie||Ottawa Public Health||Simcoe Muskoka District Health Unit|| Public Health Ontario||Ontario Wastewater Surveillance Initiativ

Wastewater-based surveillance identifies start to the pediatric respiratory syncytial virus season in two cities in Ontario, Canada

IntroductionDetection of community respiratory syncytial virus (RSV) infections informs the timing of immunoprophylaxis programs and hospital preparedness for surging pediatric volumes. In many jurisdictions, this relies upon RSV clinical test positivity and hospitalization (RSVH) trends, which are lagging indicators. Wastewater-based surveillance (WBS) may be a novel strategy to accurately identify the start of the RSV season and guide immunoprophylaxis administration and hospital preparedness.MethodsWe compared citywide wastewater samples and pediatric RSVH in Ottawa and Hamilton between August 1, 2022, and March 5, 2023. 24-h composite wastewater samples were collected daily and 5 days a week at the wastewater treatment facilities in Ottawa and Hamilton, Ontario, Canada, respectively. RSV WBS samples were analyzed in real-time for RSV by RT-qPCR.ResultsRSV WBS measurements in both Ottawa and Hamilton showed a lead time of 12 days when comparing the WBS data set to pediatric RSVH data set (Spearman’s ρ = 0.90). WBS identify early RSV community transmission and declared the start of the RSV season 36 and 12 days in advance of the provincial RSV season start (October 31) for the city of Ottawa and Hamilton, respectively. The differing RSV start dates in the two cities is likely associated with geographical and regional variation in the incidence of RSV between the cities.DiscussionQuantifying RSV in municipal wastewater forecasted a 12-day lead time of the pediatric RSVH surge and an earlier season start date compared to the provincial start date. These findings suggest an important role for RSV WBS to inform regional health system preparedness, reduce RSV burden, and understand variations in community-related illness as novel RSV vaccines and monoclonal antibodies become available

Wastewater to clinical case (WC) ratio of COVID-19 identifies insufficient clinical testing, onset of new variants of concern and population immunity in urban communities

Clinical testing has been the cornerstone of public health monitoring and infection control efforts in communities throughout the COVID-19 pandemic. With the extant and anticipated reduction of clinical testing as the disease moves into an endemic state, SARS-CoV-2 wastewater surveillance (WWS) is likely to have greater value as an important diagnostic tool to inform public health. As the widespread adoption of WWS is relatively new at the scale employed for COVID-19, interpretation of data, including the relationship to clinical cases, has yet to be standardized. An in-depth analysis of the metrics derived from WWS is required for public health units/agencies to interpret and utilize WWS-acquired data effectively and efficiently. In this study, the SARS-CoV-2 wastewater signal to clinical cases (WC) ratio was investigated across seven different cities in Canada over periods ranging from 8 to 21 months. Significant increases in the WC ratio occurred when clinical testing eligibility was modified to appointment-only testing, identifying a period of insufficient clinical testing in these communities. The WC ratio decreased significantly during the emergence of the Alpha variant of concern (VOC) in a relatively non-immunized community’s wastewater (40-60% allelic proportion), while a more muted decrease in the WC ratio signaled the emergence of the Delta VOC in a relatively well-immunized community’s wastewater (40-60% allelic proportion). Finally, a rapid and significant decrease in the WC ratio signaled the emergence of the Omicron VOC, likely because of the variant’s greater effectiveness at evading immunity, leading to a significant number of new reported clinical cases, even when vaccine-induced community immunity was high. The WC ratio, used as an additional monitoring metric, complements clinical case counts and wastewater signals as individual metrics in its ability to identify important epidemiological occurrences, adding value to WWS as a diagnostic technology during the COVID-19 pandemic and likely for future pandemics.Ontario's Ministry of Environment, Conservation and Parks||Alberta Healt

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely