Consequences and coping strategies of nurses and registered nurses perceiving to work in an environment characterized by workplace bullying

Aim

The aim of this study was to analyze the well-being and coping strategies of nurses working in an organizational setting perceived as characterized by workplace bullying. The innovative aspect of this study is that we considered only those who perceive to work in an organizational environment characterized by workplace bullying, and not those who see themselves as victims and those who perceive they work in an organizational environment not characterized by workplace bullying.

Method

A questionnaire with the NAQ-R, PGWBI, Val.Mob. and Brief COPE scales was administered to nurses. To better understand this phenomenon, a comparison was made between 331 nurses and 166 workers in other professions who also work in an organizational environment perceived to be characterized by workplace bullying.

Results

In both groups (nurses and workers), the results were approximately the same in terms of personal bullying and workplace bullying episodes and the number of physical and emotive symptoms. The PGWBI score was lower for nurses than for workers in other fields. Among the individual symptoms, nurses and registered nurses were more likely to report gastritis, insomnia and heartburn than workers in other contexts. Workers in other contexts were more likely than nurses to report symptoms of anxiety, fear, feelings of insecurity, inferiority and guilt. In terms of coping strategies, nurses were more likely than other workers to report distraction, substance use, emotional support, disengagement, venting, positive reframing, humor, and religion. Workers in other professional context were more likely than nurses to report active coping, denial, instrumental support, planning, acceptance, and self-blame.

Conclusion

Results suggest that the consequences of working in a perceived organizational environment characterized by workplace bullying are similar for both groups of workers, with nonstatistical differences in perceived workplace bullying episodes and sum of physical and emotive symptoms.

Implication

Overall, findings suggest that workplace bullying prevention is a fundamental element in training workers in all types of workplaces and should be an integral part of curriculum activities.

Knowledge, Attitudes, and Practices about Electronic Personal Health Records: A Cross-Sectional Study in a Region of Northern Italy

The Electronic Personal Health Record (EPHR) provides an innovative service for citizens and professionals to manage health data, promoting patient-centred care. It enhances communication between patients and physicians and improves accessibility to documents for remote medical information management. The study aims to assess the prevalence of awareness and acceptance of the EPHR in northern Italy and define determinants and barriers to its implementation. In 2022, a region-wide cross-sectional study was carried out through a paper-based and online survey shared among adult citizens. Univariable and multivariable regression models analysed the association between the outcome variables (knowledge and attitudes toward the EPHR) and selected independent variables. Overall, 1634 people were surveyed, and two-thirds were aware of the EPHR. Among those unaware of the EPHR, a high prevalence of specific socio-demographic groups, such as foreign-born individuals and those with lower educational levels, was highlighted. Multivariable regression models showed a positive association between being aware of the EPHR and educational level, health literacy, and perceived poor health status, whereas age was negatively associated. A higher knowledge of the EPHR was associated with a higher attitude towards the EPHR. The current analysis confirms a lack of awareness regarding the existence of the EPHR, especially among certain disadvantaged demographic groups. This should serve as a driving force for a powerful campaign tailored to specific categories of citizens for enhancing knowledge and usage of the EPHR. Involving professionals in promoting this tool is crucial for helping patients and managing health data.

Which variables and determinants influence online food delivery consumption among workers and students? Results from the DELIvery Choice In OUr Society (DELICIOUS) cross-sectional study

Introduction

Online food delivery (OFD) applications provide easy access to food, eliminating the need for cooking and meal planning. However, they predominantly promote processed and calorie-dense foods, potentially impacting diet and health. This study aimed to describe the use of OFD services in a sample of Italian workers and students, to explore potential determinants of OFD usage and to assess possible differences in use between these two categories.

Methods

Data were collected through an online survey (convenience sampling) distributed on social media platforms between July 12, 2022, and February 1, 2023. The sample included individuals aged 18 and above, currently residing in Italy. The sample was stratified according to worker/student status. Descriptive analyses were performed on key variables. A multivariable logistic regression analysis was conducted to assess the effects of variables on OFD usage, treated as a dichotomous variable (usage or non-usage).

Results

This study analyzed 3,502 questionnaires (2,594 from workers and 908 from students) after excluding 323 non-student and non-worker responses. Positive associations with OFD use included higher income, remote working, smoking, elevated BMI, depression risk, and impulsive buying among workers, while being female, frequent screen-watching during meals, daily smoking, higher BMI, and impulsive buying were associated with OFD use among students. Factors negatively associated with OFD use included older age (workers and students), living in suburbs (workers and students) or in an outline town (workers), being single (workers and students), adhering to the Mediterranean diet (students), having low health literacy (students), and job dissatisfaction (workers).

Discussion

OFD consumption was associated with some risky behaviors and conditions, such as high BMI or smoking, suggesting that it might be influenced by individual tendencies. Healthier habits, such as physical activity, did not significantly impact OFD usage, especially among workers. Whereas, among students, factors such as low health literacy and better eating habits were associated with less use of OFD, so that they could be more prone to use OFD in a measured way. Further research is needed to better understand potential associations between OFD and risky habits, as well as its role in promoting access to healthy food in underserved areas.

Impact of the Timing of Integrated Home Palliative Care Enrolment on Emergency Department Visits

BACKGROUND

The association between timing of integrated home palliative care (IHPC) enrolment and emergency department (ED) visits is still under debate, and no studies investigated the effect of the timing of IHPC enrolment on ED visits, according to their level of emergency. This study aimed to investigate the impact of the timing of IHPC enrolment on different acuity ED visits.

METHODS

A retrospective, pre-/post-intervention study was conducted from 2013 to 2019 in Italy. Analyses were stratified by IHPC duration (short ≤30 days; medium 31-90 days; long >90 days) and triage tags (white/green: low level of emergency visit; yellow/red: medium-to-high level). The impact of the timing of IHPC enrolment was evaluated in two ways: incidence rate ratios (IRRs) of ED visits were determined (1) before and after IHPC enrolment in each group and (2) post-IHPC among groups.

RESULTS

A cohort of 17 983 patients was analysed. Patients enrolled early in the IHPC programme had a significantly lower incidence rate of ED visits than the pre-enrolment period (IRR=0.65). The incidence rates of white/green and yellow/red ED visits were significantly lower post-IHPC enrolment for patients enrolled early (IRR=0.63 and 0.67, respectively). All results were statistically significant (P<.001). Comparing the IHPC groups after enrolment versus the short group, medium and long IHPC groups had a significant reduction of ED visits (IRR=0.37, IRR=0.14 respectively), showing a relation between the timing of IHPC enrolment and the incidence of ED visits. A similar trend was observed after accounting for triage tags of ED visits.

CONCLUSION

The timing of IHPC enrolment is related with a variation of the incidence of ED visits. Early IHPC enrolment is related to a high significant reduction of ED visits when compared to the 90-day pre-IHPC enrolment period and to late IHPC enrolment, accounting for both low-level and medium-to-high level emergency ED visits.

Impact of COVID-19 on emergency department visits among palliative home care recipients: a retrospective population-based cohort study in the Piedmont region, Italy

BACKGROUND

Integrated palliative home care (IHPC) is delivered to patients with progressive end-stage diseases. During the COVID-19 pandemic, IHPC needed to provide high-quality home care services for patients who were treated at home, with the goal of avoiding unnecessary care, hospital admissions, and emergency department (ED) visits. This study aimed to compare the ED visits of IHPC recipients in a large Italian region before and during the first two waves of the COVID-19 pandemic and to find sociodemographic or clinical characteristics associated with changes in ED visits during the first two waves of COVID-19 pandemic, compared with the period before.

METHODS

Administrative databases were used to identify sociodemographic and clinical variables of IHPC recipients admitted before and during the pandemic. The obtained data were balanced by applying a propensity score. The average number of ED visits before and during the pandemic was calculated by using the Welch's t test and stratified by all the variables.

RESULTS

Before and during the pandemic, 5155 and 3177 recipients were admitted to IHPC, respectively. These individuals were primarily affected by neoplasms. ED visits of IHPC recipients reduced from 1346 to 467 before and during the pandemic, respectively. A reduced mortality among IHCP patients who had at least one ED visit during the pandemic (8% during the pandemic versus 15% before the pandemic) was found. The average number of ED visits decreased during the pandemic [0.143, confidence interval (CI) = (0.128-0.158) versus 0.264, CI = (0.242-0.286) before the pandemic; p < 0.001] for all ages and IHPC duration classes. The presence of a formal caregiver led to a significant decrease in ED use. Medium and high emergency ED admissions showed no difference, whereas a decrease in low-level emergency ED admissions during the pandemic [1.27, CI = (1.194-1.345) versus 1.439, CI = (1.3-1.579) before the pandemic; p = 0.036] was found.

CONCLUSION

ED visits among IHPC recipients were significantly decreased during the first two waves of the COVID-19 pandemic, especially in those individuals characterized by a low level of emergency. This did not result in an increase in mortality among IHPC recipients. These findings could inform the reorganization of home care services after the pandemic.

Knowledge, attitude and practice about the Personal Health Record among general population in Italy

Background

The Personal Health Record (PHR) is an online tool containing a person’s health-related data, which can be shared with health professionals. This tool is widely used throughout Europe but is not very popular in Italy, despite its implementation being mandatory. This study aims to investigate knowledge, attitudes and practices (KAP) associated with the PHR among the general population in Italy, to identify the main obstacles in the usage of PHR and to establish strategies that lead to their resolution.

Methods

A cross-sectional survey was designed and shared both online and on paper (in the waiting rooms of the outpatient clinics) to an opportunistic sample of people aged ≥18 years. Factors associated with a higher knowledge and willingness to activate the PHR were investigated through multivariable logistic regression analyses.

Results

Preliminary results of the on paper survey (243 answers) showed that the median age of the participants was 45, 46% were women, 9% worked in healthcare and 68% had chronic diseases. Only 31% heard about the PHR, of which 22% showed a good knowledge of it. The 66% declared the willingness to activate the PHR and 92% agreed that the PHR is a useful tool for physicians to share information. Multivariable logistic regression models showed that those who were employed and those who were visited by a doctor in the last three months had a higher likelihood of having heard about PHR (OR 2.56, 95% CI 1.12 - 5.82 and OR 2.67, 95% CI 1.20 - 5.90 respectively). The likelihood of being willing to activate the PHR is lower for those who live alone, and is higher for those who are employed (OR 0.35, 95% CI 0.14 - 0.88 and OR 2.35, 95% CI 1.06 - 5.24).

Conclusions

The results confirm the low level of knowledge and diffusion of the PHR in Italy, although a relatively high interest in this tool was highlighted, along with a favorable perception of its usefulness. Promotional interventions are needed to increase knowledge and awareness of this tool.

Key messages

• Awareness about Personal Health Record among the Italian population is low. Despite this, a high level of willingness to activate this tool and a high perception of its usefulness were registered.

• Identifying factors that lead to lower awareness on Personal Health Record may help Public Health professionals to implement targeted promotional interventions aimed to increase the usage of this tool.

COVID-19 lockdown and physical activity changes in Italy: a cross-sectional survey

Background

The global pandemic of COVID-19 has caused radical changes in the structure of people's daily routines in most of the countries around the world and have had a big impact on physical activity (PA) and daily movement. Previous studies reported the increase of sedentary behaviours during movement restrictions. This study investigates the impact of the first Italian lockdown measures (9 march - 3 may 2020) on PA habits and factors potentially associated with starting or ceasing PA practice during home confinement.

Methods

A web-based cross-sectional survey was carried out using an online 40-item questionnaire spread in May 2020 in Italy. Multivariable regressions were performed.

Results

A total of 1865 people were enrolled. During lockdown, PA was performed by 65.5% of the sample. Overall, the number of physically active people increased by 8%, compared to the pre-pandemic period level (56%). A change in PA habits occurred in 34.1% of the sample (37.9% of them stopped PA and 62.1% started it). Starting PA during lockdown was related to being on a diet, whereas living with children and having poor psychological well-being were inversely related with starting PA. Conversely, unhealthy factors like being overweight or obese, having poor mental well-being and the occurrence of emotional overeating were related to stopping PA during lockdown.

Conclusions

The first Covid-19 Italian lockdown had a significant impact on healthy habits of the population, leading to an increase of physically active individuals. Furthermore, a relation between unhealthy lifestyle factors and stopping physical activity during lockdown was found. European governments should adopt health promotion strategies to avoid the increase of sedentary behaviours during and after the pandemic.

Key messages

Physical activity habits changed during lockdown due to Covid-19 pandemics and a relation between unhealthy lifestyle factors and stopping physical activity during lockdown was found. European governments should adopt health promotion strategies to avoid the increase of sedentary behaviours during and after the pandemic.

Interrupted time series analysis of the impact of a bundle on surgical site infections after colon surgery

BACKGROUND

Surgical site infections (SSIs) are monitored in Italy through a national surveillance system. A 4-element bundle was introduced in 2012, consisting of: appropriate preoperative shower and hair removal, perioperative normothermia, and antibiotic prophylaxis. The aim of this study was to evaluate the effect of the intervention on SSI rates after colon surgery.

METHODS

A retrospective cohort study was conducted between 2008 and 2019 in 29 hospitals of northern Italy. An interrupted time series analysis (ITSA) was modeled to assess the bundle's impact on SSI trends. Logistic regression was performed to identify predictors of SSI among procedures performed in the postintervention period, comparing full and partial bundle compliance.

RESULTS

Data of 5487 colon surgery procedures were collected (1243 preintervention and 4244 postintervention). The ITSA identified a significant change in the monthly postintervention SSI trend of -0.19% and a change in level of -2.09%. A significant protective effect of full bundle compliance compared to partial bundle compliance (OR 0.74, P.043) was found, whereas the single effect of the bundle elements was nonsignificant.

CONCLUSIONS

Results of this study suggest this relatively simple bundle protocol is effective in reducing SSI risk.

Pertussis immunisation during pregnancy: Antibody levels and the impact of booster vaccine

Pertussis (whooping cough) is a highly infectious disease caused by Bordetella pertussis. Mothers lacking adequate immunity and contracting the disease represent the biggest risk of transmission to new-borns, for which the disease is often a threat. The aim of the study was to estimate the frequency of pertussis susceptibility among pregnant women, in order to point out the need for a vaccine recall during pregnancy, and to evaluate the antibody response in already vaccinated women. A cross-sectional observational study was conducted in the blood test centre of "St. Anna" Obstetrics and Gynaecology Hospital in Turin (Piedmont, Italy). Eligibility criteria included pregnant women coming to the centre for any blood test, aged 18 or above and with gestational age between 33 and 37 weeks at the moment of the blood draw. The data collection was carried out from May 2019 to January 2020 and the concentration of anti-Pertussis Toxin (anti-PT) IgG was measured through the Enzyme-Linked Immunosorbent Assay (ELISA) technique. Two-hundred women (median age 35) were enrolled: 132 (66%) had received at least one dose of pertussis vaccine, 82 of which during pregnancy. Recently vaccinated women had significantly higher antibody titres (even 12-15 times as high) compared to those vaccinated more than 5 years before or never vaccinated at all (p < 0.0001). Moreover, 95.1% of recently vaccinated women had anti-PT IgG levels above 10 IU/ml, and 85.4% above 20 IU/ml, while the same proportions were as low as 37% and 21% (respectively) in the group of women not vaccinated in pregnancy. This study confirmed that the vaccination is greatly effective in ensuring high antibody titres in the first months after the booster vaccine, with considerable differences in anti-PT IgG compared to women vaccinated earlier or never vaccinated at all, and therefore vaccinating pregnant women against pertussis still represents a valuable strategy.

COVID-19 Lockdown and Self-Perceived Changes of Food Choice, Waste, Impulse Buying and Their Determinants in Italy: QuarantEat, a Cross-Sectional Study

Data about self-perceived food choice (FC) changes and their determinants during COVID-19 lockdowns are limited. This study investigated how the Italian lockdown affected self-perceived food purchases (FP), occurrence of impulse buying (IB), household food waste production (HFWP) and their determinants. A web-based cross-sectional survey was distributed in May 2020, collecting an opportunistic sample of the Italian population. A total of 1865 (70% females) people were enrolled, the median age was 29 (IQR 16.0). Most of the sample increased overall FP (53.4%), food consumption (43.4%), reduced HFWP (53.7%) and halved the prevalence of IB (20.9%) compared to the period before the lockdown (42.5%). Baking ingredients, fresh vegetables, fresh fruit and chocolate had the largest sales increase by individuals, while bakery products, fresh fish and salted snacks purchases highly decreased. Increased FP was associated with the occurrence of IB (adjOR 2.48, p < 0.001) and inversely associated with not having worked during lockdown (adjOR 0.71, p = 0.003). Multivariable logistic regressions revealed occurrence of IB was associated with low perceived dietary quality (adjOR 2.22, p < 0.001), resulting at risk, according to the Emotional Overeating Questionnaire (EOQ, adjOR 1.68, p < 0.001), and inversely associated with decreased HFWP (adjOR 0.73, p < 0.012). Reduced HFWP was associated with higher perceived dietary quality (adjOR 2.27, p < 0.001) and negatively associated with low score at WHO-5 Well-Being Index (adjOR 0.72, p = 0.002). The Italian lockdown highly affected FC behaviours, leading to positive and sustainable habits towards food purchase and consumption. Public health interventions are needed to keep these new positive effects and avoid negative consequences in case of future lockdowns.

Prevalence of Workplace Sexual Violence against Healthcare Workers Providing Home Care: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis sought to explore the prevalence of sexual violence including both sexual harassment and abuse, perpetrated by clients against home healthcare workers (HCWs), including professional and paraprofessional HCWs. To this end, we systematically searched five relevant databases. Two reviewers extracted data from the included studies independently and performed a quality appraisal. Overall and subgroup random-effects pooled prevalence meta-analyses were performed. Due to high heterogeneity, a more robust model using a quality effect estimator was used. Fourteen studies were included, and the prevalence of sexual violence was 0.06 (95% confidence interval (CI): 0.01–0.13). Paraprofessionals had a higher prevalence of sexual violence (0.07, 95% CI: 0.00–0.18 vs. 0.05, 95% CI: 0.00–0.12), and the prevalence of sexual abuse was lower than that of sexual harassment (0.04, 95% CI: 0.00–0.10 vs. 0.10, 95% CI: 0.03–0.18). This systematic review estimated the prevalence of sexual violence across home HCWs from different high-income countries, highlighting the presence of this phenomenon to a lesser but nevertheless considerable extent compared to other healthcare settings. Health management should consider interventions to prevent and reduce the risk of home HCWs from being subjected to sexual violence, as the home-care sector presents particular risks for HCWs because clients’ homes expose them to a relatively uncontrolled work environment.

Can Home Palliative Care services reduce Emergency Department visits? Piedmont Experience, 2013-2018

Background

Home-based Palliative Care (HPC) ensures multi-disciplinary medical, nursing, rehabilitation and psychological assistance for people with severe disabilities or with progressive end-stage disorders like cancer, promoting the continuity of care in home setting. Emergency Department (ED) visits in palliative care patients are considered an indicator of poor quality in home care services, since ED visits in these patients are not essential and potentially avoidable. There is still no agreement in literature about the efficacy of HPC in reducing the use of ED. However, recent studies demonstrated that HPC increases patient satisfaction while reducing use of medical services like ED, symptom burden and medical costs. The objective of this study was to evaluate if patients assisted by HPC have a reduction of ED visits compared to the 90-day period before HPC admission.

Methods

A retrospective study using the administrative regional database of Piedmont (Italy) was conducted on the cohort of 4433 patients admitted to HPC from 2013 to 2018. ED visits during period A (90-days before HPC) and period B (during HPC) were compared for each patient, taking into account avoidable or unavoidable visits based on triage examination.

Results

During period A, patients had 2880 ED visits, 1934 were considered avoidable (67%). During period B, 2050 ED visits were recorded, 994 were considered avoidable (48%). Patients receiving HPC had a reduction of overall ED visits (IRR 0.87, IC 95% 0.82-0.92) as well as avoidable ED visits (IRR 0.63, IC 95% 0.58-0.67). Unavoidable ED visits increased during HPC (IRR 1.36, IC 95% 1.24-1.49), as a consequence of disease progression.

Conclusions

Home-based Palliative Care is associated with a significant reduction of the use of overall Emergency Department visits (-13%) and ED avoidable visits (-37%). Since it reduces medical care costs and burden of patients and caregivers at the end of life, Home-based Palliative Care delivery should be increased.

Key messages

Home-based Palliative Care is associated with a reduction of the use of overall Emergency Department visits and avoidable ED visits, reducing medical care costs and burden of patients and caregivers. Home-based Palliative Care delivery should be encouraged and increased, aiming to an early enrolment as well as an increase of the patients.

Seroprevalence of anti-pertussis antibodies and immunization status of pregnant women in Turin, 2019

Background

Pertussis is an acute respiratory infection caused by B. pertussis. An acellular vaccine is available, but the protection it confers is estimated to wane after 5 years. Infants under 6 months have the highest risk of complications and mortality. In Italy, the first dose of vaccine is administered in the third month of life and maternal vaccination is recommended in the final weeks of pregnancy. This study aimed to evaluate the seroprevalence of IgG antibodies to pertussis toxin (IgG anti-PT) among pregnant women as a potential source of transplacental transfer of antibodies, which may reduce neonatal risk of disease.

Methods

An observational cross-sectional study was conducted. Two hundred women between the 33rd and 37th weeks of pregnancy were recruited among patients undergoing routine pregnancy check-up at the S.Anna Hospital of Turin, from May to December 2019. Participants were interviewed on their immunization status and a serum sample was collected. Anti-PT levels were assessed using ELISA “NovaLisa B. Pertussis toxin (PT) IgG”. Lacking a correlate of protection, we have distinguished contact with microorganism (10-39 IU/mL), exposure in the previous 2-3 years (40-99 IU/mL), recent infection or immunization &lt;12 months ( &gt; =100 IU/mL).

Results

The median age of participants was 35. Women who had anti-PT titers &gt; =10 IU/mL were 120 (60%) (10-39 IU/mL: 26%, 40-99 IU/mL: 14%, &gt; = 100 IU/mL: 20%). Around 70.5% of women declared previous vaccination (42.5% during pregnancy). Among women vaccinated in the previous 12 months, 7% presented antibodies titer &lt;100 IU/ml. Two women not vaccinated had a titer &gt; 100 IU/ml, indicative of recent pertussis exposure.

Conclusions

This study found 40% of women with antibody titers under cut-off (&lt;10 IU/mL) and 1% prevalence of recent exposure. Despite the late introduction of vaccination against pertussis during pregnancy, a good adherence to the program offered is evident.

Key messages

40% of pregnant women in this study were lacking in antibodies against Pertussis and could not transfer anti-PT to their newborn for early protection. Improving maternal vaccination coverage against pertussis should be a public health priority in Italy; a good adherence to intervention was reported.

The Bundle approach to reduce SSI rate of colon surgery, Piedmont (Italy): experience of 2012-2017

Background

According to ECDC, Surgical Site Infections (SSI) are the second most frequent type of Healthcare Associated Infections (HAI) in Europe and in USA, and 9.5% of colon surgical procedures develop SSI. SSIs are associated with prolonged hospital stay, higher costs burden and higher attributable morbidity and mortality. Interventional programs can reduce the risk of SSI. Care bundles are a complex of EBM-based interventions on a specific population and setting, in order to improve clinical outcomes. A bundle is successful only if all its items are properly applied, through the ‘all-or-none’ method. Application of a bundle does not exclude other good clinical practices.

Methods

Data from 37 hospitals participating in the Regional SSI surveillance of Piedmont (Italy) were collected from 2012 to 2017. In hospitals applying the bundle, 4 bundle items had to be used in all the procedures: Temperature control, preoperative shower, trichotomy, antimicrobial prophylaxis. 6909 patients undergoing colon surgery were followed for 30 post-operative days to detect SSI events (According to ECDC 2016 Protocol). For some procedures, compliance to Bundle item application was ≤ 75%.

Results

6909 procedures were assessed: 3631 with no bundle application and 3278 with bundle application; in particular 974 were compliant to all bundle items (100%), while 2304 were compliant to 3 items or less (≤ 75%). We report a SSI risk of 11.20% for surgical procedures performed without bundle application; this risk decreases to 5.63% (OR: 0.49, 95% CI: 0,36-0,67; p &lt; 0.001) when compliance to bundle is 100%. When compliance to bundle is ≤ 75% instead of 100%, SSI risk raises to 8.47% (OR: 1.49, 95% CI: 1.07-2.04; p = 0.002).

Conclusions

Care bundle, if properly applied, is associated to statistically significant reduction of SSI rate (51%) for colon surgical procedures. Bundle programs should be encouraged and improved in hospitals to reduce healthcare costs and burden of HAIs.

Key messages

The use of the 4-item Surgical Care Bundle is associated to statistically significant reduction (51%) of SSI rate for colon surgical procedures. Surgical Care Bundle programs should be recommended and improved in every hospital to reduce healthcare costs and burden of HAIs.

Escape rate of transiently active Brownian particle in one dimension

Activity significantly enhances the escape rate of a Brownian particle over a potential barrier. Whereas constant activity has been extensively studied in the past, little is known about the effect of time-dependent activity on the escape rate of the particle. In this paper, we study the escape problem for a Brownian particle that is transiently active; the activity decreases rapidly during the escape process. Using the effective equilibrium approach, we analytically calculate the escape rate under the assumption that the particle is either completely passive or fully active when crossing the barrier. We perform numerical simulations of the escape process in one dimension and find good agreement with the theoretical predictions.

Dynamical density functional theory analysis of the laning instability in sheared soft matter

Using dynamical density functional theory (DDFT) methods we investigate the laning instability of a sheared colloidal suspension. The nonequilibrium ordering at the laning transition is driven by nonaffine particle motion arising from interparticle interactions. Starting from a DDFT which incorporates the nonaffine motion, we perform a linear stability analysis that enables identification of the regions of parameter space where lanes form. We illustrate our general approach by applying it to a simple one-component fluid of soft penetrable particles.