Reliability and validity of the training satisfaction questionnaire for family members (TSQ-FM) entering the ICU during an isolation disease outbreak

BACKGROUND

The presence of family members in an isolated ICU during an isolation disease outbreak is restricted by hospital policies because of the infectious risk. This can be overcome by conferring to family members the skill and the ability to safely don and doff the personal protective equipment (PPE) through a nurse-led training intervention and assess their satisfaction, to respond to the need to define a safe, effective and quality care pathway focused on Family-Centered Care (FCC) principles.

OBJECTIVE

the study aimed to build a valid and reliable instrument for clinical practice to assess family members' satisfaction to allow ICU nurses to restore family integrity in any case of infectious disease outbreak that requires isolation.

METHODS

A cross-sectional study was conducted to test the psychometric properties. The questionnaire was constructed based on a literature review on the needs of family members in the ICU. 76 family members were admitted to a COVID-ICU. Cronbach's coefficient, Geomin rotated loading, and EFA were applied to assess the reliability and validity of the instrument.

RESULTS

The Kaiser-Mayer-Olkin (KMO) measure was 0.662, the Bartlett sphericity test showed a significant p-value (χ²=448.33; df=45; p < 0.01), Cronbach's alpha coefficient was.896. A further CFA analysis confirmed that all fit indices were acceptable. The results showed satisfactory validity and reliability, which could be generalized and extended to any outbreak of isolation disease.

CONCLUSIONS

This study provides a valid and reliable instrument for clinical practice to maintain family integrity in the dyadic relationship between the patient and the family member, even during an emergency infectious disease outbreak that requires isolation.

Nurses quality of life, sleep disturbance, and intention to leave critical care units: A cross-sectional moderated mediation analysis

OBJECTIVES

This study aims to explore the complex relationships between personal and demographic factors, intermediary factors such as quality of life (depression, anxiety, stress, burnout), and the mediating impact of sleep disturbance on nurses' intention to leave critical care units.

DESIGN

Cross-sectional quantitative survey.

SETTING

Data were collected from registered nurses at a major university hospital in southern Italy. Seven inpatient critical care units were sampled.

MAIN OUTCOME MEASURES

Intention to leave critical care units.

RESULTS

We included 160 participants recruited over five weeks in May and June 2023. The data showed that most were female, married, and possessed a bachelor's degree in nursing. The mean quality of life score was moderate, while stress, anxiety, and burnout were mild. A significant percentage of nurses reported poor sleep quality. Logistic regression indicates that service length did not significantly impact the intention to leave. The structural equation model showed that stress positively correlated with emotional exhaustion, whereas job quality was negatively associated with emotional exhaustion and the intention to leave. Sleep disturbance did not explain the relationship between stress and emotional fatigue; however, the results revealed that male gender moderated sleep mediation.

CONCLUSIONS

This study investigated factors influencing intention to leave among critical care unit nurses. The results suggest that the role of sleep disturbance should always be considered when assessing the issue. In this chain of causes, sleep disturbance explains the relationship between stress and emotional exhaustion. Furthermore, the strength of this mediation was influenced by gender, particularly by the male gender.

IMPLICATIONS FOR CLINICAL PRACTICE

Stress and emotional exhaustion significantly impact nurses' working quality of life, particularly when sleep quality is taken into account. This leads to a higher intention to leave critical care units. To reduce this tendency, healthcare managers could implement specific evidence-based interventions to promote a good climate of work, which would positively affect stress, emotional exhaustion and sleep disturbance. The likelihood of intention to leave decreased with achieving personal self-fulfilment among nurses.

The needs and difficulties during the return to work after a stroke: a systematic review and meta-synthesis of qualitative studies

PURPOSE

To describe which needs and difficulties are experienced by stroke patients and caregivers regarding their return to work and to synthesise the lived experiences of stroke patients and caregivers.

MATERIALS AND METHODS

A systematic review and metasynthesis was conducted on PubMed, CINAHL, Scopus, Web of Sciences and PsycInfo, in according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research. Studies eligible for the review had to fulfil the following inclusion criteria: qualitative studies, stroke patients and their caregivers in a working age (approximately from 18 to 65 years old), discharged from the hospital.

RESULTS

Thirty-eight studies involving stroke patients and caregivers were included in this review. For the stroke patients' group, three main themes were identified: (a) Towards the future; (b) Professional support in return to work; and (c) return to work and employment perspective, while for caregivers two main themes were: (a) daily life challenges and role overload; and (b) employment challenges.

CONCLUSIONS

Integrating public employment, social and health services, support for job placement, return to work, and social participation of stroke patients should be more supported in individual rehabilitation programs to help stroke survivors and caregivers in their return-to-work process.

Single-centre descriptive study of adverse events reported after anti-COVID vaccination

Introduction: In Italy, approximately 80.5% of the population has completed the primary anti-COVID vaccination cycle with approximately 141 million doses administered. With the introduction of new measures to counter the spread of COVID-19, including compulsory vaccination for certain categories of people, the population expressed fears about the safety and adverse effects of SARS-CoV-2 vaccines. Several factors, such as gender and age, could have influenced the outcomes associated with the vaccine. Our single-centre work seeks to provide such evidence with respect to Pfizer/BioNTech's BNT162b2 (Comirnaty) and AstraZeneca's AZD1222 (Vaxzevria) vaccines. Materials and Methods: Single-centre descriptive study carried out on a sample of subjects who underwent anti-COVID vaccination at the 'San Giovanni di Dio e Ruggi d'Aragona' AOU vaccination centre in Salerno. Patients who reported a suspected adverse reaction after receiving a dose of vaccine were included in the study. The regional vaccine platform SORESA and the VigiFarmaco portal were used to collect the data. Results: During the period covered by the study, 126,928 doses of SARS-CoV-2 vaccine were administered. The Pfizer-BioNTech vaccine group comprised 124,138 administrations. The AstraZeneca vaccine group consisted of 2,790 administrations. 287 post-vaccination adverse reaction reports entered in the National Pharmacovigilance Network were considered. In most of the reactions reported, for both vaccines considered, the symptomatology was attributable to local reactions at the injection site. At the systemic level, however, we noted the prevalence of non-specific events such as fever, headache and diffuse arthromyalgia. Conclusions: Based on our results and comparison with the literature, the data collected on the vaccines considered in the study suggest a favourable safety profile for their large-scale use. The rate of minor adverse events turned out to be low, with similarly reassuring data compared to serious adverse events, such as not to justify hesitation towards vaccination for COVID-19 disease control. Keywords: SARS-CoV-2; Surveillance system; COVID-19 vaccination; mRNA; Viral vector; Adverse events following immunisation

Synthesis and Characterization of Blended Cellulose Acetate Membranes

The casting and preparation of ultrafiltration ZnO modified cellulose acetate membrane (CA/ZnO) were investigated in this work. CA membranes were fabricated by phase inversion using dimethylformamide (DMF) as a solvent and ZnO as nanostructures materials. Ultrafiltration (UF) performance, mechanical stability, morphology, contact angle, and porosity were evaluated on both CA- and ZnO-modified CA samples. Scanning electron microscopy (SEM) was used to determine the morphology of the membranes, showing different pore sizes either on rough surfaces and cross-sections of the samples, an asymmetric structure and ultra-scale pores with an average pore radius 0.0261 to 0.045 µm. Contact angle measurements showed the highest hydrophobicity values for the samples with no ZnO addition, ranging between 48° and 82.7° on their airside. The permeability values decreased with the increasing CA concentration in the casting solution, as expected; however, ZnO-modified membranes produced lower flux than the pure CA ones. Nevertheless, ZnO modified CA membranes have higher surface pore size, pore density and porosity, and improved surface hydrophilicity compared with pure CA membranes. The results indicated that the incorporated nano-ZnO tends to limit the packing of the polymer chains onto the membrane structure while showing antifouling properties leading to better hydrophilicity and permeation with consistent UF applications.

Advanced descriptors for long-range noncovalent interactions between SARS-CoV-2 spikes and polymer surfaces

The recent pandemic triggered numerous societal efforts aimed to control and limit the spread of SARS-CoV-2. One of these aspects is related on how the virion interacts with inanimate surfaces, which might be the source of secondary infection. Although recent works address the adsorption of the spike protein on surfaces, there is no information concerning the long-range interactions between spike and surfaces, experimented by the virion when is dispersed in the droplet before its possible adsorption. Some descriptors, namely the interaction potentials per single protein and global potentials, were calculated in this work. These descriptors, evaluated for the closed and open states of the spike protein, are correlated to the long-range noncovalent interactions between the SARS-CoV-2 spikes and polymeric surfaces. They are associated with the surface's affinity towards SARS-CoV-2 dispersed in respiratory droplets or water solutions. Molecular-Dynamics simulations were performed to model the surface of three synthetic polymeric materials: Polypropylene (PP), Polyethylene Terephthalate (PET), and Polylactic Acid (PLA), used in Molecular Mechanics simulations to define the above potentials. The descriptors show a similar trend for the three surfaces, highlighting a greater affinity towards the spikes of PP and PLA over PET. For closed and open structures, the long-range interactions with the surfaces decreased in the following order PP ∼ PLA > PET and PLA > PP > PET, respectively. Thus, PLA and PP interact with the virion quite distant from these surfaces to a greater extent concerning the PET surface, however, the differences among the considered surfaces were small. The global potentials show that the long-range interactions are weak compared to classic binding energy of covalent or ionic bonds. The proposed descriptors are useful most of all for a comparative study aimed at quickly preliminary screening of polymeric surfaces. The obtained results should be validated by more accurate method which will be subject of a subsequent work.

Transmission of SARS-Cov-2 and other enveloped viruses to the environment through protective gear: a brief review

Over the past two decades, several deadly viral epidemics have emerged, which have placed humanity in danger. Previous investigations have suggested that viral diseases can spread through contaminants or contaminated surfaces. The transmission of viruses via polluted surfaces relies upon their capacity to maintain their infectivity while they are in the environment. Here, a range of materials that are widely used to manufacture personal protective equipment (PPE) are summarized, as these offer effective disinfection solutions and are the environmental variables that influence virus survival. Infection modes and prevention as well as disinfection and PPE disposal strategies are discussed. A coronavirus-like enveloped virus can live in the environment after being discharged from a host organism until it infects another healthy individual. Transmission of enveloped viruses such as SARS-CoV-2 can occur even without direct contact, although detailed knowledge of airborne routes and other indirect transmission paths is still lacking. Ground transmission of viruses is also possible via wastewater discharges. While enveloped viruses can contaminate potable water and wastewater through human excretions such as feces and droplets, careless PPE disposal can also lead to their transmission into our environment. This paper also highlights the possibility that viruses can be transmitted into the environment from PPE kits used by healthcare and emergency service personnel. A simulation-based approach was developed to understand the transport mechanism for coronavirus and similar enveloped viruses in the environment through porous media, and preliminary results from this model are presented here. Those results indicate that viruses can move through porous soil and eventually contaminate groundwater. This paper therefore underlines the importance of proper PPE disposal by healthcare workers in the Mediterranean region and around the world.

Interactions between Proteins and the Membrane Surface in Multiscale Modeling of Organic Fouling

In the present paper, an improved multiscale modeling aimed at describing membrane fouling in the UltraFiltration (UF) process was proposed. Some of the authors of this work previously published a multiscale approach to simulate ultrafiltration of Bovine Serum Albumin (BSA) aqueous solutions. However, the noncovalent interactions between proteins and the membrane surface were not taken into account in the previous formulation. Herein, the proteins-surface interactions were accurately computed by first-principle-based calculations considering also the effect of pH. Both the effective surface of polysulfone (PSU) and the first layer of proteins adsorbed on the membrane surface were accurately modeled. Different from the previous work, the equilibrium distance between proteins was calculated and imposed as lower bound to the protein-protein distances in the compact deposit accumulated on the membrane surface. The computed BSA surface charges were used to estimate the protein potential and the charge density, both necessary to formulate a forces balance at microscopic scale. The protein surface potential was compared with Z-potential measurements of BSA aqueous solution, and a remarkable agreement was found. Finally, the overall additional resistance, as due to both the compact and loose layers of the deposit, was computed, thus allowing the final transition to a macroscopic scale, where an unsteady-state mass transfer model was formulated to describe the behavior of a typical dead-end UF process. A good agreement between simulated and experimental permeate flux decays was observed.

Metabotropic glutamate receptors 5 blockade reverses spatial memory deficits in a mouse model of Parkinson's disease

Visuo-spatial deficits are the most consistently reported cognitive abnormalities in Parkinson's disease (PD), and they are frequently associated to motor symptoms in the early stages of the disease when dopamine loss is moderate and still restricted to the caudate-putamen. The metabotropic glutamate receptor 5 (mGluR5) antagonist, 2-methyl-6-(phenylethynyl)-pyridine (MPEP), has beneficial effects on motor symptoms in animal models of PD. However, the effects of MPEP on the cognitive deficits of the disease have never been investigated. Thus, the purpose of this study was to explore its therapeutic potentials by investigating its effects on the visuo-spatial deficits induced by 6-hydroxydopamine (6-OHDA) lesions of dorsal striatum in CD1 mice. The results demonstrated that systemic injections of MPEP (6, 12, and 24 mg/kg, i.p.) impair visuo-spatial discrimination in intact mice at high concentrations, whereas lower doses (1.5 and 3 mg/kg, i.p.) were void of effects. Nevertheless, when an ineffective dose (MPEP 3 mg/kg) was injected, either acutely or subchronically (8 days), it antagonized the visuo-spatial discrimination deficit induced by bilateral dopamine lesion of the striatum. Furthermore, the same treatment increased contralateral turning induced by L-DOPA in mice bearing unilateral 6-OHDA lesion. These results confirm the therapeutic potential of mGluR5 blockade on motor symptoms induced by reduced striatal dopamine function. Further, they demonstrate that mGluR5 blockade may also have beneficial effects on cognitive deficits induced by dopamine depletion.