Dem Arbeitsengagement Pflegender wird in der Pandemiebewältigung ein essenzieller Stellenwert zugeschrieben. Die job demands-resources theory nimmt an, dass das Arbeitsengagement von ...Arbeitsressourcen und Arbeitsanforderungen abhängt. Für Pflegende wurden bereits berufsspezifische Schlüsselressourcen und -anforderungen identifiziert. Für deren Bedeutung unter Pandemiebedingungen gibt es jedoch keine Evidenz. Ziel dieser Studie war es daher, ihre Relevanz für das Arbeitsengagement von Pflegenden während der zweiten Welle der COVID-19-Pandemie zu untersuchen.
Die Studie wurde im Querschnittdesign realisiert und adressierte Pflegende in der direkten Gesundheitsversorgung in Deutschland. Die Daten wurden per Online-Fragebogen in der zweiten Welle der Pandemie mit Messinstrumenten erhoben, die sich in früheren Studien als valide und reliabel erwiesen haben. Die Stichprobe wurde als Gelegenheitsstichprobe, u.a. über soziale Medien, zufällig ausgewählte Gesundheitseinrichtungen und die Hochschulen mit pflegebezogenen Studiengängen gewonnen. Es konnten 1027 Fälle ausgewertet werden. Die Stichprobe umfasste Pflegende unterschiedlicher Ausbildungsgrade und Einsatzorte. Die Relevanz von Schlüsselressourcen und -anforderungen für das Arbeitsengagement wurde mit einer multiplen linearen Regressionsanalyse nach Multipler Imputation untersucht.
Die Schlüsselressourcen und -anforderungen erklärten 36% der Varianz des Arbeitsengagements der Pflegenden während der COVID-19-Pandemie. Es zeigten sich positive Zusammenhänge zwischen den Schlüsselressourcen Autonomie (β¯SP= 0,072, 95%-KI 0,011; 0,133), professionelle Ressourcen (β¯SP= 0,204, 95%-KI 0,124; 0,285) und zwischenmenschliche Beziehungen (β¯SP= 0,178, 95%-KI 0,117; 0,240) und dem Arbeitsengagement der Pflegenden. Bei den Anforderungen wirkten sich mangelnde formale Belohnungen negativ (β¯SP= -0,312, 95%-KI -0,380; -0,245) auf das Arbeitsengagement aus, Arbeitsüberlastung (β¯SP= 0,063, 95%-KI 0,001; 0,126) hingegen war positiv mit dem Arbeitsengagement assoziiert.
Die job demands-resources theory ist geeignet, das Arbeitsengagement auch in Krisenzeiten zu erklären. Die Schlüsselressourcen und -anforderungen haben insgesamt einen erheblichen Einfluss auf das Arbeitsengagement der Pflegenden unter Pandemiebedingungen. Allerdings kommt während der Pandemie nicht allen Schlüsselressourcen und -anforderungen tatsächlich ein Schlüsselstatus zu.
Mangelnden formalen Belohnungen sollte entgegengesteuert, professionelle Ressourcen sollten nachhaltig gesichert und die Autonomie von Pflegenden sowie deren zwischenmenschliche Beziehungen sollten gestärkt werden. Entscheidungen sollten dabei so getroffen werden, dass sie nicht nur pandemiegerecht, sondern nachhaltig tragfähig sind und damit verstetigt werden können.
Nurses are assigned a key role in pandemic response, with work engagement considered to be pivotal. The job demands-resources theory assumes that work engagement depends on job resources and job demands. Key job resources and demands have already been proposed for nurses. However, there is no evidence on their importance under pandemic conditions. Hence, the aim of this study was to investigate their relevance to nurses’ work engagement during the second wave of the COVID-19 pandemic.
The study was carried out in a cross-sectional design and addressed nurses in direct health care settings in Germany. Data was collected administering a quantitative online survey using valid and reliable measures during the second wave of the pandemic. A convenience sample was obtained, including the use of social media, randomly selected health care facilities, and all universities with nursing-related programs in Germany. The dataset for analyses comprised a total of 1,027 cases. The sample included nurses of various educational levels and from different sectors. Multiple linear regression analysis after multiple imputation was used to examine the relevance of key resources and demands for work engagement.
Key resources and demands explained 36% of the variance in nurses’ work engagement during the COVID-19 pandemic. Positive associations were found between the key resources of autonomy (β¯SP=0.072, 95% CI 0.011; 0.133), professional resources (β¯SP=0.204, 95% CI 0.124; 0.285), and interpersonal relationships (β¯SP=0.178, 95% CI 0.117; 0.240) and nurses’ work engagement. On the demands side, lack of formal rewards negatively (β¯SP=–0.312, 95% CI –0.380; –0.245) affected work engagement, whereas work overload (β¯SP=0.063, 95% CI 0.001; 0.126) was positively associated with work engagement.
The job demands-resources theory is suitable for explaining nurses’ work engagement even in times of crisis. Taken together, key resources and demands have a significant influence on nurses’ work engagement under pandemic conditions. However, not all so-called key resources and demands actually have a key status in a pandemic.
Any lack of formal rewards should be countered, professional resources should be sustainably secured, and the autonomy of nurses and their interpersonal relationships should be strengthened. Nursing management decisions should be made not only with the current pandemic but also the post-pandemic period in mind.
Nurses are assigned a key role in pandemic response, with work engagement considered to be pivotal. The job demands-resources theory assumes that work engagement depends on job resources and job ...demands. Key job resources and demands have already been proposed for nurses. However, there is no evidence on their importance under pandemic conditions. Hence, the aim of this study was to investigate their relevance to nurses' work engagement during the second wave of the COVID-19 pandemic.
The study was carried out in a cross-sectional design and addressed nurses in direct health care settings in Germany. Data was collected administering a quantitative online survey using valid and reliable measures during the second wave of the pandemic. A convenience sample was obtained, including the use of social media, randomly selected health care facilities, and all universities with nursing-related programs in Germany. The dataset for analyses comprised a total of 1,027 cases. The sample included nurses of various educational levels and from different sectors. Multiple linear regression analysis after multiple imputation was used to examine the relevance of key resources and demands for work engagement.
Key resources and demands explained 36% of the variance in nurses' work engagement during the COVID-19 pandemic. Positive associations were found between the key resources of autonomy (β¯
=0.072, 95% CI 0.011; 0.133), professional resources (β¯
=0.204, 95% CI 0.124; 0.285), and interpersonal relationships (β¯
=0.178, 95% CI 0.117; 0.240) and nurses' work engagement. On the demands side, lack of formal rewards negatively (β¯
=-0.312, 95% CI -0.380; -0.245) affected work engagement, whereas work overload (β¯
=0.063, 95% CI 0.001; 0.126) was positively associated with work engagement.
The job demands-resources theory is suitable for explaining nurses' work engagement even in times of crisis. Taken together, key resources and demands have a significant influence on nurses' work engagement under pandemic conditions. However, not all so-called key resources and demands actually have a key status in a pandemic.
Any lack of formal rewards should be countered, professional resources should be sustainably secured, and the autonomy of nurses and their interpersonal relationships should be strengthened. Nursing management decisions should be made not only with the current pandemic but also the post-pandemic period in mind.
Demands, resources, and work engagement of nurses during the second wave of the COVID-19 pandemic - A cross-sectional study
Nurses are assigned a key role in managing the COVID-19 pandemic. Of ...particular importance is their work engagement, depending on job demands and resources. So far, there have only been scattered and first-wave related indications of nurses' job demands, resources and work engagement in Germany during the pandemic.
To systematically assess key job demands, key job resources and work engagement of nursing staff for the second wave of the COVID-19 pandemic, also differentiating between various groups of nurses.
The study was realized in a cross-sectional design and included nurses in direct health care settings in Germany. Data was collected with an online questionnaire using valid and reliable measures during the second wave of the pandemic. The dataset for analyses comprised 1027 cases in total.
Regarding demands, work overload was even higher than before the pandemic, but work-life interferences were less pronounced. Nurses' resource architecture was not fundamentally changed by the pandemic, but interpersonal relationships and autonomy were rated more positively. Domiciliary care workers assessed demands and resources more positively than nurses in nursing homes or hospitals, whereas nurses caring for COVID-19 patients evaluated demands and resources more critically. Nurses' work engagement was higher during the second pandemic wave than in the first wave, but still low overall.
Due to the importance of work engagement for nurses' health and performance and thus the quality of care, demands and resources must be further improved. Starting points are, e. g., fostering team cohesion, strengthening autonomy, and managing workload.
Growth differentiation factor 15 (GDF15) is a stress‐responsive cytokine also known as a mitokine; however, its role in mitochondrial homeostasis and cellular senescence remained elusive. We show ...here that knocking down GDF15 expression in human dermal fibroblasts induced mitochondrial dysfunction and premature senescence, associated with a distinct senescence‐associated secretory phenotype. Fibroblast‐specific loss of GDF15 expression in a model of 3D reconstructed human skin induced epidermal thinning, a hallmark of skin aging. Our results suggest GDF15 to play a so far undisclosed role in mitochondrial homeostasis to delay both the onset of cellular senescence and the appearance of age‐related changes in a 3D human skin model.
Depletion of growth differentiation factor 15 (GDF15) leads to mitochondrial dysfunction and premature senescence in human dermal fibroblasts. GDF15, a mitokine regulated in response to different sources of stress, is upregulated during cellular senescence and in the plasma of aged animals, including humans. In normal cells, under stress conditions, transcription and secretion of GDF15 are increased, although the mechanisms of intra and extracellular action of this protein are still not fully understood. Here, we demonstrate that knockdown of GDF15 induces premature senescence in human dermal fibroblasts. In this context, senescence was characterized by the accumulation of ROS, mitochondrial dysfunction, and secretion of a distinct SASP. When inserted in 3D skin equivalents, senescent GDF15 knockdown fibroblasts induced epidermal thinning, a common characteristic of skin aging, supporting the important role of GDF15 in maintenance of cell homeostasis.
Skin aging is a complex process influenced by intrinsic factors and environmental stressors, including ultraviolet (UV) radiation and air pollution, among others. In this study, we investigated the ...effects of UVA and UVB radiation, combined with urban particulate matter (UPM), on human dermal fibroblasts (HDF). We show here that treatment of HDF with a subcytotoxic dose of UVA/UVB results in a series of events leading to mitochondrial dysfunction, increased ROS levels, and DNA damage. These effects are known to trigger either cellular senescence or cell death, depending on the cells' ability to clear damage by activating autophagy. Whereas UPM treatment in isolation did not affect proliferation or survival of HDF, of note, simultaneous UPM treatment of UV-irradiated cells selectively inhibited autophagic flux, thereby changing cell fate of a fraction of the cell population from senescence to apoptotic cell death. Our findings highlight the synergistic effects of UV radiation and UPM on skin aging, emphasizing the need to consider these factors in assessing the impact of environmental stressors on human health and opening opportunities for developing comprehensive approaches to protect and preserve skin integrity in the face of growing environmental challenges.
Organismal aging is normally accompanied by an increase in the number of senescent cells, growth-arrested metabolic active cells that affect normal tissue function. These cells present a series of ...characteristics that have been studied over the last few decades. The damage in cellular organelles disbalances the cellular homeostatic processes, altering the behavior of these cells. Lysosomal dysfunction is emerging as an important factor that could regulate the production of inflammatory molecules, metabolic cellular state, or mitochondrial function.
Cellular senescence, a state of irreversible growth arrest, is implicated in various age-related pathologies, including skin aging. In this study, we investigated the role of CLCA2, a ...calcium-activated chloride channel accessory protein, in cellular senescence and its implications for skin aging. Utilizing UVB and Nutlin3a-induced senescence models, we observed the upregulation of CLCA2 at both transcriptomic and proteomic levels, suggesting its involvement in senescence pathways. Further analysis revealed that the depletion of CLCA2 led to accelerated senescence onset, characterized by classic senescence markers and a unique secretome profile. In 3D skin equivalent models, SEs constructed with CLCA2 knockdown fibroblasts exhibited features reminiscent of aged skin, underscoring the importance of CLCA2 in maintaining skin homeostasis. Our findings highlight CLCA2 as a novel regulator of cellular senescence and its potential implications for skin aging mechanisms.
Background
Post-COVID-Fatigue (PCF) is one of the most reported symptoms following SARS-CoV-2 infection. Currently, research on persistent symptoms focuses mainly on severe infections, while ...outpatients are rarely included in observations.
Objective
To investigate whether the severity of PCF is related to the number of acute and persistent symptoms due to mild-to-moderate COVID-19 and to compare the most common symptoms during acute infection with the persistent symptoms in PCF patients.
Methods
A total of 425 participants were examined after COVID-19 treated as an outpatient (median 249 days IQR: 135; 322 after acute disease) at the site of University Hospital Augsburg, Germany. The Fatigue Assessment Scale (FAS) was used to quantify the severity of PCF. The number of symptoms (maximum 41) during acute infection and persistent symptoms (during the last 14 days before examination) were added up to sum scores. Multivariable linear regression models were used to show the association between the number of symptoms and PCF.
Results
Of the 425 participants, 37% (
n
= 157) developed PCF; most were women (70%). The median number of symptoms was significantly higher in the PCF group than in the non-PCF group at both time points. In multivariable linear regression models, both sum scores were associated with PCF (acute symptoms: β-estimate per additional symptom 95%-CI: 0.48 0.39; 0.57,
p
< 0.0001); persistent symptoms: β-estimate per additional symptom 95%-CI: 1.18 1.02; 1.34,
p
< 0.0001). The acute symptoms strongest associated with PCF severity were difficulty concentrating, memory problems, dyspnea or shortness of breath on exertion, palpitations, and problems with movement coordination.
Conclusion
Each additional symptom that occurs in COVID-19 increases the likelihood of suffering a higher severity of PCF. Further research is needed to identify the aetiology of PCF.
Trial registration: Nr. NCT04615026. Date of registration: November 4, 2020.
Lymph node metastasis (LNM) occurs in less than 5% of soft tissue sarcoma (STS) patients and indicates an aggressive course of disease. Suspicious lymph nodes (LN) in staging imaging are a frequent ...topic of discussion in multidisciplinary tumor boards. Predictive markers are needed to facilitate stratification and improve treatment of STS patients. In this study, 56 STS patients with radiologically suspicious and subsequently histologically examined LN were reviewed. Patients with benign (n = 26) and metastatic (n = 30) LN were analyzed with regard to clinical, laboratory and imaging parameters. Patients with LNM exhibited significantly larger short axis diameter (SAD) and long axis diameter (LAD) vs. patients with benign LN (median 22.5 vs. 14 mm, p < 0.001 and median 29.5 vs. 21 mm, p = 0.003, respectively). Furthermore, the presence of central necrosis and high maximal standardized uptake value (SUVmax) in FDG-PET-CT scans were significantly associated with LNM (60 vs. 11.5% of patients, p < 0.001 and median 8.59 vs. 3.96, p = 0.013, respectively). With systemic therapy, a slight median size regression over time was observed in both metastatic and benign LN. Serum LDH and CRP levels were significantly higher in patients with LNM (median 247 vs. 187.5U/L, p = 0.005 and 1.5 vs. 0.55 mg/dL, p = 0.039, respectively). This study shows significant associations between LNM and imaging features as well as laboratory parameters of STS patients. The largest SAD, SUVmax in FDG-PET-CT scan, the presence of central necrosis, and high serum LDH level are the most important parameters to distinguish benign from metastatic LNs.
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