Aim
This study aims to identify the most effective interventions to facilitate nurses' clinical leadership in the hospital setting.
Background
There is a gap in the literature on the identification ...and measurement of effective interventions for leadership skill development among clinical nurses in hospitals. To the best of our knowledge, no systematic review has been performed on this issue.
Evaluation
A systematic review was conducted. The PubMed, CINAHL, PsycINFO and Cochrane databases were reviewed. Data extraction, quality appraisal and narrative synthesis were conducted in line with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines.
Key issues
The evidence reveals that interventions designed to promote nurses' clinical leadership are complex, requiring that cognitive, interpersonal and intrinsic competencies as well as psychological empowerment, emotional intelligence and critical reflexivity skills be addressed.
Conclusions
The development of multicomponent, theory‐based and mixed‐format programmes may be more suitable to facilitate nurses' clinical leadership in the hospital setting.
Implications for Nursing Management
Strategies to facilitate nurses' clinical leadership in the hospital setting should address simultaneously the knowledge and ability of bedsides nurses to solve the practical problem collaboratively with a sense of control, competency and autonomy. Hence, it would promote high quality care, satisfaction and retention of bedside nurses.
There is a gap in the literature on identifying and describing effective interventions for the retention of newly graduated registered nurses in hospital settings. To the best of our knowledge, no ...systematic review has been conducted on this issue.
To identify effective interventions that promote the retention of newly graduated registered nurses in the hospital setting and their components.
A systematic review was conducted according to PRISMA 2020 Statement.
Information derived from the PubMed, CINAHL, Scopus, PsycINFO and Cochrane Library databases was reviewed, for the period January 2012-October 2022. Screening, data extraction and quality appraisal were conducted independently by two reviewers. The Joanna Briggs Institute Critical Appraisal tools were used for descriptive, quasi-experimental and cohort studies. Disagreements between the two reviewers were resolved through discussion.
Following the critical appraisal, nine studies were included. The evidence reveals the heterogeneity of programmes developed in the hospital context to promote the retention of newly graduated registered nurses, clarifies the three competencies to be addressed (core, cross-cutting and specific), their components (programme development framework, duration, content and support components), and shows significant improvements after their implementation.
This systematic review identifies that either nurse residency or individualised mentoring programmes, lasting 1 year, and multi-component, addressing core and specific competencies and including preceptor or mentor components seem to be the most comprehensive and effective in promoting the retention of new nurses in the hospital setting.
The knowledge provided by this review will contribute to developing and implementing more effective and context-specific strategies directed at retaining newly graduated registered nurses and subsequently enhancing patient safety and healthcare costs.
Given the study design and focus.
Aim
To explore experiences of frontline nurse managers during COVID‐19.
Background
The COVID‐19 pandemic has complicated care provision and healthcare management around the world. Nurse managers have ...had to face the challenge of managing a crisis with precarious resources. Little research has been published about the experiences of nurse managers during the COVID‐19 pandemic.
Methods
A qualitative descriptive study of 10 frontline nurse managers at a highly specialized university hospital in Spain was carried out. Semi‐structured interviews were conducted between June and September 2020. The Consolidated Criteria for Reporting Qualitative Research checklist was used for reporting.
Results
Six themes emerged: constant adaptation to change, participation in decision‐making, management of uncertainty, prioritization of the biopsychosocial well‐being of the staff, preservation of humanized care and ‘one for all’.
Conclusions
This study provides evidence for the experiences of nurse managers during the COVID‐19 pandemic. In addition, analysing these experiences has helped identify some of the key competencies that these nurses must have to respond to a crisis and in their dual role as patient and nurse mediators.
Implications for Nursing Management
Knowing about the experiences of frontline nurse managers during the pandemic can facilitate planning and preparing nurse managers for future health disasters, including subsequent waves of COVID‐19.
Human metapneumovirus (hMPV) is a frequent cause of bronchiolitis in young children. Its F glycoprotein mediates virus-cell membrane fusion and is the primary target of neutralizing antibodies. The ...inability to produce recombinant hMPV F glycoprotein in the metastable pre-fusion conformation has hindered structural and immunological studies. Here, we engineer a pre-fusion-stabilized hMPV F ectodomain and determine its crystal structure to 2.6 Å resolution. This structure reveals molecular determinants of strain-dependent acid-induced fusion, as well as insights into refolding from pre- to post-fusion conformations. A dense glycan shield at the apex of pre-fusion hMPV F suggests that antibodies against this site may not be elicited by host immune responses, which is confirmed by depletion studies of human immunoglobulins and by mouse immunizations. This is a major difference with pre-fusion F from human respiratory syncytial virus (hRSV), and collectively our results should facilitate development of effective hMPV vaccine candidates.
Human respiratory syncytial virus (hRSV) is the most important viral agent of pediatric respiratory infections worldwide. The only specific treatment available today is a humanized monoclonal ...antibody (Palivizumab) directed against the F glycoprotein, administered prophylactically to children at very high risk of severe hRSV infections. Palivizumab, as most anti-F antibodies so far described, recognizes an epitope that is shared by the two conformations in which hRSV_F can fold, the metastable prefusion form and the highly stable postfusion conformation. We now describe a unique class of antibodies specific for the prefusion form of this protein that account for most of the neutralizing activity of either a rabbit serum raised against a vaccinia virus recombinant expressing hRSV_F or a human Ig preparation (Respigam), which was used for prophylaxis before Palivizumab. These antibodies therefore offer unique possibilities for immune intervention against hRSV, and their production should be assessed in trials of hRSV vaccines.
Let
X
,
Y
be two linear subspaces of the
m
-dimensional complex space
ℂ
m
with
m
> 1. The dimensions of the subspaces
X
and
Y
are
k
and
m
−
k
respectively and let
F
:
ℂ
m
→
ℂ
m
be a non-degenerate ...linear operator. In this work, we study the properties of the intersection between the subspace
Y
and the
n
-iteration of the subspace
X
under
F
. In the case when the dimension of the subspace
X
is either one or two, we give some results about a geometrical classification when we obtain an infinite set of moments
n
of no transversality between the space
Y
and the
n
-iteration of
X
under
F
.
Aims
To identify the most effective interventions to empower cardiorenal patients.
Design
A systematic review of the literature has been carried out.
Data sources
The PubMed, CINAHL, PsycINFO and ...Cochrane databases were reviewed, and journals in the field were manually searched between January and February 2020.
Review methods
Five randomized clinical trials and quasi‐experimental studies that met the selection and CONSORT & TREND methodological quality criteria were selected.
Results
The evidence supports that there are no existing interventions aimed at empowering cardiorenal patients. However, the interventions to empower people with chronic kidney disease and heart failure suggest that their integration should address seven domains: patient education, sense of self‐management, constructive coping, peer sharing, enablement, self‐efficacy and quality of life.
Conclusion
A gap has been revealed in the literature regarding the empowerment of cardiorenal patients. This review provides relevant information to help design, implement and evaluate interventions to empower these patients by describing the strategies used to empower people experiencing both chronic conditions and the tools used for their assessment.
Impact
There is a need for further research to design, implement and evaluate a multidimensional intervention that favours the empowerment of cardiorenal patients by using valid and reliable instruments that measure the domains that constitute it in an integrated manner. Interventions aimed at empowering the cardiorenal patient should include seven domains: patient education, sense of self‐management, constructive coping, peer sharing, enablement, self‐efficacy and quality of life.
Escherichia coli biofilms consist of bacteria embedded in a self‐produced matrix mainly made of protein fibers and polysaccharides. The curli amyloid fibers found in the biofilm matrix are promising ...versatile building blocks to design sustainable bio‐sourced materials. To exploit this potential, it is crucial to understand i) how environmental cues during biofilm growth influence the molecular structure of these amyloid fibers, and ii) how this translates at higher length scales. To explore these questions, the effect of water availability during biofilm growth on the conformation and functions of curli is studied. Microscopy and spectroscopy are used to characterize the amyloid fibers purified from biofilms grown on nutritive substrates with different water contents, and micro‐indentation to measure the rigidity of the respective biofilms. The purified curli amyloid fibers present differences in the yield, structure, and functional properties upon biofilm growth conditions. Fiber packing and β‐sheets content correlate with their hydrophobicity and chemical stability, and with the rigidity of the biofilms. This study highlights how E. coli biofilm growth conditions impact curli structure and functions contributing to macroscopic materials properties. These fundamental findings infer an alternative strategy to tune curli structure, which will ultimately benefit engineering hierarchical and functional curli‐based materials.
The curli amyloid fibers found in Escherichia coli biofilms are promising building blocks for designing sustainable bio‐sourced materials. Understanding how biofilm growth conditions influence the structure and functions of curli helps to exploit their potential. This work shows that water availability during biofilm growth affects the conformation of curli, which in turn contributes to the properties of curli‐based materials.
The objective of this study is to describe the characteristics and outcomes of rheumatic and musculoskeletal disease (RMD) patients who were treated with rituximab and had suspected or confirmed ...severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this descriptive study, RMD patients who were treated with rituximab in the last 12 months at the Rheumatology Department of our hospital were screened for SARS-CoV-2 infection via telephone interview and a comprehensive review of clinical health records (01/02/2020–26/05/2020). Those with probable or confirmed SARS-CoV-2 infection were included. In total, 76 patients were screened. Of these, 13 (17.1%) had suspected or confirmed SARS-CoV-2 infection. With regard to these 13 patients, the median age at coronavirus disease (COVID-19) diagnosis was 68 years (range 28–76 years) and 8 (61.5%) were female. Five patients had rheumatoid arthritis, three had systemic vasculitis, two had Sjögren syndrome, and two had systemic lupus erythematosus. Additionally, seven patients (53.8%) had pulmonary involvement secondary to RMD. Eight patients (61.5%) developed severe disease leading to hospitalization, and seven developed bilateral pneumonia and respiratory insufficiency. Of the eight hospitalized patients, five (62.5%) fulfilled the acute respiratory distress syndrome criteria and three developed a critical disease and died. Our cohort had a high rate of severe disease requiring hospitalization (61.5%), with bilateral pneumonia and hyperinflammation leading to a high mortality rate (23.1%). Treatment with rituximab should be considered a possible risk factor for unfavorable outcomes in COVID-19 patients with RMD. However, further study is required to confirm this association.
The gas-phase atmospheric degradation of chlorpyrifos-methyl (a widely used organophosphate insecticide in Southern European regions) has been investigated at the large outdoor European Photoreactor ...(EUPHORE) in Valencia, Spain. Photolysis under sunlight conditions and reaction with ozone were shown to be unimportant. The rate constant for reaction of chlorpyrifos-methyl with OH radicals was measured using a conventional relative rate method with cyclohexane and n-octane employed as reference compounds with k = (4.1 ± 0.4) × 10−11 cm3 molecule−1 s−1 at 300 ± 5 K and atmospheric pressure. The available evidence indicates that tropospheric degradation of chlorpyrifos-methyl is mainly controlled by reaction with OH radicals and that the tropospheric lifetime is estimated to be around 3.5 h. Significant aerosol formation was observed following the reaction of chlorpyrifos-methyl with OH radicals, and the main carbon-containing products detected in the gas phase were chlorpyrifos-methyl oxone and 3,5,6-trichloro-2-pyridinol.
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