Mccrayklitgaard2507

To implement and evaluate a co-designed staff well-being programme.

Working in health care can be physically and psychologically demanding. The job demands-resources model indicates job resources moderate the impact of job demands on staff well-being. Well-being initiatives introduced by organisations improve staff commitment, and reduce absences and incidents.

A qualitative descriptive design was applied. In 2019, within an Australian local health district, 232 health care professionals across eight hospitals and two community settings attended a six-week well-being programme, which included a variety of self-care strategies, for example mindfulness. Nine 1-hr focus groups were completed 2-4weeks post-programme. Data were analysed using thematic analysis to explore participants' thoughts and experiences.

Participants experienced joy from workshops and guilt for leaving peers with their workload. Participants developed strong interpersonal relationships with workshop attendees within a 'safe well-being space'. Broader impacts expressed by participants were; learnt coping mechanisms and proactive self-care practices and can be easily embedded into daily routines. Participants shared their 'toolkit' with colleagues, family and friends, positively impacting the well-being of people around them.

Participants encouraged by their new well-being 'toolkit' engaged with colleagues, better managed stressors and shared learnings.

Building well-being capability within a health organisation requires nursing management to make staff well-being a strategic priority, use a co-design approach and embed coping mechanisms at the grassroots levels.

Building well-being capability within a health organisation requires nursing management to make staff well-being a strategic priority, use a co-design approach and embed coping mechanisms at the grassroots levels.

Changes in circadian rhythm are related to various diseases, such as immune system diseases and cardiovascular diseases. The PERIOD3 (PER3) clock gene is one of the most important genes in the rhythm regulation system. Our goal was to evaluate the possible association between the PER3 rs228729 (T/C) polymorphism or PER3 rs2797685(T/C) polymorphism and clopidogrel resistance (CR) and to study the impact of clinical baseline data on clopidogrel resistance.

PER3 polymorphisms rs2797685 (T/C) and rs228729 (T/C) were assessed in 156 patients with (72) and without (84) CR. Blood samples were collected and analyzed after the application of clopidogrel for interventional therapy.

Age, albumin, PLT, and PCT levels influenced the risk of CR (p<0.05). For rs2797685, when the PCT value was greater than 0.19, patients with the TT + TC genotype had an increased risk of clopidogrel resistance compared with those with the CC genotype (PCT≥0.19, p=0.014; PCT p=0.004). In patients with albumin values greater than 40 or PCT greater than 0.19, those with the rs228729TT + TC genotype had an increased risk of clopidogrel resistance compared with those with the CC genotype (albumin≥40, TT+TCCC, p=0.01, albumin p=0.005; PCT≥0.19, TT+TCCC, p<0.001, PCT p=0.004). Logistic regression analysis of clinical baseline data and genotype showed that high albumin is a protective factor against clopidogrel resistance. The PER3 gene polymorphism has no clear correlation with clopidogrel resistance.

In summary, our research shows that PER3 SNPs may be helpful to assess the pathogenesis of CR.

In summary, our research shows that PER3 SNPs may be helpful to assess the pathogenesis of CR.

The clinical significance of Coronavirus disease 2019 (COVID-19) as an associate of myocardial injury is controversial.

Type 2 MI/Myocardial Injury are associated with worse outcomes if complicated by COVID-19.

This longitudinal cohort study involved consecutive patients admitted to a large urban hospital. Myocardial injury was determined using laboratory records as ≥1 hs-TnI result >99th percentile (male >34 ng/L; female >16 ng/L). Endotypes were defined according to the Fourth Universal Definition of Myocardial Infarction (MI) and COVID-19 determined using PCR. Outcomes of patients with myocardial injury with and without COVID-19 were assessed.

Of 346 hospitalized patients with elevated hs-TnI, 35 (10.1%) had laboratory-confirmed COVID-19 (median age [IQR]; 65 [59-74]; 64.8% male vs. COVID-19 negative 74 [63-83] years; 43.7% male). Cardiac endotypes by COVID-19 status (yes vs. no) were Type 1 MI (0 [0%] vs. 115 [100%]; p < .0005), Type 2 MI (13 [16.5%] vs. 66 [83.5%]; p = .045), and non-ischemic myocardial injury (cardiac 4 [5.8%] vs. 65 [94.2%]; p = .191, non-cardiac19 [22.9%] vs. 64 [77.%]; p < .0005). COVID-19 patients had less comorbidity (median [IQR] Charlson Comorbidity Index 3.0 [3.0] vs. find more 5.0 [4.0]; p = .001), similar hs-TnI concentrations (median [IQR] initial 46 [113] vs. 62 [138]; p = .199, peak 122 [474] vs. 79 [220] ng/L; p = .564), longer admission (days) (median [IQR] 14[19] vs. 6[12]; p = .001) and higher in-hospital mortality (63.9% vs. 11.3%; OR = 13.2; 95%CI 5.90, 29.7).

Cardiac sequelae of COVID-19 typically manifest as Non-cardiac myocardial injury/Type 2MI in younger patients with less co-morbidity. Paradoxically, the admission duration and in-hospital mortality are increased.

Cardiac sequelae of COVID-19 typically manifest as Non-cardiac myocardial injury/Type 2MI in younger patients with less co-morbidity. Paradoxically, the admission duration and in-hospital mortality are increased.

Although there is growing evidence the Clinical Nurse Specialist role makes a difference to patient care, the full value of this service may not be always appreciated with current models not meeting the needs of those with cancer. The primary aim of this integrative literature review was to evaluate outcomes associated with the role of the Clinical Nurse Specialist in cancer care. The secondary aim was to identify the components of the Clinical Nurse Specialist role in cancer care from the included papers in the literature review.

An integrative literature review using a systematic approach was adopted. Literature searches were undertaken in four databases and supplemented with a search in the grey literature and reference lists of included papers. Searches were limited to January 2009-July 2019 and those written in the English language. Three reviewers independently completed the searches and reviewed the papers before reaching a consensus.

Fourteen eligible research papers were identified. Evaluations were predominately positive with the role contributing to improving patient outcomes with regards psychological support, information provision, symptom management, service coordination and patient satisfaction.