Exercise, diet, and sleep habits of nurses working full-time during the COVID-19 pandemic: An observational study

BACKGROUND

Healthy diet, exercise, and sleep practices may mitigate stress and prevent illness. However, lifestyle behaviors of acute care nurses working during stressful COVID-19 surges are unclear.

PURPOSE

To quantify sleep, diet, and exercise practices of 12-hour acute care nurses working day or night shift during COVID-19-related surges.

METHODS

Nurses across 10 hospitals in the United States wore wrist actigraphs and pedometers to quantify sleep and steps and completed electronic diaries documenting diet over 7-days.

FINDINGS

Participant average sleep quantity did not meet national recommendations; night shift nurses (n = 23) slept significantly less before on-duty days when compared to day shift nurses (n = 34). Proportionally more night shift nurses did not meet daily step recommendations. Diet quality was low on average among participants.

DISCUSSION

Nurses, especially those on night shift, may require resources to support healthy sleep hygiene, physical activity practices, and diet quality to mitigate stressful work environments.

Projecting biodiversity benefits of conservation behavior-change programs

Biodiversity loss is driven by human behavior, but there is uncertainty about the effectiveness of behavior-change programs in delivering benefits to biodiversity. To demonstrate their value, the biodiversity benefits and cost-effectiveness of behavior changes that directly or indirectly affect biodiversity need to be quantified. We adapted a structured decision-making prioritization tool to determine the potential biodiversity benefits of behavior changes. As a case study, we examined two hypothetical behavior-change programs--wildlife gardening and cat containment--by asking experts to consider the behaviors associated with these programs that directly and indirectly affect biodiversity. We assessed benefits to southern brown bandicoot (Isoodon obesulus) and superb fairy-wren (Malurus cyaneus) by eliciting from experts estimates of the probability of each species persisting in the landscape given a range of behavior-change scenarios in which uptake of the behaviors varied. We then compared these estimates to a business-as-usual scenario to determine the relative biodiversity benefit and cost-effectiveness of each scenario. Experts projected that the behavior-change programs would benefit biodiversity and that benefits would rise with increasing uptake of the target behaviors. Biodiversity benefits were also predicted to accrue through indirect behaviors, although experts disagreed about the magnitude of additional benefit provided. Scenarios that combined the two behavior-change programs were estimated to provide the greatest benefits to species and be most cost-effective. Our method could be used in other contexts and potentially at different scales and advances the use of prioritization tools to guide conservation behavior-change programs.

Understanding Australia’s national feral cat control effort

Abstract Context. Feral cats (Felis catus) pose a significant threat to Australia’s native species and feral cat control is, therefore, an important component of threatened species management and policy. Australia’s Threatened Species Strategy articulates defined targets for feral cat control. Yet, currently, little is known about who is engaged in feral cat control in Australia, what motivates them, and at what rate they are removing feral cats from the environment. Aims. We aim to document who is engaging in feral cat control in Australia, how many cats they remove and to estimate the number of feral cats killed in a single year. Furthermore, we seek to better understand attitudes towards feral cat control in Australia. Methods. We used a mixed methods approach combining quantitative and qualitative techniques. Feral cat control data were obtained from existing data repositories and via surveys targeting relevant organisations and individuals. A bounded national estimate of the number of feral cats killed was produced by combining estimates obtained from data repositories and surveys with modelled predictions for key audience segments. Attitudes towards feral cat control were assessed by exploring qualitative responses to relevant survey questions. Key results. We received information on feral cat control from three central repositories, 134 organisations and 2618 individuals, together removing more than 35000 feral cats per year. When including projections to national populations of key groups, the estimated number of feral cats removed from the environment in the 2017–2018 financial year was 316030 (95% CI: 297742–334318). Conclusions. Individuals and organisations make a significant, and largely unrecorded, contribution to feral cat control. Among individuals, there is a strong awareness of the impact of feral cats on Australia’s biodiversity. Opposition to feral cat control focussed largely on ethical concerns and doubts about its efficacy. Implications. There is significant interest in, and commitment to, feral cat control among some groups of Australian society, beyond the traditional conservation community. Yet more information is needed about control methods and their effectiveness to better understand how these efforts are linked to threatened species outcomes.

VKORC1 sequence variants associated with resistance to anticoagulant rodenticides in Irish populations of Rattus norvegicus and Mus musculus domesticus

While resistance to anticoagulant rodenticides is known to occur in many European populations of Norway rat and house mouse, to-date no data is available on the occurrence in Ireland of such resistance. No genetic evidence for the occurrence of resistance was found in 65 Norway rat samples analysed, indicative of an absence, or low prevalence, of resistance in rats in at least the Eastern region of the island of Ireland. The presence of two of the most commonly found amino acid substitutions Leu128Ser and Tyr139Cys associated with house mouse resistance to anticoagulant rodenticides was confirmed. The occurrence of two such mutations is indicative of the occurrence of resistance to anticoagulant rodenticides in house mice in the Eastern region of the island of Ireland.

User Involvement in Dementia Product Development

This article is in two parts. The first part describes the design of new assistive technology for people with dementia developed within the ENABLE project, with designs coming from both personal and professional carers as well as design engineers. The second part looks at traditional user-led design methodologies for assistive technology to see what lessons have been learnt from the ENABLE project to adapt these methodologies to make them more appropriate for people with dementia. The article concludes with a series of recommendations for designers to assist the generation of effective new devices for people with dementia.

Doses measured using AEC on direct digital radiographic (DDR) X-rays systems: updated results with an RP 162 perspective

As digital technology in diagnostic radiology systems becomes more prevalent, there is a need to provide comparative dose information for these new systems. This is needed in particular for testing the automatic exposure control (AEC) devices on direct digital radiography (DDR) systems as there is no consensus on the receptor dose level in the current guidelines. The new European Commission RP 162 document sets the suspension level for the 'verification of kerma at receptor entrance in computed radiography and DDR systems under AEC' as ≥10 µGy. This document also notes that alternate methodologies are acceptable, and may require adjustment in the suspension level if used. This study provides a range of typical doses under AEC for DDR systems, for a variety measurement methodologies, including that described in RP 162.

Pharmacokinetics and Colchicine in Pediatric and Adult Patients with Familial Mediterranean Fever

This study sought to determine the appropriate starting dose of colchicine in children aged 2 to 4 years with familial Mediterranean fever (FMF) based on steady-state pharmacokinetics in pediatric patients with FMF ⩾2 to <16 years and adult patients with FMF ⩾16 to ⩽65 years. Outpatients received colchicine for 90 days starting with a fixed dose for 14 days (blood sampling days 14 and 15). After starting doses of colchicine (0.6 mg/day [⩾2 to <4 years], 0.9 mg/day [⩾4 to <6 years], 0.9 mg/day [⩾6 to <12 years], 1.2 mg/day [⩾12 to <16 years], and 1.2 mg/day [⩾16 to ⩽65 years]), the observed steady-state pharmacokinetic parameters were comparable across age groups, despite the higher doses of colchicine on a mg/kg/day basis in the younger age groups. An exception occurred with once-daily colchicine, whereby mean Cmax for colchicine was higher in patients 4 to <6 years (9.4 ng/mL) compared with the younger and older age groups (6.1–6.7 ng/mL). Mean AUC0-24h values in children 2 to <4, 6 to <12, and 12 to <16 years were similar to those in adults. However, mean AUC0-24h values in children 4 to <6 years were 25% higher than those observed in adults. The results show that the recommended starting dose for children 2–4 years and 4–6 years should be 0.6 mg/day (half the US adult dose). Children aged 6 to <12 years should receive 0.9 mg/day (i.e. three-quarters of the US adult dose). The safety of colchicine in children 2 to <4 years was comparable to that in older children and adults.

Real time sensor for monitoring oxygen in radio-frequency plasma applications

Real time closed loop control of plasma assisted semiconductor manufacturing processes has received significant attention in recent years. Therefore we have developed and tested a customized optical sensor based on buffer gas (argon) actinometry which has been used to determine relative densities of atomic and molecular oxygen in an Ar/O(2) radio-frequency ICP chamber. The operation and accuracy of our optical sensor compared favorably with a high resolution commercial spectrometer but at lower cost and exhibited improved actinometric performance over a low resolution commercial spectrometer. Furthermore, threshold tests have been performed on the validity of buffer gas based actinometry in Ar/O(2) ICP plasmas where Ar is no longer a trace gas through Xe actinometry. The plasma conditions for which this customized optical sensor can be used for closed loop control have been established.

Meeting the support and information needs of women with advanced breast cancer: a randomised controlled trial

Addressing psychosocial and quality of life needs is central to provision of excellent care for people with advanced cancer. This study tested a brief nurse-delivered intervention to address the needs of urban women with advanced breast cancer. This study was conducted at four large urban hospitals in Australia. One hundred and five women with advanced breast cancer were recruited and randomised to receive the intervention or usual care, then asked to complete the European Organisation of Research and Treatment of Quality of life Q-C30 version (2.0) (EORTC Q-C30) (version 2) and Supportive Care Needs Survey (SCNS) at 1 month and 3 months postrecruitment. No significant differences were detected between intervention and usual care groups in the SCNS or the EORTC Q-C30 subscale scores. However, when the groups were divided into high needs (score of above 50) and low baseline needs (score of 50 or below) for each SCNS subscale, a significant difference between intervention and usual care groups was found in the psychological/emotional subscale among women with high baseline needs. In conclusions, this study demonstrated that a face-to-face session and follow-up phone call with a breast care nurse significantly reduced the psychological and emotional needs of those with high initial needs. There was no evidence of the intervention influencing the quality of life; or perceived needs of women with low initial psychological/emotional needs or perceived needs in other domains. Possibly, the intervention was not sufficiently intense to achieve an effect.

Mapping the quality of life and unmet needs of urban women with metastatic breast cancer

Enhancing quality of life and reducing the unmet needs of women are central to the successful management of advanced breast cancer. The objective of this study was to investigate the quality of life and support and information needs of urban women with advanced breast cancer. This study was conducted at four large urban hospitals in Melbourne, Australia. A consecutive sample of 105 women with advanced breast cancer completed a questionnaire that contained the European Organization of Research and Treatment of Cancer Quality of Life Q-C30 and the Supportive Care Needs Survey. Between one quarter and a third of the women reported difficulties with their physical, role and social functioning, and a little over a quarter of the women reported poor global health status. Fatigue was a problem for most women. The highest unmet needs were in the psychological and health information domains. Almost no differences in unmet needs were detected when comparing different demographic and disease characteristics of women. Health care providers should routinely monitor the quality of life and needs of women with advanced breast cancer to ensure that appropriate treatment, information or supportive services are made available.

The Installation and Support of Internationally Distributed Equipment for People With Dementia

This paper describes the evaluation and support of assistive technology designed to increase the independence of people with dementia. Devices were evaluated by people with dementia in their own homes. Working with and supporting people with dementia requires relational skills not normally needed by installers and technical supporters.

The role of human papillomavirus vaccines in cervical neoplasia

Cervical cancer is the second most common cause of cancer-related death in women, in some developing countries accounting for the highest cancer mortality. The evidence for the association of high-risk human papillomavirus types with the aetiology of cervical neoplasia is firmly established, human papillomavirus being detected in virtually all cervical cancers. The risk of progression of precursor cervical intra-epithelial neoplasia lesions is associated with persistence of human papillomavirus infection. One strategy for the management of cervical neoplasia worldwide could be the development of prophylactic and/or therapeutic human papillomavirus vaccines. This chapter will discuss the natural history of human papillomavirus infection, viral immunity and the clinical course of resultant disease as the background to the effective design and use of human papillomavirus vaccines for protection or therapy. The progress of ongoing phase I and II clinical trials for several different vaccine preparations and the challenges for establishing their future use will be discussed.

Provisional implant-supported fixed restorations

Implant-supported provisional restorations serve several valuable functions. In the anterior region, they are beneficial in determining the best restorative design, ultimately allowing for the most appropriate definitive prosthesis. They also provide a template around which soft tissue contours may be evaluated and manipulated. In areas where bone quality is compromised and implant success is suspect, whether it be anteriorly or more likely posteriorly, implant-supported provisional restorations may be used to "test" the osseointegration prior to fabricating and placing the definitive restorations.

Evaluation of recombinant human factor IX: pharmacokinetic studies in the rat and the dog

The pharmacokinetics of intravenously administered recombinant human factor IX (rhFIX) were studied in Sprague-Dawley rats and Beagle dogs. Rats received rhFIX (50 IU/kg once daily) for 28 days, and the plasma half-life was 5 h. Anti-Human Factor IX serum antibody levels were found in only 1 of 12 rats. The pharmacokinetic profiles of rhFIX or Mononine, a purified human plasma-derived factor IX, after single 100 IU/kg i.v. doses in dogs, were similar. Peak plasma concentrations of rhFIX and Mononine were 4-5 micrograms/ml. The mean plasma half-lives were 13.2 +/- 1.6 h for rhFIX and 13.3 +/- 1.6 h for Mononine. Dogs also received rhFIX (40 IU/kg i.v., daily) for 28 days or Mononine (40 IU/kg i.v. daily) for 14 days. Anti-human Factor IX serum antibody levels were determined for each compound. Pharmacokinetic half-lives decreased in these treated dogs which developed antihuman Factor IX antibodies. The antibody responses in 28 day rhFIX (40 IU/kg) dogs were similar to 14 day Mononine (40 IU/kg) dogs.

Single-dose pharmacokinetics of piperacillin and tazobactam in patients with renal disease

Tazobactam is an irreversible inhibitor of many beta-lactamases. In combination with piperacillin, tazobactam exhibits synergy against many beta-lactamase-producing bacteria. The pharmacokinetics of piperacillin and tazobactam were evaluated in eight normal volunteers and in 52 patients with renal dysfunction. Plasma and urine were obtained for up to 30 hours after an infusion of piperacillin and tazobactam (3 and 0.375 gm, respectively). Dialysate samples were collected from patients undergoing dialysis. Piperacillin and tazobactam concentrations were determined by high-performance liquid chromatography. Noncompartmental methods were used for pharmacokinetic analysis. Piperacillin and tazobactam total body clearance, area under the curve, and terminal elimination rate correlated with renal function. Hemodialysis removed 31% and 39% of piperacillin and tazobactam, respectively. During continuous ambulatory peritoneal dialysis, 5.5% of the piperacillin and 10.7% of the tazobactam was recovered in the dialysate over 28 hours. Peak plasma concentrations of both drugs increased minimally with decreasing creatinine clearance. Dosage alterations for creatinine clearance values less than 40 ml/min are recommended.

The role of phospholipid in the multiple functional forms of brain monoamine oxidase

The nature of phospholipid requirement and lipid-protein interactions for the multiple functional forms of monoamine oxidase was investigated by rebinding the purified phospholipid to a lipid-depleted brain mitochondrial preparation. It was found that phosphatidylinositol uniquely stimulated the monoamine oxidase A activity to 80% over that in the original intact mitochondria. Other negatively charged phospholipids, although not as potent, could fully or partially reactivate the A or the B activity. Phosphatidylserine was relatively more effective in restoring the B activity. Phosphatidylcholine, a zwitterionic phospholipid, reconstituted 70% of the A activity but did not influence the B. More importantly, efficiency-gradient analyses indicated a distinct nature in the mechanism of lipid-protein interactions for the negatively charged and the zwitterionic phospholipids. The potency of the negatively charged phospholipid decreased sharply with increasing lipid molecules. No further stimulation could be detected when the lipid to protein ratio reached about 30 molecules of the negatively charged phospholipid for 100,000 daltons of membrane protein. The negatively charged phospholipid appeared to bind directly to the monoamine oxidase protein boundary with a high affinity. Phosphatidylcholine might reassociate as the membrane fluid bilayer, which in turn modulated the monoamine oxidase A activity.

Vaccinia gangrenosa and 1-methylisatin 3-thiosemicarbazone (methisazone)

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