Determinants of Post-Traumatic Stress Disorders in Italian university students during the Covid-19 outbreak: the leading role of sex, health concerns, and health engagement.

Background: The unprecedented changes in daily-life caused by Covid-19 restrictions had many psycho-logical and adverse effects, not only in sufferers but also in the general population, including university students. To date, little is known about Post-Traumatic Stress Disorder symptoms experienced by university students during the peak of Covid-19 in Italy. Thus, the study describes Post-Traumatic Stress Disorders related to the Covid-19 outbreak among Italian university students and identifies the psychological distress risk and protective factors. Study design: A multicentre observational cross-sectional study. Methods: Data collection was involved in a self-reported web questionnaire, using the on-line platform Qualtrics®, in March and April 2020, involving convenience and consecutive sampling of Italians university students in different Italy regions. Results: A sample of 720 Italian university students was enrolled. Data analysis highlighted the leading role of sex, health concerns, and health engagement as negative or positive determinants of Post-Traumatic Stress Disorders in Italian university students during the Covid-19 outbreak. In particular, it is very insightful having discovered that health engagement is a protective factor of students' mental health. Conclusions: This is the first study identifying sex, health issues and health commitment as positive or negative determinants of Post-Traumatic Stress Disorders symptoms in Italian university students during the Covid-19 epidemic. Accordingly, this new achievement could be the starting point for the development of awareness campaigns for the psychological health of Italian university students.

The state of the evidence about the Synergy Model for patient care.

AIM: To systematically and critically summarize the state of the evidence about the Synergy Model and its utilization in nursing practice. BACKGROUND: The Synergy Model emphasizes the importance of alignment between patient needs and nurse competencies in achieving adequate patient- and nurse-related outcomes. It is a relatively new patient-centred care model developed at the end of the 1990s. INTRODUCTION: Despite the Synergy Model's potential to support patient-centred care, its practical application is still mainly limited. Thus far, literature about the Synergy Model has not yet been synthesized, undermining its broader utilization globally. METHODS: A systematic search was performed on the following databases: PubMed, CINAHL and Scopus. The authors used the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement and checklist to guide the systematic search; 26 papers were included in this study. A critical interpretative synthesis was adopted to summarize the data extracted from the included papers. RESULTS: Five interpretative themes emerged: conceptualization, experiences from the field, nursing education, patient-related outcomes and system-related outcomes. Synergy Model shows a precise theoretical definition, and it was implemented in multiple clinical settings, mainly in critical care contexts. It seems to have a positive influence on patient-related, nurse-related and system-related outcomes. DISCUSSION: Synergy Model seems to be positively associated with specific susceptible outcomes, such as patient satisfaction, reduction of patient's complications, staff satisfaction, empowerment, and engagement of patients and healthcare providers. However, the level of evidence is still limited. CONCLUSION: Future international research should demonstrate the feasibility of implementing the Synergy Model at an international level. More empirical research is needed to demonstrate the effectiveness of the model on susceptible outcomes. IMPLICATIONS FOR NURSING AND HEALTH POLICY: This systematic review could support further development of international programmes based on the Synergy Model. The Synergy Model's implementation has the potential to optimize nursing competencies, patient- and nurse-related outcomes.

A systematic review and Meta-analysis on the association between Hand-Foot Syndrome (HFS) and Cancer Chemotherapy Efficacy.

Hand-foot syndrome (HFS) is a common skin toxicity of traditional chemotherapies. Some studies showed that HFS has an association with progression-free survival (PFS) and the overall survival (OS). So far, there is not available any systematic literature reviews or meta-analysis aimed to assess the associations between HFS, PFS and OS. For this reason, this study aims to quantitatively summarize, critically review, and interpret the recent literature related to the associations between HFS and efficacy of chemotherapy in terms of PFS and OS. Queries shaped by PICOM framework, a systematic search of three electronic databases (PubMed, Scopus, and Science Direct) was carried out for the period between January 2010 and December 2017. Quantitative data pooling was based on the calculation of Hazard Ratio (HR) with 95% Confidence Interval (95% CI) for the OS and PFS associated to the presence of HFS, through the data of original publications. Five papers were included in this systematic review for the quantitative data pooling. Patients with HFS showed improved PFS (HR = 0.532 [0.431-0.656]; p = 0.000) and improved OS (HR = 0.522 [0.427-0.638]; p = 0.000). HFS causes a reduction of compliance with oncology treatments. Healthcare providers should use this result as a trigger to foster patients' coping and the one of their family caregivers, enhancing their adherence to cancer treatments.

Systematic review of shift work and nurses' health.

BACKGROUND: Nursing is characterized by a working articulation in shifts to ensure continuity of care throughout the 24 h. However, shift work and the resulting desynchronization of circadian rhythms may have adverse effects on nurses' health. AIMS: To describe the effects of shift work and desynchronization of circadian rhythms on nurse's health. METHODS: Databases: PubMed, Cinahl, Scopus, Embase and Ilisi. Search terms (free terms, MeSH): 'nurses', 'shiftwork', 'nightwork', 'sleep disorder, circadian rhythm', 'work schedule tolerance', 'breast neoplasm', 'metabolic syndrome X', 'metabolic cardiovascular syndrome', 'Cardiovascular disease', 'stress', 'diabetes'. We included all randomized controlled trials, observational studies, reviews and papers studying nurses' shift work. Quality assessment of the retrieved papers was verified according to Dixon-Woods checklist. RESULTS: Twenty-four articles were analyzed. Literature review has shown that shift work involves an alteration in psychophysical homeostasis, with a decrease in performance. It is an obstacle for social and family relationships, as well as a risk factor for stress, sleep disorders, metabolic disorders, diabetes, cardiovascular disorders and breast cancer. CONCLUSIONS: An organized ergonomic turnaround can be less detrimental to the health of nurses and more beneficial for the healthcare providers. Therefore, we suggest organizing studies to assess whether improving nurses' health would lead to a reduction in miscarriages, absenteeism and work-related stress.