Differential Gene Expression in the Upper Respiratory Tract following Acute COVID-19 Infection in Ambulatory Patients That Develop Long COVID.

Background: Post-acute sequelae of COVID-19, or long COVID, is a condition characterized by persistent COVID-19 symptoms. As long COVID is defined by clinical criteria after an elapsed period, an opportunity for early intervention may aid in future prophylactic approaches; however, at present, the pathobiological mechanisms are multifactorial. By analyzing early virally infected upper respiratory tract tissue prior to eventual clinical diagnosis, it may be possible to identify biomarkers of altered immune response to facilitate future studies and interventions. Methods: This is a sub-group analysis of samples collected from those with confirmed COVID-19. RNA extraction from nasopharyngeal/mid-turbinate samples, sequencing, and bioinformatic analysis were performed to analyze long COVID and non-long COVID cohorts at day 14 post infection. Differences in mean viral load at various timepoints were analyzed as well as serological data. Results: We identified 26 upregulated genes in patients experiencing long COVID. Dysregulated pathways including complement and fibrinolysis pathways and IL-7 upregulation. Additionally, genes involved in neurotransmission were dysregulated, and the long COVID group had a significantly higher viral load and slower viral clearance. Conclusions: Uncovering early gene pathway abnormalities associated with eventual long COVID diagnosis may aid in early identification. We show that, post acute infection, in situ pathogenic deviations in viral response are associated with patients destined to meet consensus long COVID diagnosis that is entirely dependent on clinical factors. These results identify an important biological temporal window in the natural history of COVID-19 infection and long COVID pathogenesis amenable to testing from standard-of-care upper respiratory tract specimens.

Hand hygiene compliance before and after wearing gloves among intensive care unit nurses in Iran.

Nosocomial infections are considered a major risk factor in hospital wards, and hand hygiene is the first step in their control. An observational study was conducted in 2015 with 200 nurses working in intensive care units in teaching hospitals of Tabriz, Iran. Data were collected by using the Hand Hygiene Observation Tool questionnaire. The researchers monitored nurses' opportunities for hand hygiene during the 8-week period from February 3-April 4, 2015. A total of 1,067 opportunities occurred for hand hygiene before and after wearing gloves. The results show that hand hygiene compliance before wearing gloves is poor among nurses who work in intensive care units (14.8%). Therefore it is necessary to conduct effective interventions through continuing education programs to improve hand hygiene compliance.

Are nurses empowered to make decisions about levels of patient observation in mental health?

BACKGROUND: The Clinical Resource and Audit Group (2002) guidelines emphasise that local policies should make the procedure for deciding and maintaining patient observation levels clear. AIM: To investigate the views of nurses, doctors and other members of the multidisciplinary team on patient observation. METHOD: A postal survey of all acute adultinpatient facilities and intensive patient care units in Scotland was carried out, followed by 38 interviews, 37 with staff members and one with a service user. RESULTS: We found a lack of multidisciplinary team involvement, limited pre agreed plans for nurses to reduce levels of observation and limited use of validated risk assessment tools. CONCLUSION: There is a need to ensure that local practice follows national policy recommendations more closely.

An examination of the scope and purpose of education in mental health nursing.

This study examined the education of mental health nurses by surveying all qualified mental health nurses working within one National Health Service region in Scotland. Using an adaptation of a previously used instrument, 488 questionnaires were distributed producing a response rate of 194 (39.75%). The study's themes - initial preparation, professional development and future practice - reveal findings of interest, particularly the axis of RMN (pre-1992 education) and RMN (Project 2000 education). In terms of initial preparation, clear differences between groups were found. Pre-1992 RMNs' report on educational experience majoring on practical skills contrasts sharply with Project 2000 respondents who, in spite of a course philosophy of reflective practice, emphasised an apparent lack of practical skills for practice. For professional development, both groups valued flexible approaches via journal reading, teaching, networking and participating in clinical supervision. In terms of educational provision, short course provision with an emphasis on short, flexible course provision (e.g., in-service study days), practice education and closer (and flexible) links between higher education and the practice area were highlighted as the most important ways to prepare for future practice.