Anforderungen, Ressourcen und Arbeitsengagement Pflegender während der zweiten Welle der COVID-19-Pandemie.

Demands, resources, and work engagement of nurses during the second wave of the COVID-19 pandemic - A cross-sectional study Abstract. Background: Nurses are assigned a key role in managing the COVID-19 pandemic. Of particular importance is their work engagement, depending on job demands and resources. So far, there have only been scattered and first-wave related indications of nurses' job demands, resources and work engagement in Germany during the pandemic. Aim: To systematically assess key job demands, key job resources and work engagement of nursing staff for the second wave of the COVID-19 pandemic, also differentiating between various groups of nurses. Method: The study was realized in a cross-sectional design and included nurses in direct health care settings in Germany. Data was collected with an online questionnaire using valid and reliable measures during the second wave of the pandemic. The dataset for analyses comprised 1027 cases in total. Results: Regarding demands, work overload was even higher than before the pandemic, but work-life interferences were less pronounced. Nurses' resource architecture was not fundamentally changed by the pandemic, but interpersonal relationships and autonomy were rated more positively. Domiciliary care workers assessed demands and resources more positively than nurses in nursing homes or hospitals, whereas nurses caring for COVID-19 patients evaluated demands and resources more critically. Nurses' work engagement was higher during the second pandemic wave than in the first wave, but still low overall. Conclusions: Due to the importance of work engagement for nurses' health and performance and thus the quality of care, demands and resources must be further improved. Starting points are, e. g., fostering team cohesion, strengthening autonomy, and managing workload.

[How are key resources and key demands associated with nurses' work engagement during the COVID-19 pandemic? A cross-sectional study]. / Wie sind Schlüsselressourcen und -anforderungen mit dem Arbeitsengagement Pflegender während der COVID-19-Pandemie assoziiert? Eine Querschnittstudie.

INTRODUCTION: Nurses are assigned a key role in pandemic response, with work engagement considered to be pivotal. The job demands-resources theory assumes that work engagement depends on job resources and job demands. Key job resources and demands have already been proposed for nurses. However, there is no evidence on their importance under pandemic conditions. Hence, the aim of this study was to investigate their relevance to nurses' work engagement during the second wave of the COVID-19 pandemic. METHODS: The study was carried out in a cross-sectional design and addressed nurses in direct health care settings in Germany. Data was collected administering a quantitative online survey using valid and reliable measures during the second wave of the pandemic. A convenience sample was obtained, including the use of social media, randomly selected health care facilities, and all universities with nursing-related programs in Germany. The dataset for analyses comprised a total of 1,027 cases. The sample included nurses of various educational levels and from different sectors. Multiple linear regression analysis after multiple imputation was used to examine the relevance of key resources and demands for work engagement. RESULTS: Key resources and demands explained 36% of the variance in nurses' work engagement during the COVID-19 pandemic. Positive associations were found between the key resources of autonomy (߯SP=0.072, 95% CI [0.011; 0.133]), professional resources (߯SP=0.204, 95% CI [0.124; 0.285]), and interpersonal relationships (߯SP=0.178, 95% CI [0.117; 0.240]) and nurses' work engagement. On the demands side, lack of formal rewards negatively (߯SP=-0.312, 95% CI [-0.380; -0.245]) affected work engagement, whereas work overload (߯SP=0.063, 95% CI [0.001; 0.126]) was positively associated with work engagement. DISCUSSION: The job demands-resources theory is suitable for explaining nurses' work engagement even in times of crisis. Taken together, key resources and demands have a significant influence on nurses' work engagement under pandemic conditions. However, not all so-called key resources and demands actually have a key status in a pandemic. CONCLUSION: Any lack of formal rewards should be countered, professional resources should be sustainably secured, and the autonomy of nurses and their interpersonal relationships should be strengthened. Nursing management decisions should be made not only with the current pandemic but also the post-pandemic period in mind.

Analysis of frozen strawberries involved in a large norovirus gastroenteritis outbreak using next generation sequencing and digital PCR.

Virus-contaminated frozen berries have been frequently identified as cause of foodborne disease outbreaks. To provide new tools for virus detection and characterization in berries, next generation sequencing (NGS) and reverse transcription-digital PCR (RT-dPCR) techniques were tested here with strawberries previously involved in a large-scale norovirus (NoV) gastroenteritis outbreak in Germany. By NGS, about 29 million sequence reads were generated, which mainly showed identities to sequences from the plant matrix and from the bacterial flora. Most abundant virus sequences originated from plant-specific viruses, whereas sequences with high identity to human viruses were rare. Only two sequence reads showed homologies to human NoV. They were identical to GII.P16/GII.13 NoV sequences from patients and a strawberry sample independently analyzed during the outbreak. Quantification of the GII NoV RNA of the berries using RT-dPCR confirmed a low mean virus amount of 185 copies/25 g, which is similar to independently assessed RT-qPCR results (257 copies/25 g). The study shows that identification of human-pathogenic viruses in naturally contaminated frozen berries is possible using NGS technologies. However, the method needs to be further optimized in order to enable convenient and reproducible detection of a low amount of human-pathogenic virus sequences in a background of highly abundant nucleic acids of other sources.

Comparison and optimization of detection methods for noroviruses in frozen strawberries containing different amounts of RT-PCR inhibitors.

Frozen berries have been repeatedly identified as vehicles for norovirus (NoV) transmission causing large gastroenteritis outbreaks. However, virus detection in berries is often hampered by the presence of RT-PCR-inhibiting substances. Here, several virus extraction methods for subsequent real-time RT-PCR-based NoV-RNA detection in strawberries were compared and optimized. NoV recovery rates (RRs) between 0.21 ± 0.13% and 10.29 ± 6.03% were found when five different artificially contaminated strawberry batches were analyzed by the ISO/TS15216-2 method indicating the presence of different amounts of RT-PCR inhibitors. A comparison of five different virus extraction methods using artificially contaminated strawberries containing high amounts of RT-PCR inhibitors revealed the best NoV RRs for the ISO/TS15216 method. Further improvement of NoV RRs from 2.83 ± 2.92% to 15.28 ± 9.73% was achieved by the additional use of Sephacryl(®)-based columns for RNA purification. Testing of 22 frozen strawberry samples from a batch involved in a gastroenteritis outbreak resulted in 5 vs. 13 NoV GI-positive and in 9 vs. 20 NoV GII-positive samples using the original ISO/TS15216 method vs. the extended protocol, respectively. It can be concluded that the inclusion of an additional RNA purification step can increase NoV detection by the ISO/TS15216-2 method in frozen berries containing high amounts of RT-PCR inhibitors.

Motor Improvement and Emotional Stabilization in Patients With Tourette Syndrome After Deep Brain Stimulation of the Ventral Anterior and Ventrolateral Motor Part of the Thalamus.

BACKGROUND: Since its first application in 1999, the potential benefit of deep brain stimulation (DBS) in reducing symptoms of otherwise treatment-refractory Tourette syndrome (TS) has been documented in several publications. However, uncertainty regarding the ideal neural targets remains, and the eventuality of so far undocumented but possible negative long-term effects on personality fuels the debate about the ethical implications of DBS. METHODS: In this prospective open-label trial, eight patients (three female, five male) 19-56 years old with severe and medically intractable TS were treated with high-frequency DBS of the ventral anterior and ventrolateral motor part of the thalamus. To assess the course of TS, its clinical comorbidities, personality parameters, and self-perceived quality of life, patients underwent repeated psychiatric assessments at baseline and 6 and 12 months after DBS onset. RESULTS: Analysis indicated a strongly significant and beneficial effect of DBS on TS symptoms, trait anxiety, quality of life, and global functioning with an apparently low side-effect profile. In addition, presurgical compulsivity, anxiety, emotional dysregulation, and inhibition appeared to be significant predictors of surgery outcome. CONCLUSIONS: Trading off motor effects and desirable side effects against surgery-related risks and negative implications, stimulation of the ventral anterior and ventrolateral motor part of the thalamus seems to be a valuable option when considering DBS for TS.

Stimulate or degenerate: deep brain stimulation of the nucleus basalis Meynert in Alzheimer dementia.

OBJECTIVE: Deep brain stimulation (DBS) is a therapeutically effective neurosurgical method originally applied in movement disorders. Over time, the application of DBS has increasingly been considered as a therapeutic option for several neuropsychiatric disorders, including Gilles de la Tourette syndrome, obsessive compulsive disorder, major depression and addiction. Latest research suggests beneficial effects of DBS in Alzheimer dementia (AD). Because of the high prevalence and the considerable burden of the disease, we endeavored to discuss and reveal the challenges of DBS in AD. METHODS: Recent literature on the pathophysiology of AD, including translational data and human studies, has been studied to generate a fundamental hypothesis regarding the effects of electrical stimulation on cognition and to facilitate our ongoing pilot study regarding DBS of the nucleus basalis Meynert (NBM) in patients with AD. RESULTS: It is hypothesized that DBS in the nucleus basalis Meynert could probably improve or at least stabilize memory and cognitive functioning in patients with AD by facilitating neural oscillations and by enhancing the synthesis of nerve growth factors. CONCLUSIONS: Considering the large number of patients suffering from AD, there is a great need for novel and effective treatment methods. Our research provides insights into the theoretical background of DBS in AD. Providing that our hypothesis will be validated by our ongoing pilot study, DBS could be an opportunity in the treatment of AD.

Update on the role of antipsychotics in the treatment of Tourette syndrome.

Tourette syndrome (TS) is a neuropsychiatric disorder with typical onset in childhood and characterized by chronic occurrence of motor and vocal tics. The disorder can lead to serious impairments of both quality of life and psychosocial functioning, particularly for those individuals displaying complex tics. In such patients, drug treatment is recommended. The pathophysiology of TS is thought to involve a dysfunction of basal ganglia-related circuits and hyperactive dopaminergic innervations. Congruently, dopamine receptor antagonism of neuroleptics appears to be the most efficacious approach for pharmacological intervention. To assess the efficacy of the different neuroleptics available, a systematic, keyword-related search in PubMed (National Library of Medicine, Washington, DC) was undertaken. Much information on the use of antipsychotics in the treatment of TS is based on older data. Our objective was to give an update and therefore we focused on papers published in the last decade (between 2001 and 2011). Accordingly, the present review aims to summarize the current and evidence-based knowledge on the risk-benefit ratio of both first and second generation neuroleptics in TS.