Mental health effects of adult children's outmigration on older parents in Central and Eastern Europe.

OBJECTIVE: To examine the association between adult children's migration and depression among older parents in Central and Eastern Europe (CEE) and explore the role of intergenerational support in contributing to their depression. METHODS: Data are from the eighth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), pooling a study sample of 11 CEE countries, with a cross-sectional design. Analysis of covariance (ANCOVA) and hierarchical linear regression were conducted using a study sample of 9133 respondents. RESULTS: Older adults whose children migrated over 500 km were more likely to experience depression compared to those with no migrant child or all children within 500 km. Among intergenerational support, frequent parent-child contact mitigated the effects of migration on depression in older parents with all their children who migrated over 500 km. CONCLUSION: This study suggests that older parents with migrant children over 500 km away should be considered a vulnerable population at risk for mental health in CEE countries. It is crucial for local governments and policymakers to address these challenges through improving integrated mental health and social programs for better mental health outcomes among older adults in CEE countries.

Characterization of a conjugated polysuccinimide-carboplatin compound.

Carboplatin, an advanced anticancer drug with excellent efficacy against ovarian cancer, was developed to alleviate the side effects that often occur with cisplatin and other platinum-based compounds. Our study reports the in vitro characteristics, viability, and activity of cells expressing the inducible nitric oxide synthase (iNOS) gene after carboplatin was conjugated with polysuccinimide (PSI) and administered in combination with other widely used anticancer drugs. PSI, which has promising properties as a drug delivery material, could provide a platform for prolonging carboplatin release, regulating its dosage, and improving its side effects. The iNOS gene has been shown to play an important role in both cancer cell survival and inhibition. Herein, we synthesized a PSI-carboplatin conjugate to create a modified anticancer agent and confirmed its successful conjugation. To ensure its solubility in water, we further modified the structure of the PSI-carboplatin conjugate with 2-aminoethanol groups. To validate its biological characteristics, the ovarian cancer cell line SKOV-3 and normal ovarian Chinese hamster ovary cells were treated with the PSI-carboplatin conjugate alone and in combination with paclitaxel and topotecan, both of which are used in conventional chemotherapy. Notably, PSI-carboplatin conjugation can be used to predict changes in the genes involved in cancer growth and inhibition. In conclusion, combination treatment with the newly synthesized polymer-carboplatin conjugate and paclitaxel displayed anticancer activity against ovarian cancer cells but was not toxic to normal ovarian cancer cells, resulting in the development of an effective candidate anticancer drug without severe side effects.

Translation and validation of the Hungarian Version of the infection control standardized questionnaire: a cross-sectional study.

BACKGROUND: To our knowledge, there is currently no psychometrically validated Hungarian scale to evaluate nurses' knowledge about infection prevention and control (IPC) practices. Thus, we aim in this study to assess the validity and reliability of the infection control standardized questionnaire Hungarian version (ICSQ-H). METHODS: A cross-sectional, multisite study was conducted among 591 nurses in Hungary. The original ICSQ included 25 questions. First, the questionnaire was translated into Hungarian. Then, content validity was assessed by a committee of four specialists. This was done by calculating the item content validity index and scale content validity index. Afterward, structural validity was evaluated in a two-step process using principal component analysis and confirmatory factor analysis. The goodness of fit for the model was measured through fit indices. Convergent validity was assessed by calculating the average variance extracted. Additionally, discriminant validity was evaluated by computing the Spearman correlation coefficient between the factors. Finally, the interitem correlations, the corrected item-total correlations, and the internal consistency were calculated. RESULTS: The content validity of the questionnaire was established with 23 items. The final four-factor ICSQ-H including 10 items showed a good fit model. Convergent validity was met except for the alcohol-based hand rub (ABHR) factor, while discriminant validity was met for all factors. The interitem correlations and the corrected item-total correlations were met for all factors, but the internal consistency of ABHR was unsatisfactory due to the low number of items. CONCLUSIONS: The results did not support the original three-factor structure of the ICSQ. However, the four-factor ICSQ-H demonstrated an adequate degree of good fit and was found to be reliable. Based on our findings, we believe that the ICSQ-H could pave the way for more research regarding nurses' IPC knowledge to be conducted in Hungary. Nevertheless, its validation among other healthcare workers is important to tailor effective interventions to enhance knowledge and awareness.

Predicting cervical screening and HPV vaccination attendance of Roma women in Hungary: community nurse contribution is key.

BACKGROUND: HPV screening/vaccination has been observed lower for ethic minorities. Understanding factors that predict and can improve attendance is therefore key. Hence, the aim was to identify causes, especially concerning the quality of the patient-provider relationship, that predict past HPV screening and vaccination turnout of Roma women in Hungary. METHODS: Cross-sectional research design with self-developed, culturally sensitive questionnaire. A final, female Roma sample of 368 participants was randomly selected from census register. Community nurses contacted participants and distributed surveys. Surveys were mailed-in by participants. Bivariate logistic regression was used to predict former participation in HPV screening/vaccination. RESULTS: Of the total sample, 17.4% of women attended at least one cervical screening and HPV vaccination in the past. Bad screening experience was positively associated with racially unfair behaviors of physicians. The odds of past attendance were 4.5 times greater if 'no negative earlier experience' occurred, 3.3 times likelier if community nurse performed screening/immunization and 1.6 times more probable if respondent felt 'no shame'. Evaluating the screening/vaccination process painful, being only financially motivated and attendance involving a lot of travel decreased the odds of 'no show' by 50%, 40% and 41%, respectively. CONCLUSIONS: When considering the ratio of past cervical screening attendance, we conclude that our female Roma sample did not behave differently from the general population. We saw no evidence that racial mistreatment made any contribution to explaining cervical screening participation. Past positive screening experience and the quality of patient-provider relationship increased the odds of participation the most. Cancer of friends, pain, financial motivation and travel distance decreased odds of participation to a lesser extent. In order to improve future screening and immunization, community nurses should play more central and advanced role in the organization and implementation of such services specifically targeting Roma populations.

Sports activities of 60 above Hungarian elderly-explaining and predicting impact of exercise on health.

BACKGROUND: The proportion of elderly is on the rise both in Europe and in Hungary. The challenge is to increase the number of years spent in good health as well as to improve quality of life of those 60 years and above. This study focuses on the impact of physical activity on this age group. METHODS: A nationally representative sample of 2000 respondents were surveyed in an age range of 15-74. Our data concerns those being 60-74 years of age. The focus of our investigation was level and impact of physical activity in the group above. First, we used Chi-squared tests and correspondence analysis to identify the deviation in the answers of different groups in our sample. After we built a hierarchical linear regression model to get a deeper understanding of the impact of physical activity for elderly. RESULTS: Those reporting no physical/sports activity at all have to do with the negative culture of exercising. Only 9.3% reported being engaged with any sports; 72% reported no regular exercising throughout their lives. The relationship between sport activity and self-reported health was significant (p = 0.009, Cramer's V = 0.2). Elderly were characterized by walking, hiking and less intense sports. CONCLUSIONS: Those who actively exercised in this research reported better health outcomes than those who stopped or had never been engaged in any sports. We conclude that of all variables tested, physical activity was most effective to improve personal health of the elderly in this sample. Compared to European data on physical activity of elderly populations, Hungary seems to fall behind and needs to consider concentrated efforts to improve the future health of its senior populace.

Discriminating low-, medium- and high-burnout nurses: Role of organisational and patient-related factors.

AIM: To discriminate low/medium/high burnout in nurses by work and patient-related indicators and explore what factors characterize these categories best. METHODS: Cross-sectional, online survey with a representative sample of nurses. Measures assessed burnout, intragroup conflict, job insecurity, overt aggression and impact of patient aggression on nurses. RESULTS: Top nurse managers experienced more burnout than middle managers or staff, middle managers also reported greater burnout than staff. Those who had never suffered aggression experienced greater burnout but less intragroup conflict and job insecurity. Staff differed on job insecurity from top and midlevel managers. The first discriminant function differentiated high burnout from medium and low; this function was characterized by exhaustion, aggression and intragroup conflict. The second function differentiated medium burnout from others; job insecurity, years worked, over aggression and overtime dominated this function. CONCLUSIONS: Burnout affects managers and staff differently; top managers may be more susceptible to burnout than reported before. Low, medium and high burnout groups require tailored interventions because of their different characteristics. IMPLICATIONS FOR NURSING MANAGEMENT: In the future, burnout assessment should focus on both organisational and care related factors. Determining levels of burnout will guide managers to improve the right aspects of practice and work environment.

Poly(amino acid)-Based Gel Fibers with pH Responsivity by Coaxial Reactive Electrospinning.

Electrospinning is a well-known technique for the preparation of scaffolds for biomedical applications. In this work, a continuous electrospinning method for gel fiber preparation is presented without a spinning window. As proof of concept, the preparation of poly(aspartic acid)-based hydrogel fibers and their properties are described by using poly(succinimide) as shell polymer and 2,2,4(2,4,4)-trimethyl-1,6-hexanediamine as cross-linker in the core of the nozzle. Cross-linking takes place as the two solutions get in contact at the tip of the nozzle. The impact of solution concentrations and feeding rates on fiber morphology, proof of the presence of cross-links as well as pH sensitivity after the transformation of the poly(succinimide)-based material to poly(aspartic acid) is presented.

Dual-Physical Cross-Linked Tough and Photoluminescent Hydrogels with Good Biocompatibility and Antibacterial Activity.

Development of novel photoluminescent hydrogels with toughness, biocompatibility, and antibiosis is important for the applications in biomedical field. Herein, novel tough photoluminescent lanthanide (Ln)-alginate/poly(vinyl alcohol) (PVA) hydrogels with the properties of biocompatibility and antibiosis have been facilely synthesized by introducing hydrogen bonds and coordination bonds into the interpenetrating networks of Na-alginate and PVA, via approaches of frozen-thawing and ion-exchanging. The resultant hydrogels exhibit high mechanical strength (0.6 MPa tensile strength, 5.0 tensile strain, 6.0 MPa compressive strength, and 900 kJ m-3 energy dissipation under 400% stretch), good photoluminescence as well as biocompatibility and antibacterial activity. The design strategy provides a new avenue for the fabrication of multifunctional photoluminescent hydrogels based on biocompatible polymers.

Fe3 O4 Anisotropic Nanostructures in Hydrogels: Efficient Catalysts for the Rapid Removal of Organic Dyes from Wastewater.

Fe3 O4 anisotropic nanostructures that exhibit excellent catalytic performance are rarely used to catalyze Fenton-like reactions because of the inevitable drawbacks resulting from traditional preparation methods. In this study, a facile, nontoxic, water-based approach is developed for directly regulating a series of anisotropic morphologies of Fe3 O4 nanostructures in a hydrogel matrix. In having the advantages of both the catalytic activity of Fe3 O4 and the adsorptive capacity of an anionic polymer network, the hybrid nanocomposites have the capability to effect the rapid removal of cationic dyes, such as methylene blue, from water samples. Perhaps more interestingly, hybrid nanocomposites loaded with Fe3 O4 nanorods exhibit the highest catalytic activity compared to those composed of nanoneedles and nanooctahedra, revealing the important role of nanostructure morphology. By means of scanning electrochemical microscopy, it is revealed that Fe3 O4 nanorods can efficiently catalyze H2 O2 decomposition and thus generate more free radicals ((.) OH, (.) HO2 ) for methylene blue degradation, which might account for their high catalytic activity.

A novel method to determine the elastic modulus of extremely soft materials.

Determination of the elastic moduli of extremely soft materials that may deform under their own weight is a rather difficult experimental task. A new method has been elaborated by means of which the elastic modulus of such materials can be determined. This method is generally applicable to all soft materials with purely neo-Hookean elastic deformation behaviour with elastic moduli lower than 1 kPa. Our novel method utilises the self-deformation of pendent gel cylinders under gravity. When suspended, the material at the very top bears the weight of the entire gel cylinder, but that at the bottom carries no load at all. Due to the non-uniform stress distribution along the gel sample both the stress and the resulting strain show position dependence. The cross-sectional area of the material is lowest at the top of the sample and gradually increases towards its bottom. The equilibrium geometry of the pendant gel is used to evaluate the elastic modulus. Experimental data obtained by the proposed new method were compared to the results obtained from underwater measurements. The parameters affecting the measurement uncertainty were studied by a Pareto analysis of a series of adaptive Monte Carlo simulations. It has been shown that our method provides an easily achievable method to provide an accurate determination of the elastic modulus of extremely soft matter typically applicable for moduli below 1 kPa.

Exceptionally tough and notch-insensitive magnetic hydrogels.

Most existing magnetic hydrogels are weak and brittle. The development of strong and tough magnetic hydrogels would extend their applications into uncultivated areas, such as in actuators for soft machines and guided catheters for magnetic navigation systems, which is still a big challenge. Here a facile and versatile approach to fabricating highly stretchable, exceptionally tough and notch-insensitive magnetic hydrogels, Fe(3)O(4)@Fe-alginate/polyacrylamide (PAAm), is developed, by dispersing alginate-coated Fe(3)O(4) nanoparticles into the interpenetrating polymer networks of alginate and PAAm, with hybrid physical and chemical crosslinks. A cantilever bending beam actuator as well as a proof-of-concept magnetically guided hydrogel catheter is demonstrated. The method proposed in this work can be integrated into other strong and tough magnetic hydrogels for the development of novel hydrogel nanocomposites with both desirable functionality and superior mechanical properties.

Self-healing gels based on constitutional dynamic chemistry and their potential applications.

As representative soft materials with widespread applications, gels with various functions have been developed. However, traditional gels are vulnerable to stress-induced formation of cracks. The propagation of these cracks may affect the integrity of network structures of gels, resulting in the loss of functionality and limiting the service life of the gels. To address this challenge, self-healing gels that can restore their functionalities and structures after damage have been developed as "smart" soft materials. In this paper, we present an overview of the current strategies for synthesizing self-healing gels based on the concept of constitutional dynamic chemistry, which involves molecular structures capable of establishing dynamic networks based upon physical interactions or chemical reactions. The characterization methods of self-healing gels and the key factors that affect self-healing properties are analyzed. We also illustrate the emerging applications of self-healing gels, with emphasis on their usage in industry (coatings, sealants) and biomedicine (tissue adhesives, agents for drug or cell delivery). We conclude with a perspective on challenges facing the field, along with prospects for future development.

Dextran-based self-healing hydrogels formed by reversible diels-alder reaction under physiological conditions.

A dextran-based self-healing hydrogel is prepared by reversible Diels-Alder reaction under physiological conditions. Cytocompatible fulvene-modified dextran as main polymer chains and dichloromaleic-acid-modified poly(ethylene glycol) as cross-linkers are used. Both macro- and microscopic observation as well as the rheological recovery test confirm the self-healing property of the dextran-l-poly(ethylene glycol) hydrogels ("l" means "linked-by"). In addition, scanning electrochemical microscopy is used to qualitatively and quantitatively in situ track the self-healing process of the hydrogel for the first time. It is found that the longitudinal depth of scratch on hydrogel surface almost completely healed at 37 °C after 7 h. This work represents a facile approach for fabrication of polysaccharide self-healing hydrogel, which can be potentially used in several biomedical fields.

Nurse preferences of caring robots: A conjoint experiment to explore most valued robot features.

AIM: Due to the COVID pandemic and technological innovation, robots gain increasing role in nursing services. While studies investigated negative attitudes of nurses towards robots, we lack an understanding of nurses' preferences about robot characteristics. Our aim was to explore how key robot features compare when weighed together. METHODS: Cross-sectional research design based on a conjoint analysis approach. Robot dimensions tested were: (1) communication; (2) look; (3) safety; (4) self-learning ability; and (5) interactive behaviour. Participants were asked to rank robot profile cards from most to least preferred. RESULTS: In order of importance, robot's ability to learn ranked first followed by behaviour, look, operating safety and communication. Most preferred robot combination was 'robot responds to commands only, looks like a machine, never misses target, runs programme only and behaves friendly'. CONCLUSIONS: Robot self-learning capacity was least favoured by nurses showing potential fear of robots taking over core nurse competencies.

Characterization of Electrospun Polysuccinimide-Dopamine Conjugates and Effect on Cell Viability and Uptake.

Biocompatible nanofibrous systems made by electrospinning have been studied widely for pharmaceutical applications since they have a high specific surface and the capability to make the entrapped drug molecule amorphous, which increases bioavailability. By covalently conjugating drugs onto polymers, the degradation of the drug as well as the fast clearance from the circulation can be avoided. Although covalent polymer-drug conjugates have a lot of advantages, there is a lack of research focusing on their nano-formulation by electrospinning. In this study, polysuccinimide (PSI) based electrospun fibrous meshes conjugated with dopamine (DA) are prepared. Fiber diameter, mechanical properties, dissolution kinetics and membrane permeability are thoroughly investigated, as these are crucial for drug delivery and implantation. Dopamine release kinetics prove the prolonged release that influenced the viability and morphology of periodontal ligament stem cells (PDLSCs) and SH-SY5Y cells. The presence of dopamine receptors on both cell types is also demonstrated and the uptake of the conjugates is measured. According to flow cytometry analysis, the conjugates are internalized by both cell types, which is influenced by the chemical structure and physical properties. In conclusion, electrospinning of PSI-DA conjugates alters release kinetics, meanwhile, conjugated dopamine can play a key role in cellular uptake.

The relationship between paediatric nurses' quality of life and intent to leave: The moderating role of hospital type.

BACKGROUND: Different types of hospitals exist in Jordan, and each type has its own leadership style. This might affect the nursing workforce in terms of quality of life and intent to leave. AIM: This study aimed at (1) assessing the relationship between paediatric nurses' quality of life and intent to leave, (2) examining the moderating effect of the hospital type on this relationship, (3) comparing the quality of life of paediatric nurses working at ministry of health and the University-Affiliated hospitals and (4) exploring the determinants of nurses' intent to leave. DESIGN: A cross-sectional, comparative and correlational design was used in this study. METHODS: A multi-site sample was selected from two types of hospitals in Jordan; the ministry of health and the University-Affiliated hospitals. A sample of 225 paediatric nurses responded to the brief quality of life questionnaire by the World Health Organization in addition to a group of sociodemographic and work-related questions. RESULTS AND CONCLUSION: Nurses' quality of life and intent to leave were negatively correlated. This correlation was moderated by the type of hospital. Nurses' quality of life was significantly different in the two types of hospitals. Both salary and nursing care model predicted paediatric nurses' intent to leave. The managerial style and work environment of the ministry of health hospitals should be benchmarked against the University-Affiliated hospitals.

Discriminating Low to High Adherent Type 2 Patients with Diabetes by Glycosylated Hemoglobin A1c, Eating Self-Efficacy and Other Psychosocial Determinants: Difference Between Patient and Physician Adherence Models.

Objective: Develop individual discriminant models using clinical and psychosocial variables for physicians and patients with diabetes based on their perceptions of patient adherence. Methods: This was a cross-sectional research design utilizing a discriminant analysis approach. Type 2 patients on treatment for diabetes for at least 2 years prior to research were selected. Clinical data were obtained from patient records, and psychosocial variables were collected by survey instruments filled out by patients. A final sample of 200 patients was recruited. Results: We found a positive correlation between patient and physician assessment of patient adherence behaviors. Greater adherence efforts were associated with lower HbA1c. Better quality of the patient-physician relationship was linked to better patient adherence. Increased HbA1c, longer therapy duration and higher BMI described low patient adherence for physicians. Lower HbA1c, female gender and fewer difficulties in marital adjustment characterized high adherence for patients. Dietary self-efficacy as well as emotional and social isolation discriminated mid-level adherers in both models. Conclusion: This research confirmed that patients and physicians perceived and judged patients' adherence behaviors differently. Physicians and patients associated different clinical and psychological factors with low and high adherence. Further research is recommended to clarify how the quality of the physician-patient as well as the patient-spouse relationship affect dietary efficacy and patient adherence. A randomized, controlled clinical trial approach is recommended to establish the effectiveness of interventions aiming to improve dietary self-efficacy on adherence outcomes.

Analysis of Three-Dimensional Cell Migration in Dopamine-Modified Poly(aspartic acid)-Based Hydrogels.

Several types of promising cell-based therapies for tissue regeneration have been developing worldwide. However, for successful therapeutical application of cells in this field, appropriate scaffolds are also required. Recently, the research for suitable scaffolds has been focusing on polymer hydrogels due to their similarity to the extracellular matrix. The main limitation regarding amino acid-based hydrogels is their difficult and expensive preparation, which can be avoided by using poly(aspartamide) (PASP)-based hydrogels. PASP-based materials can be chemically modified with various bioactive molecules for the final application purpose. In this study, dopamine containing PASP-based scaffolds is investigated, since dopamine influences several cell biological processes, such as adhesion, migration, proliferation, and differentiation, according to the literature. Periodontal ligament cells (PDLCs) of neuroectodermal origin and SH-SY5Y neuroblastoma cell line were used for the in vitro experiments. The chemical structure of the polymers and hydrogels was proved by 1H-NMR and FTIR spectroscopy. Scanning electron microscopical (SEM) images confirmed the suitable pore size range of the hydrogels for cell migration. Cell viability assay was carried out according to a standardized protocol using the WST-1 reagent. To visualize three-dimensional cell distribution in the hydrogel matrix, two-photon microscopy was used. According to our results, dopamine containing PASP gels can facilitate vertical cell penetration from the top of the hydrogel in the depth of around 4 cell layers (~150 µm). To quantify these observations, a detailed image analysis process was developed and firstly introduced in this paper.

Factors influencing adolescent blood pressure: the Debrecen Hypertension Study.

AIM: To obtain epidemiological data on the blood pressure (BP) status of high school students and factors influencing BP. METHODS: Subjects filled out a questionnaire and three repeated BP measurements were taken. All high school attending students in Debrecen (final sample n = 10,194, mean age 16.6 ± 1.0 years) participated in the study. RESULTS: Boys had significantly higher systolic BP (+11.3 mm Hg) and diastolic BP (+2.2 mm Hg) than girls (p < 0.001). There was a positive correlation between weight and BP (r(syst) = 0.42, r(diast) = 0.29), height and BP (r(syst) = 0.33, r(diast) = 0.15), body mass index (BMI) and BP (r(syst) = 0.31, r(diast) = 0.27). Multiple regression was used for statistical analysis. Gender (ß = 0.36), BMI (ß = 0.25), hypertension of parents (father ß = 0.04 and mother ß = 0.02), smoking, alcohol consumption and age determined systolic outcomes in descending order. For the diastolic model, BMI remained a strong determining factor (ß = 0.25) and gender was also significant (ß = -0.09). Entering independents together accounted for 28.2% of the total variance in systolic and for 18.1% in diastolic BP. CONCLUSION: Body weight is central to determining BP. Because that is an alterable cardiovascular risk factor, we presume that lifestyle modification will not only result in reduced weight, but also in decreased BP.