Exploring the gap between school of nursing theoretical foundations and clinical practice.

BACKGROUND: Theoretical and practical preparation is essential for developing competent nurses. The clinical setting is the most effective context for learning nursing skills. It gives opportunities for newly qualified nurses to practice clinical decision-making by applying theoretical knowledge. Integrating theory and clinical practice with good supervision improves newly qualified nurses' competencies to care for patients and enhance their self-confidence. OBJECTIVE: To identify the gaps between theoretical preparation in the schools of nursing and actual hospital clinical work in a public hospital in Bahrain and to suggest possible solutions to overcome these gaps. METHODS: A qualitative descriptive study design was used in a tertiary public hospital in Bahrain. Ten newly employed registered nurses were recruited using purposive sampling. Semi-structured interviews were conducted, and a thematic analysis was employed. RESULTS: Two Over-arching themes emerged from the analysis of the responses. The first identified the causes of the gaps that new nurses face in the transition (Lack of autonomy, technology employed in healthcare settings, impact of the COVID-19 pandemic, and lack of clinical exposure). The second provided possible solutions for these gaps (Open communication and collaboration, orientation phase and preceptorship, empowerment and self-confidence, and more clinical exposure). CONCLUSIONS: Good collaboration between schools of nursing and healthcare care organizations can incorporate suggested solutions given by the study participants to reduce the identified gaps.

The Effect of Oral Iron Supplementation on Gut Microbial Composition: a Secondary Analysis of a Double-Blind, Randomized Controlled Trial among Cambodian Women of Reproductive Age.

The World Health Organization recommends untargeted iron supplementation for women of reproductive age (WRA) in countries where anemia prevalence is greater than 40%, such as Cambodia. Iron supplements, however, often have poor bioavailability, so the majority remains unabsorbed in the colon. The gut houses many iron-dependent bacterial enteropathogens; thus, providing iron to individuals may be more harmful than helpful. We examined the effects of two oral iron supplements with differing bioavailability on the gut microbiomes in Cambodian WRA. This study is a secondary analysis of a double-blind, randomized controlled trial of oral iron supplementation in Cambodian WRA. For 12 weeks, participants received ferrous sulfate, ferrous bisglycinate, or placebo. Participants provided stool samples at baseline and 12 weeks. A subset of stool samples (n = 172), representing the three groups, were randomly selected for gut microbial analysis by 16S rRNA gene sequencing and targeted real-time PCR (qPCR). At baseline, 1% of women had iron-deficiency anemia. The most abundant gut phyla were Bacteroidota (45.7%) and Firmicutes (42.1%). Iron supplementation did not alter gut microbial diversity. Ferrous bisglycinate increased the relative abundance of Enterobacteriaceae, and there was a trend towards an increase in the relative abundance of Escherichia-Shigella. qPCR detected an increase in the enteropathogenic Escherichia coli (EPEC) virulence gene, bfpA, in the group that received ferrous sulfate. Thus, iron supplementation did not affect overall gut bacterial diversity in predominantly iron-replete Cambodian WRA, however, evidence does suggest an increase in relative abundance within the broad family Enterobacteriaceae associated with ferrous bisglycinate use. IMPORTANCE To the best of our knowledge, this is the first published study to characterize the effects of oral iron supplementation on the gut microbiomes of Cambodian WRA. Our study found that iron supplementation with ferrous bisglycinate increases the relative abundance of Enterobacteriaceae, which is a family of bacteria that includes many Gram-negative enteric pathogens like Salmonella, Shigella, and Escherichia coli. Using qPCR for additional analysis, we were able to detect genes associated with enteropathogenic E. coli, a type of diarrheagenic E. coli known to be present around the world, including water systems in Cambodia. The current WHO guidelines recommend blanket (untargeted) iron supplementation for Cambodian WRA despite a lack of studies in this population examining iron's effect on the gut microbiome. This study can facilitate future research that may inform evidence-based global practice and policy.

The efficacy of different sanitizers against MS2 bacteriophage introduced onto plastic or stainless steel surfaces.

The virucidal activities of 11 prepared disinfectant solutions (active ingredients of household sanitizers) and 10 household sanitizers against bacteriophage MS2 on plastic and stainless steel surfaces were studied. Among the prepared sanitizers, 70-90% ethanol and ethanol-based disinfectants resulted in 1-2.5 log PFU/mL reductions on both surfaces. The 70% isopropanol and isopropanol-based formula reduced MS2 by 0.7-1.5 log PFU/mL on both surfaces. Other disinfectants, containing 0.1% benzalkonium chloride (BAC), 0.5% hydrogen peroxide, or 4% acetic acid, showed significant (P < 0.05) lower log reductions (-0.17-0.55 log PFU/mL) compared with other treatments. At room temperature, the virucidal activities of 70% ethanol on plastic (1.46-1.64 log PFU/mL reductions) and stainless steel (0.84-0.93 log PFU/mL reductions) surfaces were not significantly (P > 0.05) affected by the treatment time (30-600 s). However, 85% ethanol-treated groups showed significant (P < 0.05) higher log reductions in 60 and 600 s treated groups (1.69-2.24 log PFU/mL) compared with those in 30 s treated groups (0.92-1.32 log PFU/mL). Their virucidal activities were further examined at low temperatures (4 and 8 °C). We observed that the surface inactivation efficacies were not affected by the low temperatures. In addition, the virucidal activities of household sanitizers revealed that sanitizers with 1.84% (pH = 12.5, ∼17,500 ppm free-chlorine concentrations) or 3% (pH = 13.1, ∼38,100 ppm free-chlorine concentrations) sodium hypochlorite (NaClO) reduced 4.15-6.23 log PFU/mL MS2 on hard surfaces after 60 s contact time. Furthermore, an approximately 1.5 log PFU/mL reduction was observed in groups treated by sanitizer H (active ingredients: 58% ethanol + 0.1% quaternary ammonium compound). Household products with BAC or organic acid resulted in -0.28-0.33 log reductions on two surfaces after 30 or 60 s treatment. Therefore, the use of ethanol and NaClO-based products should be considered as a potential surface decontamination strategy in the food industry.

Antibiotic Resistance in Shiga Toxigenic Escherichia coli Isolates from Surface Waters and Sediments in a Mixed Use Urban Agricultural Landscape.

Antibiotic resistance (AR) phenotypes and acquired resistance determinants (ARDs) detected by in silico analysis of genome sequences were examined in 55 Shiga toxin-producing Escherichia coli (STEC) isolates representing diverse serotypes recovered from surfaces waters and sediments in a mixed use urban/agricultural landscape in British Columbia, Canada. The isolates displayed decreased susceptibility to florfenicol (65.5%), chloramphenicol (7.3%), tetracycline (52.7%), ampicillin (49.1%), streptomycin (34.5%), kanamycin (20.0%), gentamycin (10.9%), amikacin (1.8%), amoxicillin/clavulanic acid (21.8%), ceftiofur (18.2%), ceftriaxone (3.6%), trimethoprim-sulfamethoxazole (12.7%), and cefoxitin (3.6%). All surface water and sediment isolates were susceptible to ciprofloxacin, nalidixic acid, ertapenem, imipenem and meropenem. Eight isolates (14.6%) were multidrug resistant. ARDs conferring resistance to phenicols (floR), trimethoprim (dfrA), sulfonamides (sul1/2), tetracyclines (tetA/B), and aminoglycosides (aadA and aph) were detected. Additionally, narrow-spectrum ß-lactamase blaTEM-1b and extended-spectrum AmpC ß-lactamase (cephalosporinase) blaCMY-2 were detected in the genomes, as were replicons from plasmid incompatibility groups IncFII, IncB/O/K/Z, IncQ1, IncX1, IncY and Col156. A comparison with surveillance data revealed that AR phenotypes and ARDs were comparable to those reported in generic E. coli from food animals. Aquatic environments in the region are potential reservoirs for the maintenance and transmission of antibiotic resistant STEC, associated ARDs and their plasmids.

Impact of Cognitive and Psychological Symptoms on Work Productivity and Quality of Life among Breast Cancer Survivors in Hong Kong.

OBJECTIVE/BACKGROUND: Employed breast cancer survivors (BCS) may experience residual symptoms that can impact their work productivity and quality of life (QoL), but it is unclear whether such associations exist among BCS in Hong Kong. Therefore, this study was designed to explore the symptom burden (cognitive limitation and psychological distress) of employed BCS in HK, and to investigate whether such factors are related to work productivity and QoL. METHODS: A cross-sectional study including employed BCS (n = 30), women with musculoskeletal conditions (n = 30), and healthy women (n = 30) was conducted. Participants completed a questionnaire covering their sociodemographics, the Hospital Anxiety and Depression Scale, Cognitive Symptom Checklist, Work Limitation Questionnaire, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. RESULTS: The self-perceived cognitive limitations at work of BCS were significantly higher than that of the healthy control group (5.33 vs. 2.60; p < .05). The cognitive limitations in BCS were significantly associated with their QoL (ß = -0.320; p = .032). A negative relationship between depression and QoL in BCS was also observed in this study. CONCLUSION: This exploratory study provides local evidence that BCS experience greater work-task related cognitive limitations and that is related to QoL. Similar to findings in other countries, this provides insight for the consideration of early identification of cognitive problems in this particular patient group. Further studies may be needed to further substantiate such findings and to examine the effectiveness of potential cognitive interventions.