Effect, feasibility, and acceptability of a Comprehensive Active Resilience Education (CARE) program in emergency nurses exposed to workplace violence: A quasi-experimental, mixed-methods study.

BACKGROUND: Workplace violence (WPV) against emergency nurses has been common but unavoidable. Promoting resilience may mitigate the subsequent health harms of workplace violence. Current interventions mainly focused on internal factors related to resilience, though the external factors can influence personal growth. AIM: To test the effect, feasibility, and acceptability of a Comprehensive Active Resilience Education (CARE) program on promoting resilience in emergency nurses exposed to workplace violence. DESIGN: This is a two-armed quasi-experimental using mixed methods, following the TREND checklist. METHODS: This study was conducted from March 2023 to July 2023 in a tertiary hospital in Shanghai, China. Emergency nurses exposed to workplace violence were recruited using cluster sampling and allocated to the intervention and control groups. The intervention group received the CARE program. The control group received no intervention. RESULTS: 71participants were recruited and no participants withdrew during the intervention. The resilience and anxiety scores displayed a significant effect in the group*time interaction effect. After four months, the intervention group demonstrated a significant improvement in resilience and anxiety scores. The intervention group showed greater improvement in coping, perceived organizational support, and depression scores compared to the control group. Two themes of joyful engagement experience and effective intervention were identified from qualitative interviews with the intervention group. CONCLUSION: The Comprehensive Active Resilience Education (CARE) program was effective, feasible, and acceptable in increasing resilience in emergency nurses exposed to workplace violence. The CARE program we developed can be replicated and integrated into systematic education programs for all nurses to help them maintain their mental health and good job performance while dealing with workplace violence.

A latent profile analysis of resilience and the associations with flourishing in emergency nurses exposed to workplace violence in China.

Workplace violence (WPV) exposure has been particularly prevalent in emergency nurses, coupled with negative mental health outcomes. Few explored resilience after WPV exposure using the perspective of positive mental health. We aimed to identify latent profiles of resilience and examine associations with flourishing in emergency nurses with WPV exposure. A total of 1241 Chinese emergency nurses were surveyed on the frequency of WPV exposure, resilience, and flourishing. Eight hundred and twenty five participants (90.1% female, 86.6% aged 20-39) reported WPV exposure at least once in the past 3 months. Latent profile analysis identified profiles of resilience as low resilience (15.0%), moderate decision respond and interpersonal link with low rational thought and flexible adaption (18.0%), moderate resilience (31.0%), high decision respond, interpersonal link, and rational thought with moderate flexible adaption (16.0%), and high resilience (20.0%). Higher flourishing was observed in profiles of moderate resilience, high decision respond, interpersonal link, and rational thought with moderate flexible adaption, and high resilience. We differentiated profiles of resilience and the associations with flourishing in emergency nurses with WPV exposure, which informed targeted interventions for promoting positive mental health.

Perceived organizational support, self-efficacy and cognitive reappraisal on resilience in emergency nurses who sustained workplace violence: A mediation analysis.

AIMS: The aims of this study were as follows: (a) to examine the relationship between perceived organizational support and resilience; (b) to investigate the potential mediating role of general self-efficacy and cognitive reappraisal among emergency nurses who have experienced workplace violence; and (c) to explore the application of Kumpfer's resilience framework to emergency department nurses. DESIGN: A cross-sectional study. METHODS: From February 17, 2021, to March 8, 2021, 825 emergency nurses working in the emergency departments of tertiary hospitals in Shanghai, China, completed an online survey. Data on resilience, organizational support, cognitive reappraisal and general self-efficacy were collected through questionnaires. The Spearman analysis was employed to investigate the relationship between variables, while the mediation analysis was conducted using AMOS 23.0 statistical software. RESULTS: The findings of a study involving 825 emergency nurses who reported experiencing workplace violence reveal a positive correlation between perceived organizational support and resilience. Additionally, it has been observed that the relationship between these two factors is mediated by both cognitive reappraisal and general self-efficacy. Furthermore, the mediating effect of cognitive reappraisal is more significant in this relationship. CONCLUSION: Kumpfer's resilience framework is found to apply to emergency nurses. Perceived organizational support, an environmental factor, affects resilience directly and positively. In addition, cognitive reappraisal and general self-efficacy, which are individual factors, mediate this influence path. These findings suggest an interaction between environmental and individual factors in determining the resilience of emergency nurses. IMPACT: These findings have implications for developing resilience intervention strategies for emergency nurses exposed to occupational violence. Enhancing personal attributes such as general self-efficacy and cognitive reappraisal is as significant as strengthening external organizational support environments for enhancing nurses' resilience. PATIENT OR PUBLIC CONTRIBUTION: Emergency nurses participated in the pilot test of our questionnaire survey and gave their opinions on the questionnaire design. SUMMARY STATEMENT: What is already known about the topic? In emergency rooms, workplace violence is prevalent, and it seriously endangers nurses' physical and mental health. Enhancing resilience can improve nurses' ability to self-regulate after experiencing violence. However, the drivers and mechanisms of resilience among emergency nurses who have experienced workplace violence remain unidentified. What this paper adds? This study confirms the applicability of Kumpfer's resilience framework to emergency nurses who have experienced workplace violence. Nurses' self-efficacy and cognitive reappraisal mediate the relationship between perceived organizational support and resilience after exposure to workplace violence. The resilience process for emergency nurses involves the interaction of individual and environmental factors. Implications for practice/policy. Managers and researchers should consider the interaction between individual and environmental factors when developing resilience intervention strategies for emergency nurses who have suffered workplace violence. It is essential to support emergency nurses from the dyadic dimensions of the environment and the individual. A supportive organizational environment and individual positive adjustment strategies are equally important in promoting resilience among nurses.

Development and validation of the Nurse Team Resilience Scale (NTRS) in the context of public health emergencies.

BACKGROUND: Team resilience can help nurse to respond positively to adversity at work and maintain normal team function in complex and unstable environments. However, much less research attention has been paid to team resilience than to individual resilience, and nurses lack reliable and valid tools to measure team resilience. This study aimed to develop and evaluate the psychometric properties of a scale that measures the nursing team resilience in the context of a public health emergency. METHODS: The study was conducted in three stages that item development, scale development, and scale evaluation. This scale was based on that of Morgan and Sharma et al. proposed four-factor team resilience model, and the draft scale was generated based on the literature review, existing scales, experts' validations, and cognitive interviews. During July 2022 to August 2022, the construct validity and the internal consistency reliability of the NTRS were evaluated through an online survey of 421 nurses. RESULTS: The 8-item NTRS scale has good reliability and validity and is suitable for measuring the nurse team resilience. The EFA found a common factor solution and explained 72.33% of the common varianc and the CFA score showed construct validity. Reliability of the internal consistency of the scale with a good Cronbach alpha of 0.94. CONCLUSION: This scale can assess team resilience in nurses that nursing education and management resources can be allocated to improve policies and training programs to provide effective positive support to nurses in challenging workplace situations and to enable greater health systems resilience in the future.

Downregulation of α-Synuclein Protein Levels by an Intracellular Single-Chain Antibody.

BACKGROUND: Accumulation of α-synuclein (αSyn) in the dopaminergic neurons is a common pathology seen in patients with Parkinson's disease (PD). Overproduction of αSyn potentiates the formation of oligomeric αSyn aggregates and enhances dopaminergic neuron degeneration. Downregulating intracellular monomeric αSyn prevents the formation of αSyn oligomers and is a potential therapeutic strategy to attenuate the progression of PD. OBJECTIVE: The purpose of this study is to investigate the efficacy of gene delivery of αSyn-specific single-chain antibodies in vitro and in vivo. METHODS AND RESULTS: The plasmids for αSyn and selective antibodies (NAC32, D10, and VH14) were constructed and were transfected to HEK293 and SH-SY5Y cells. Co-expression of αSyn with NAC32, but not D10 or VH14, profoundly downregulated αSyn protein, but not αSyn mRNA levels in these cells. The interaction of αSyn and NAC32 antibody was next examined in vivo. Adeno-associated virus (AAV)-αSyn combined with AAV-NAC32 or AAV-sc6H4 (a negative control virus) were stereotactically injected into the substantia nigra of adult rats. AAV-NAC32 significantly reduced AAV-encoded αSyn levels in the substantia nigra and striatum and increased tyrosine hydroxylase immunoreactivity in the striatum. Also, in the animals injected with AAV-NAC32 alone, endogenous αSyn protein levels were significantly downregulated in the substantia nigra. CONCLUSION: Our data suggest that AAV-mediated gene transfer of NAC32 is a feasible approach for reducing the expression of target αSyn protein in brain.

Organic anion-transporting polypeptide 1B3 as a dual reporter gene for fluorescence and magnetic resonance imaging.

Reporter proteins have broad applications in visualizing molecular events at the cellular, tissue and whole-body levels. Transmembrane transporters recognizing specific molecular domains are of particular interest because they enable the migration of signal-source molecules from the extracellular space to the cytoplasm for subsequent application in multimodality imaging. Organic anion-transporting polypeptides (OATPs) have demonstrated their MRI reporter efficacy. We further expanded their use as a dual-modality reporter in MRI and noninvasive in vivo imaging system (IVIS). We overexpressed OATP1B3 in the HT-1080 sarcoma cell line. Both Gd-EOB-DTPA, an MRI contrast agent, and indocyanine green (ICG), a near-infrared fluorescent dye that provides better deep-tissue detection because of its long wavelength, could be delivered to the intracellular space and imaged in a tumor-bearing nude mouse model. Our in vivo dual-imaging reporter system achieved high sensitivity in MRI and observation periods lasting as long as 96 h in IVIS. Because of the superior temporal and spatial resolutions and the clinical availability of both ICG and Gd-EOB-DTPA, this dual-imaging OATP1B3 system will find biomedical use in tumor biology, stem cell trafficking, and tissue engineering.-Wu, M.-R., Liu, H.-M., Lu, C.-W., Shen, W.-H., Lin, I.-J., Liao, L.-W., Huang, Y.-Y., Shieh, M.-J., Hsiao, J.-K. Organic anion-transporting polypeptide 1B3 as a dual reporter gene for fluorescence and magnetic resonance imaging.

A Point Temperature Sensor Based on Upconversion Emission in Er3+/Yb3+ Codoped Tellurite-Zinc-Niobium Glass.

Er3+/Yb3+ codoped tellurite-zinc-niobium (TZNb) glass was prepared by the melt-quenching method and used for the construction of a point all-fiber temperature sensor. The glass thermal stability and network structural properties were studied by differential thermal analysis and Raman spectrum, respectively. High glass transition temperature is beneficial to widen the working temperature range. The dependence of fluorescence intensity ratio (FIR) of green upconversion emissions on the surrounding temperature from 276 to 363 K was experimentally investigated and the maximum temperature sensitivity is 95 × 10-4 K-1 at 363 K. Strong green upconversion emission, broad temperature measurement range and high sensitivity indicate this point temperature sensor is a promising optical device for application on optical temperature sensing.

Proteomic study of renal uric acid stone.

OBJECTIVE: To analyze urinary uric acid stone matrix proteins (SMP) with mass spectrometry (MS) to evaluate the mechanisms of uric acid stone formation. SMP plays an important role in urinary stone formation. Several proteomic studies apply to calcium-containing stones have been reported; however no proteomic study for urinary uric acid stone has been reported. METHODS: Pure kidney uric acid stones from 5 individuals were demineralized, and SMPs were isolated. The obtained proteins were analyzed with reverse-phase liquid chromatography-tandem MS. The acquired data were searched against a Swiss Prot human protein database using Matrix Science, Mascot. The identified proteins were submitted to the AmiGO Web site for gene ontology analysis. They were also sumitted to Metacore software and Kyoto Encyclopedia of Genes and Genomes website (KEGG) for pathway analysis. MS-determined protein expressions were verified by immunoblot. RESULTS: MS analysis identified 242 proteins from 5 proteomic results and the number of the identified protein of each result ranged from 52 to 156. Metacore software analysis suggested that inflammation may play an important role for kidney uric acid stone formation. Endogenous metabolic pathways were also analyzed and submitted to KEGG Web site, which revealed that these proteins may participate in fat metabolism. Five identified proteins were selected for immunoblot validation, and 3 proteins were confirmed. CONCLUSION: Our results suggest that inflammatory process may play a role in kidney uric acid stone formation. Our endogenous metabolic pathway analysis data revealed that these proteins may participate in lipid metabolism. Whether this finding implies a relation between lipotoxicity and kidney uric acid stone former requires further investigation.

Effects of low intensity pulsed ultrasound on rat Schwann cells metabolism.

The effects of low intensity pulsed ultrasound to tenocytes and osteocytes are well understood and applied clinically. However, its effects on cultured Schwann cells are still not well elucidated. This study was designed to elucidate the effects of low intensity pulsed ultrasound on cultured Schwann cells and their possible molecular mechanism. Schwann cells were harvested from sciatic nerves of 3-day-old Sprague-Dawley rats. Low intensity pulsed ultrasound stimulator (frequency: 1 MHz, duration: 2 min, duty cycle: 20%, total treatment time: 3 min) was applied to three different culture conditions: regular culture medium containing 0, 5, or 10% fetal bovine serum. The viability, damage, and differentiation of Schwann cells were examined; gene expression was also analyzed. In the presence of 0.3 W/cm(2) pulsed ultrasound stimulation, increases in cell viability and decreases in cell apoptosis were observed in the serum deprivation group; in this culture condition, interleukin-1, tumor necrosis factor-alpha, and protein zero genes expression were downregulated and Desert Hedgehog transcripts gene expression was upregulated. We concluded that intervention with low intensity pulsed ultrasound could promote Schwann cell proliferation, prevent cell death, and keep adequate phenotype presentation for peripheral nerve recovery. The low intensity pulsed ultrasound stimulation to an injured nerve site could be applied as early as possible especially when the microenvironment is almost serum-free to obtain the most benefit.