Competency versus proficiency: trying to develop an understanding of these terms in the context of practice learning.

The language of nurse education in the UK has shifted from 'competency' to 'proficiency' since 2018. The shift in language has been poorly articulated leaving individual higher education institutions, practice supervisors and assessors to interpret what these terms mean in relation to assessing student nurses. There appeared to be some confusion regarding the interpretation of the term proficiency among those who engaged in an exchange on the topic via Twitter. Students may focus on the procedure-based checklists within the standards. The relationship between proficiency and implementing a person-centred approach to care remains unclear.

Nitrogen Balance at the Recommended Dietary Allowance for Protein in Minimally Active Male Vegans.

Vegan diets have gained popularity in recent years for reasons including health benefits and concerns for animal welfare. Although these diets are considered to be nutritionally adequate, questions remain over whether the current protein recommendation (0.8 g/kg/d) is sufficient. Protein status is determined through a nitrogen balance analysis when the protein content of the diet is known. A negative balance indicates a catabolic state, and a positive nitrogen balance indicates an anabolic state. In healthy adults, nitrogen equilibrium is the expectation reflecting the net synthesis and breakdown of proteins. Currently, there are no known studies measuring nitrogen balance in strict vegan men fed the protein requirement. Eighteen minimally active vegan men received a 5-day eucaloric diet (protein content: 0.8 g/kg/d). On day five, 24 h urine was collected for nitrogen analysis. Both the mean absolute nitrogen balance (-1.38 ± 1.22 g/d) and the mean relative nitrogen balance (-18.60 ± 16.96 mg/kg/d) were significantly lower than zero (equilibrium) (p < 0.001). There were no correlations seen between nitrogen balance and age, years as vegan, or fat-free mass. Consuming 0.8 g/kg/d of protein is not adequate to produce nitrogen balance in men adhering to typical strict vegan diets for at least one year.

Curcumin Confers Anti-Inflammatory Effects in Adults Who Recovered from COVID-19 and Were Subsequently Vaccinated: A Randomized Controlled Trial.

COVID-19 infection and vaccination offer disparate levels of defense against reinfection and breakthrough infection. This study was designed to examine the effects of curcumin supplementation, specifically HydroCurc (CURC), versus placebo (CON) on circulating inflammatory biomarkers in adults who had previously been diagnosed with COVID-19 and subsequently received a primary series of monovalent vaccine doses. This study was conducted between June 2021 and May 2022. Participants were randomized to receive CURC (500 mg) or CON capsules twice daily for four weeks. Blood sampling was completed at baseline and week-4 and analyzed for biomarkers. Linear regression was utilized to examine the between-group differences in post-trial inflammatory biomarker levels, adjusting for baseline and covariates including age, sex, race/ethnicity, and interval between COVID-19 diagnosis and trial enrollment. The sample (n = 31) was 71% female (Age 27.6 ± 10.4 y). The CURC group exhibited significantly lower post-trial concentrations of proinflammatory IL-6 (ß = -0.52, 95%CI: -1.03, -0.014, p = 0.046) and MCP-1 (ß = -0.12, 95%CI: -0.23, -0.015, p = 0.027) compared to CON, adjusting for baseline and covariates. Curcumin intake confers anti-inflammatory activity and may be a promising prophylactic nutraceutical strategy for COVID-19. These results suggest that 4 weeks of curcumin supplementation resulted in significantly lower concentrations of proinflammatory cytokines in adults who recovered from COVID-19 infection and were subsequently vaccinated.

Self-Reported Intake and Circulating EPA and DHA Concentrations in US Pregnant Women.

In the United States, pregnant women have low concentrations of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which are essential for fetal development. Although maternal blood provides accurate polyunsaturated fatty acid (PUFA) concentrations, venipuncture is expensive and not always accessible. PUFA-containing foods consumption, both omega-3 ad omega-6 is supposed to reflect in the status (plasma, RBC, adipose tissue) of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). De novo synthesis of DHA and EPA during pregnancy is supposed to be higher compared to pre and/or post-pregnancy periods. Thus, this study aimed to determine the association between maternal self-reported dietary intake of foods high in DHA and EPA, along with vegetable oils as a source of omega-6 fatty acids, with maternal blood DHA and EPA concentrations. Pregnant women (13-16 weeks gestation) were recruited and asked to complete a food-frequency questionnaire (FFQ) and blood draw at enrollment and 36 weeks. Circulating concentrations of DHA and EPA were quantified and change scores were calculated. Correlations were done to determine associations between FFQ results and EPA/DHA maternal blood concentrations. Regression analyses were run to examine significant predictors of the main outcomes. Overall, PUFA-food consumption and RBC's DHA levels decreased from early to late pregnancy; self-reported PUFA-rich food consumption positively correlated with DHA and EPA levels. DHA concentration was predicted by self-reported PUFA-rich oils (sunflower/soy/corn/olive) consumption, but EPA concentration was predicted by maternal BMI. These findings suggest that EPA and DHA consumption decreased across pregnancy and the FFQ can be utilized as an effective method for estimating PUFA blood concentration during pregnancy.

Family Formation History and the Psychological Well-Being of Women from Diverse Racial-Ethnic Groups.

Studying disparities in psychological well-being across diverse groups of women can illuminate the racialized health risks of gendered family life. Integrating life course and demand-reward perspectives, this study applied sequencing techniques to the National Longitudinal Study of Youth: 1979 to reveal seven trajectories of partnership and parenthood through women's 20s and 30s, including several in which parenthood followed partnership at different ages and with varying numbers of children and others characterized by nonmarital fertility or eschewing such roles altogether. These sequences differentiated positive and negative dimensions of women's well-being in their 50s. Women who inhabited any family role had greater life satisfaction and fewer depressive symptoms, although these general patterns differed by race-ethnicity. Family roles were more closely related to well-being than ill-being for White women, parenthood had more pronounced importance across outcomes for Black women, and the coupling of partnership and parenthood generally mattered more for Latinas.

Associations Between Food Skills and Resilience in Adults Ages 18 to 45 in the USA During the COVID-19 Pandemic (2020 April-June): A Brief Report.

Early in the COVID-19 pandemic, there were limited options for eating away from home, obligating many US adults to prepare foods at home, a situation that provided an opportunity to examine relationships between food skills, resilience, and coping in the initial months of the pandemic. This research surveyed a convenience sample of adults (n = 134; 18-45 years of age) from the Phoenix Metropolitan area when a "stay at home" pandemic directive was mandated in the state of AZ. The study objective was to explore how food skills correlated to resilience and whether resilience directly related to the ability to manage oneself during this time. Previously validated measures for food skills and resiliency were utilized for the online questionnaire, which also included the question, "I was able to manage myself during the Coronavirus Pandemic." The Spearman's rank order correlation test and a linear, stepwise regression analysis were used to examine relationships between scores. Participants scored at the 77% percentile for total food skill proficiency, and at the 84th percentile for resilience. Both total food skills and resilience were correlated to the ability to self-manage during COVID-19 (r = 0.246 and r = 0.444, respectively; p ≤ 0.004). The stepwise linear regression model retained only the food skill domain "food selection and planning" as a significant predictor of resilience (standardized coefficient, 0.278; 99% CI [- 0.056, 0.414]; p < 0.05). These data suggest that resilience and food skills factored into participants' ability to self-manage during the COVID-19 mandate, "stay at home."

An integrative review exploring the impact of Electronic Health Records (EHR) on the quality of nurse-patient interactions and communication.

AIM: To explore how nurses' use of electronic health records impacts on the quality of nurse-patient interactions and communication. DESIGN: An integrative review. DATA SOURCES: MEDLINE®, CINAHL®, PscyINFO, PubMed, BNI and Cochrane Library databases were searched for papers published between January 2005 and April 2022. REVIEW METHODS: Following a comprehensive search, the studies were appraised using a tool appropriate to the study design. Data were extracted from the studies that met the inclusion criteria relating to sample characteristics, methods and the strength of evidence. Included empirical studies had to examine interactions or communication between a nurse and patient while electronic health records were being used in any healthcare setting. Findings were synthesized using a thematic approach. RESULTS: One thousand nine hundred and twenty articles were initially identified but only eight met the inclusion criteria of this review. Thematic analysis revealed four key themes, indicating that EHR: impedes on face-to-face communication, promotes task-orientated and formulaic communication and impacts on types of communication patterns. CONCLUSION: Research examining nurse-patient interactions and communication when nurses' use electronic health records is limited but evidence suggests that closed nurse-patient communications, reflecting a task-driven approach, were predominantly used when nurses used electronic health records, although some nurses were able to overcome logistical barriers and communicate more openly. Nurses' use of electronic health records impacts on the flow, nature and quality of communication between a nurse and patient. IMPACT: The move to electronic health records has taken place largely without consideration of the impact that this might have on nurse-patient interaction and communication. There is evidence of impact but also evidence of how this might be mitigated. Nurses must focus future research on examining the impact that these systems have, and to develop strategies and practice that continue to promote the importance of nurse-patient interactions and communication. PATIENT OR PUBLIC CONTRIBUTION: Studies examined within this review included patient participants that informed the analysis and interpretation of data.

Detection of the threatened snail darter Percina tanasi in the Tennessee River system using environmental DNA.

The distribution of many fishes that occupy large rivers is poorly known, in part due to the difficulties of sampling for them. This is especially true for small-bodied or rare species, such as the snail darter Percina tanasi, 44, 469-488; 1976). This federally listed (threatened) species has a limited distribution in the Tennessee River system in Alabama and Tennessee, where it is known from a few large tributaries or small rivers. In Alabama, P. tanasi was previously known from only one locality, but has recently been found in two additional, widely separated systems. These new records raise questions regarding the accuracy of our current understanding of the range for this species. Particularly, is P. tanasi present throughout the main stem Tennessee River, and is this species dispersing into new areas from source populations in the river? To clarify the distribution of P. tanasi in Alabama, 83 unique sites were surveyed using environmental DNA analysis. This cost-effective detection tool reduces the difficulty associated with empirically sampling large rivers for small fishes. Approximately 42% of sites sampled were positive for P. tanasi DNA. This study confirmed the known localities of P. tanasi in the Bear Creek, Elk River and Paint Rock River. Several new localities were also discovered throughout the main stem Tennessee River and in Shoal Creek, near Florence, Alabama. These findings can inform biologists about where to prioritize conservation efforts and further could lead to studies assessing movement and relatedness between populations in this system.

Sport Participation for Adults Aged 50 + Years: A Socioecological Analysis.

Sport participation can play a key role in older adults' successful aging as it provides an enjoyable opportunity for leisure-time physical activity. Research focusing on the benefits of sport participation in later life and facilitators for involvement has been increasing in the past several years. Drawing on the socioecological model, this study investigated select socioecological factors that predict older adults' sport participation from a holistic perspective. An online survey provided quantitative data from 1203 adults aged 50 and older across the United States. Results from logistic regression analyses showed that personal characteristics, individual behavior, environment/policy, and life course effects were significant predictors of sport participation in later life. The findings in this study enhance our understanding of factors related to older adults' sport participation and are also of value to practitioners seeking to promote sport participation among older adults.

Vitamin B6 Supplementation Reduces Symptoms of Depression in College Women Taking Oral Contraceptives: A Randomized, Double-Blind Crossover Trial.

Oral contraceptive (OC) users have a heightened risk of low plasma concentrations of vitamin B6, a cofactor in the tryptophan-serotonin pathway critical to mood regulation. The purpose of this crossover study was to determine whether vitamin B6 supplementation reduced symptoms of depression and improved mood states in college women using OC. Participants were healthy (aged 18-25 yrs), did not take dietary supplements, and used OC (estrogen with progestin) consistently for at least 1 year. During the 12-week, randomized, double-blind crossover trial (4-week treatment periods [100 mg vitamin B6 daily or placebo] separated by a 4-week washout) participants (n = 8) maintained normal exercise and eating patterns and recorded tablet consumption daily. The Beck Depression Inventory-II (BDI-II) and Profile of Mood States (POMS) were used to assess mental health before and after each 4-week treatment period. Average dietary vitamin B6 intakes did not vary during the trial (1.2-1.4 mg/d), whereas vitamin B6 status rose significantly following the B6 supplementation period compared to the other three time points. BDI-II scores were reduced 20% by vitamin B6 supplementation in comparison to an 11% rise with placebo ingestion (p = 0.046). POMS scores were not significantly impacted by vitamin B6 supplementation. These preliminary data support a growing literature suggesting the benefits of B6 supplementation for reducing symptoms of depression in young women using OC.

An examination of relationships between vitamin B12 status and functional measures of peripheral neuropathy in young adult vegetarians.

Introduction: Prevalence rates for vitamin B12 deficiency in U.S. adult vegetarians may exceed 30%, which is concerning given the role for this vitamin in numerous nervous system functions, including the synthesis of myelin sheaths. Defective myelin synthesis and repair are directly linked to peripheral neuropathy; yet, few investigations have examined how physical indicators of peripheral neuropathy (e.g., hand dexterity, vibration sensitivity and balance) are impacted in individuals adhering to vegetarian diets. This feasibility research explored the relationships between peripheral neuropathy and vitamin B12 status using a cross-sectional study design. In addition, a small pilot trial was conducted for limited-efficacy testing of vitamin B12 supplementation for reducing peripheral neuropathy. Methods: Healthy, able-bodied adults (n = 38; 19-40 years of age) reported exclusive adherence to a vegetarian or vegan diet for 3 years. Peripheral neuropathy was measured using a force plate for assessing balance, and a vibration sensitivity tester and pegboard tests to assess hand dexterity. Serum vitamin B12 and folate were measured using standard radioimmunoassay techniques. Results: Twenty-six percent of the sample displayed deficient or marginal vitamin B12 status (serum vitamin B12 <221 pmol/L). Participants with adequate vitamin B12 status scored 10% higher on the Purdue pegboard assembly test and 20% higher on the left hand adjusted functional dexterity test in comparison to participants with marginal-to-deficient vitamin B12 status (p < 0.05). Discussion: These data provide preliminary evidence that peripheral neuropathy can be detected in individuals with marginal-to-deficient vitamin B12 status.

Incipient speciation in allopatric Etheostoma rupestre (Percidae: Etheostomatinae) lineages, with the description of three new subspecies.

In recent years, new species descriptions for the North American darters have proliferated. Most species concepts accepted by contemporary ichthyologists require that a valid species be both monophyletic and diagnoseable, yet many lineages exhibit modal or range differences in morphological characteristics without individuals being diagnosable. Such scenarios present difficulties with regards to proper taxonomic recognition of divergent lineages and often prohibit appropriate conservation action. Following the example of recent authors, we provide meristic, geometric morphometric, and pigmentation data to support the recognition of three subspecies of Etheostoma rupestre, a species endemic to the Mobile Basin. These morphological data cohere with previous genetic work for E. rupestre. The nominate subspecies Etheostoma rupetsre rupestre (Tsais Rock Darter) is endemic to the Tombigbee River and Black Warrior River watersheds in Alabama and Mississippi and is characterized by having lower numbers of lateral blotches, lower range and mean of lateral line scales, lower modal number of scales above the lateral line, and lower degrees of nape squamation than other subspecies. Etheostoma rupestre piersoni (Shamrock Darter), ssp. nov., is endemic to the Cahaba and Alabama River Watersheds in Alabama and is characterized by intermediate counts of lateral blotches and higher scale counts and nape squamation than E. r. rupestre. Etheostoma rupestre uphapeense (Jade Darter), ssp. nov., is restricted to several small, disjunct populations in the Coosa and Tallapoosa watersheds in Alabama, Georgia, and Tennessee. Etheostoma r. uphapeense is characterized by having a higher mean number of lateral blotches than both other subspecies and higher scale counts than E. r. rupestre. While E. r. rupestre and E. r. piersoni are widespread and abundant within their respective ranges, E. r. uphapeense has a disjunct range and is often uncommon where it occurs. Etheostoma r. uphapeense should be monitored where it occurs to discern population trends.

Early time-restricted eating may favorably impact cognitive acuity in university students: a randomized pilot study.

Cognitive acuity is important for academic success. The preliminary efficacy of early time-restricted eating (eTRE) on cognitive acuity was examined in a sample of university students attending a large southwestern university. It was hypothesized that adherence to eTRE would result in improved cognitive acuity as assessed by the Trail Making Tests (i.e., TMT-A and TMT-B) and the Stroop Color and Word Test. Participants were randomized to an intervention group (eTRE) with a daily 6-hour eating window or a control group (CON) with a daily 16-hour eating window; 24 participants initiated the study (13 eTRE and 11 CON). Blood ketones (i.e., ß-hydroxybutyrate [BHB]) and brain-derived neurotrophic factor were also assessed. The 8-week intervention was forestalled by COVID-19 laboratory closures beginning in March 2020, and only data obtained at week 0 (baseline) and week 4 were viable for statistical analyses. Study attrition was high (50% for eTRE and 23% for CON). At week 4, there was a 27% and 6% decrease in TMT-B response time for the eTRE and CON groups, respectively (P = .02). TMT-B response time was inversely correlated to plasma BHB among participants (r = -0.633; P = .008). Considering the inverse relationship between TMT-B response time and plasma BHB, these preliminary data suggest that eTRE may improve some aspects of cognitive acuity in this population. Future investigations are needed to confirm these findings and should accommodate individual preferences regarding the initiation time of the eating window while also considering the impact on social influences and exercise engagement.

Effect of increased water intake on uropathogenic bacterial activity of underhydrated menstruating young adult women: A randomized crossover trial.

Background: Females are prone to urinary tract infections (UTIs) due to estrogen fluctuations affecting vaginal flora. While menstruating, increased fluid consumption to support urination frequency and void volume may be important, as the urethra and urinary tract are more predisposed to bacteria, particularly UTI pathogens. Aim: This study aimed to investigate the impact of hydration on urinary tract health during menstruation among underhydrated premenopausal women. Methods: Thirteen females participated in a 60-day 2 × 2 randomized crossover trial to evaluate the effectiveness of consuming ≥2.2 L of total beverage fluid intake, with 1.9 L being water, (intervention, INT) and maintaining habitual fluid intake (control, CON) on two subsequent menses. Participants completed fluid and urination diaries at days 2 and 5 after the onset of bleeding (day 1) to determine the fluid amount consumed and urination frequency. Urine concentration was assessed in afternoon (days 2 and 5) and uropathogenic bacterial activity in first-morning (days 3 and 6) urinations. General linear models assessed differences in bacterial and hydration outcomes. Results: The intervention led to a 62% mean total fluid increase, INT 3.0 ± 1.1 L and CON 1.9 ± 0.9 L, p < 0.001, η2 = 0.459. Urination frequency was greater and urine concentration less in the INT to CON, all ps < 0.05, η2 range = 0.023-0.019. Only four cultures detected uropathogenic bacteria, with no patterns between conditions or days, making it difficult to determine the intervention's effectiveness. Conclusion: Fluid intake increased, and hydration status improved. No differences in uropathogenic bacterial activity were seen between the hydration and control conditions.

The feasibility and preliminary efficacy of early time-restricted eating on diet quality in college students: A randomized study.

Meal timing is an important consideration when assessing health. The primary outcome of this pilot study was to examine the feasibility and preliminary efficacy of early time-restricted eating (eTRE) on diet quality in a sample of college students attending a large southwestern university. Cardiometabolic indices and anthropometric measures were also obtained. The study was planned as an eight-week intervention; however, COVID-19 necessitated laboratory closures that disrupted data collection at week eight. Hence, only data obtained at week zero (baseline) and week four were viable for analysis and are presented herein. Twenty-five healthy participants were randomized to the intervention group (eTRE) which consisted of a daily 6-hour eating window or the control group (CON) which consisted of a daily 16-hour eating window. Each week, participants were permitted one day off from their respective study protocol. Seventeen participants completed all aspects of the study, and diet quality data were obtained from one additional participant (n = 18). Preliminary findings indicate that the 6-hour eTRE protocol may be beneficial for weight reduction and for reducing energy-dense foods typically consumed during the evening hours or later at night. Future research should accommodate individual preferences with regard to the initiation time of the eating window while also providing evidence-based nutrition recommendations to improve diet quality.

Influence of exercise type on maternal blood pressure adaptation throughout pregnancy.

BACKGROUND: It has been reported that 10% of all pregnancies are complicated by a hypertensive disorder of pregnancy. Previous research has shown that moderate-vigorous intensity exercise has a positive effect on maternal resting blood pressure. A research gap, however, exists related to how different types of exercise (resistance, aerobic, combined resistance and aerobic) affect maternal blood pressure. Most of the previous studies solely focused on aerobic exercise. OBJECTIVE: The aim of this study was to examine the effects of exercise types on maternal blood pressure throughout pregnancy. STUDY DESIGN: This study employed a secondary analysis using data from a randomized controlled prenatal exercise intervention trial. This study utilized 3 exercise intervention groups (aerobic, resistance, combination) and compared the results with those of a nonexercize control group. Participants completed 3 50-minute sessions weekly from 16 weeks of gestation until delivery. Maternal vital signs and physical measurements such as systolic blood pressure, diastolic blood pressure, and heart rate were measured every 4 weeks throughout the intervention period. Between-group mean differences in maternal measurements were assessed using Pearson's chi-square tests for continuous (age, prepregnancy body mass index, heart rate, systolic blood pressure, diastolic blood pressure, pulse pressure) variables. For gravida, exact Wilcox 2-sample tests were performed to determine between-group differences in mean values. Hierarchical linear growth curves were used to estimate maternal trajectories of systolic blood pressure and diastolic blood pressure from 16 weeks to 36 weeks' gestation in each of the 4 groups (aerobic, combination, control, and resistance). RESULTS: There were no differences among the groups in maternal age or prepregnancy body mass index. Controlling for maternal body mass index, the lowest significant systolic blood pressure curve was noted throughout the pregnancy for women who participated in resistance exercise, followed by women in the aerobic exercise group all relative to the no exercise control group. At 36 weeks' gestation, the systolic blood pressure was lower in the resistance group by 12.17 mm Hg (P<.001) and in the aerobic group by 7.90 mm Hg (P<.001) relative to controls. No significant change in systolic blood pressure was noted in the combination group in comparison with controls at 36 weeks' gestation. Similarly, we demonstrated a significantly lower linear growth curve in diastolic blood pressure that was maintained throughout pregnancy in any exercise type relative to controls. After controlling for maternal body mass index, all 3 exercise types (combination, resistance, and aerobic) significantly predicted a similar decrease in diastolic blood pressure that was maintained throughout pregnancy. At 36 weeks' gestation, the diastolic blood pressure was lower in the aerobic group by 7.30 mm Hg (P<.01), in the combination group by 6.43 mm Hg (P<.05), and in the resistance group relative to controls. CONCLUSION: Overall, all exercise types were beneficial in lowering maternal resting blood pressure throughout pregnancy. Resistance training was noted to be the most beneficial in improving systolic blood pressure, followed by aerobic exercise. All 3 exercise groups were noted to improve diastolic blood pressure equally. Further research needs to be done to determine if either resistance or aerobic exercise throughout pregnancy decreases the risk for hypertensive disorders of pregnancy and the associated morbidity and mortality.

Serum creatinine as an indicator of lean body mass in vegetarians and omnivores.

Growing numbers of Americans are adopting vegetarian or vegan diets. While risk for some chronic conditions may be lower when following these diets, concern remains over the ability to consume adequate amounts of various nutrients, notably, protein. Knowing that serum creatinine is a reliable marker of muscle mass, this study examined the relationships between serum creatinine, lean body mass (LBM), handgrip strength, and protein intake in healthy vegetarian (n = 55) and omnivorous (n = 27) adults. Significantly higher protein intakes (+31%), LBM (+7%), serum creatinine (+12%) and handgrip strength (+14%) were observed for the omnivore participants compared to vegetarian participants. Positive correlations (p < 0.001) were noted between creatinine and LBM (R2 = 0.42), creatinine and handgrip strength (R2 = 0.41), protein intake and LBM (R2 = 0.29), and handgrip strength and LBM (R2 = 0.69). These data show that serum creatinine concentrations were lower in vegetarian women and men in comparison to their omnivorous counterparts and that serum creatinine concentrations correlate with LBM and strength in healthy adults, regardless of diet.

Palmitoylethanolamide Reduces Proinflammatory Markers in Unvaccinated Adults Recently Diagnosed with COVID-19: A Randomized Controlled Trial.

BACKGROUND: Inflammation is at the core of many chronic conditions and exacerbates infectious conditions, including the severity of coronavirus disease 2019 (COVID-19) infections. OBJECTIVES: This study aimed to examine the effects of a novel food supplement, palmitoylethanolamide (PEA), specifically Levagen+, as compared with a placebo on proinflammatory biomarkers in adults recently diagnosed with COVID-19 who were unvaccinated and nonhospitalized. METHODS: This study was a double-blind randomized placebo-controlled trial conducted October 2020-March 2021 (clinicaltrials.gov: NCT04912921). Participants aged 19-53 y were unvaccinated and recently infected with COVID-19 as indicated by a positive test result per RT-PCR or antigen test, and they reported to the test site following diagnosis as allowed by the CDC's return-to-work policy. Participants were stratified by age, sex, and BMI and randomly assigned by coin toss to receive 600 mg Levagen+ twice daily (LEV) or placebo tablets twice daily (CON) for 4 wk. At baseline and week 4, participants completed health histories, 24-h dietary recalls, anthropometrics, and nonfasting blood sampling. The primary outcomes were the 4-wk change between groups for IL-6, C-reactive protein, ferritin, intercellular adhesion molecule 1, soluble P-selectin (sP-selectin), and neutrophil/lymphocyte ratio. Multiple linear regression models were utilized to assess treatment effects on outcomes, adjusting for covariates. RESULTS: A total of 60 participants completed the study (LEV: n = 30; CON: n = 30). After 4 wk of supplementation, sP-selectin (ß = -11.5; 95% CI: -19.8, -3.15; P = 0.0078), IL-1ß (ß = -22.9; 95% CI: -42.4, -3.40; P = 0.0222), and IL-2 (ß = -1.73; 95% CI: -3.45, -0.065; P = 0.0492) concentrations were significantly reduced in the LEV group compared with the CON group. CONCLUSIONS: Inflammatory mechanisms are crucial to optimal resolution of infectious conditions, yet unchecked secretion of inflammatory mediators can promote the dysregulated immune response implicated in COVID-19 complications. Overall, PEA supplementation produced anti-inflammatory effects in individuals recently diagnosed with COVID-19 who were nonhospitalized.

Erythrocyte osmotic fragility is not linked to vitamin C nutriture in adults with well-controlled type 2 diabetes.

Erythrocyte fragility is amplified by oxidative stress and linked to diabetes-specific microvascular disease. Vitamin C supplementation improves glycemic indices in adults with type 2 diabetes (T2D) by improving antioxidant status. This cross-sectional study examined the relationships between vitamin C status and erythrocyte osmotic fragility in adults with or without T2D. Participants provided a fasting blood sample for erythrocyte osmotic fragility testing as a function of hypotonic NaCl concentrations. Additionally, plasma was stabilized with metaphosphoric acid prior to vitamin C analysis using isocratic reverse-phase UV-HPLC separation. Participants were grouped as diagnosed T2D (n = 14; 36% female; 55.5 ± 8.2 y; 31.5 ± 9.0 kg/m2; HbA1c: 7.4 ± 1.9%; plasma vitamin C: 36.0 ± 12.2 µM) or no diabetes (n = 16; 69% female; 38.7 ± 13.5 y; 26.8 ± 6.6 kg/m2; HbA1c: 5.4 ± 0.3%; plasma vitamin C: 34.8 ± 10.9 µM). Participant characteristics differed between groups only for age and hemoglobin A1c (HbA1c; p < 0.05). All hemolysis parameters were in normal ranges for the participants with T2D, and no significant differences in hemolysis parameters were noted between those with or without T2D. However, among participants with T2D, the NaCl concentration eliciting 50% hemolysis was higher for those with low (<7%) vs. high (>7%) HbA1c values (p = 0.037) indicating a slightly higher erythrocyte fragility in the former group. Vitamin C status did not impact any of the hemolysis parameters in adults with or without T2D. Thus, erythrocyte fragility was not elevated in T2D, and vitamin C nutriture was not related to erythrocyte fragility in adults with well-controlled T2D.

Giving nurses a voice through 'listening to staff' conversations to inform nurse retention and reduce turnover.

Health and social care employers in the UK cannot afford to lose nurses given the current nursing workforce crisis. A variety of staff engagement initiatives aim to improve employee retention. This article describes how Listening to Staff (L2S) events were used as part of a service review to inform nurse retention strategies in one acute hospital trust. Over a 3-year period, 576 nurses took part in L2S events that examined nurses' perspectives of teamworking and support as well as career plans in areas with high nurse turnover rates. Comparative content analysis was used to analyse narrative data, which informed managers' retention plans. Examination of retention data before and after L2S events showed nursing turnover decreased, suggesting a variety of strategies to retain staff may have improved nurse retention. Findings imply capturing nurses' perceptions through staff engagement events may offer solutions for nurse retention.