The development of cultural competences in nursing students and their significance in shaping the future work environment: a pilot study.

BACKGROUND: Working in a culturally diverse environment entails a moral and professional responsibility to provide culturally competent care. This has been recognised as an important measure to reduce health inequalities, improve the quality of care and increase patient satisfaction. The aim of this study was to assess the level of cultural competence in nursing students a decade after the introduction of transcultural nursing content into the nursing curriculum in Slovenia. METHODS: A descriptive cross-sectional design with 180 s-year nursing students as a convenience sample was used. Cultural competence was assessed using the Cultural Competence Assessment Tool (CCATool) via an online survey. IBM SPSS facilitated statistical analysis, using descriptive statistics and inferential methods, including the chi-square test. Non-parametric tests (Mann Whitney U, Kruskal-Wallis H and Wilcoxon signed-rank) were used for non-normally distributed data (Shapiro-Wilk test, p < 0.05). The significance was set at p ≤ 0.05. RESULTS: The results indicate that students demonstrate a high level of cultural competence, although there is room for improvement in terms of cultural sensitivity, as determined by coding the CCATool. The results also show a remarkable contrast between their self-assessed scores and the objective scores obtained from CCATool coding of the statements in each subscale (p < 0.005). In addition, significant differences (p = 0.002) are found in subscale "Cultural Knowledge" particularly between students who have lived abroad for more than 6 months and those who have not. The latter group has a higher score in the CCATool, indicating greater cultural knowledge. CONCLUSIONS: The study suggests that the presence of transcultural elements in the Slovenian nursing curriculum is associated with higher self-reported levels of cultural competence among nursing students, although the present research design does not allow for causal interpretations. This competence is of immense importance in preparing students for their future professional environment. However, it is crucial to further refine the nursing curriculum, especially through greater integration of transcultural content in all health disciplines. In addition, the introduction of innovative teaching and learning approaches can better prepare students to deal with the diverse cultural experiences they will encounter in their nursing careers.

Newly graduated nurses' perceptions of their professional role and professional competency: a qualitative focus group study.

BACKGROUND: In recent years, complex and rapidly changing healthcare settings have placed high demands on nursing graduates, who must effectively assume new professional roles with a wide variety of competencies. However, in an ever-altering environment it is impossible to teach students everything. This means that assessing nursing students' perceptions of their ability to practise their competencies and assume their professional roles is critical for faculty to further develop the nursing education curriculum and to assist healthcare organisations in supporting the transition of graduates. The aim of the study was to explore newly graduated nurses' perceptions of their new professional role and professional competency associated with this role. METHODS: A qualitative study using the focus group method. The purposive sample included 18 nursing graduates with an average of 29 years, most of whom were female. The average time that had elapsed since graduation was 1.5 years. Four face-to-face focus group interviews were conducted. Thematic analysis was employed to identify themes and subthemes. RESULTS: Three main themes describing newly graduated nurses' perceptions were found: (1) significance of the transition period; (2) commitment to the nursing profession; and (3) perceived needs and challenges to professional competency. CONCLUSION: The transition from a safe academic environment to turbulent clinical practice is shaped by both graduates' expectations and reality. The results of the study indicate a high level of commitment to the profession immediately after graduation and point to groups of competencies that need greater emphasis in the nursing curriculum. Although the responsibility for adequately preparing and supporting nursing students for their new professional roles rests with faculty and healthcare organisations, the responsibility for professional development should also lie on the students themselves.

Developing the better and effective nursing education for improving transcultural nursing skills cultural competence and cultural sensitivity assessment tool (BENEFITS-CCCSAT).

BACKGROUND: A clear need for the development of new comprehensive, reliable, sensitive and valid measurement tools to adequately asses the cultural competence and cultural sensitivity of nursing students exists. This study aimed to develop a new measurement tool to assess the nursing students' cultural competence and sensitivity. METHODS: This cross-sectional, instrument development study's first phase included postgraduate nursing students (n = 60) for the piloting study, and the second one included undergraduate nursing students (n = 459) for the main survey. This study used two data collection forms: The Student Descriptive Information Form and the Better and Effective Nursing Education for Improving Transcultural Nursing Skills Cultural Competence and Cultural Sensitivity Assessment Tool (BENEFITS-CCCSAT) draft. The content validity index was calculated using the Davis method. Cronbach's α coefficient and the item total correlation were calculated during the reliability analysis. The Kaiser-Meyer-Olkin (KMO) coefficient test, Bartlett significance test, and explanatory factor analysis (EFA) were used to evaluate the validity of the assessment tool. RESULTS: Scale validity and reliability analyses showed that the BENEFITS-CCCSAT included 26 items and five sub-dimensions: respect for cultural diversity; culturally sensitive communication; achieving cultural competence; challenges and barriers in providing culturally competent care; and perceived meaning of cultural care. CONCLUSION: The BENEFITS-CCCSAT appears to be a valid and reliable instrument for measuring the cultural sensitivity and cultural competence of nursing students. This can be of great use, especially before attending clinical areas, and can offer both students and faculty reliable information to promote reflective and critical thinking, especially in areas where improvement is needed.

UNDERSTANDING DEMOGRAPHIC AND EPIDEMIOLOGIC CHARACTERISTICS OF HOSPITALIZED IMMIGRANT FEMALE PATIENTS: A RETROSPECTIVE OBSERVATIONAL STUDY.

Precise epidemiologic and demographic characteristics of immigrant women admitted to gynecology or obstetrics departments are rarely explored. The aim of this retrospective observational study was to analyze the epidemiologic and demographic characteristics of immigrant female patients hospitalized between 2012 and 2017 in one maternity hospital in south-west Slovenia. Clinical data retrieved from hospital electronic information system were used to analyze these characteristics. In the mentioned period, 605 immigrant women were hospitalized, most of them originating from countries of the former Yugoslavia (60.50%) or former Eastern Bloc (14.05%). The results show that in recent years there has been a constantly growing trend of immigrant women being admitted compared to the total number of hospitalizations. No statistical differences were established in the incidence of abortion, preterm delivery or vacuum extraction between Slovenian and immigrant women, although the analysis revealed a higher rate of cesarean section among immigrant women (χ2=26.960, p<0.01). Education level seems to be a significant predictor of the likelihood of an abortion in the group of immigrant women (B=-0.492, p=0.015), where less educated women are at a greater risk. To improve what is known about the sexual and reproductive health-related problems of immigrant women, a large-scale epidemiologic study is needed in the near future.

Financial competencies as investigated in the nursing field: Findings of a scoping review.

AIM(S): This study aims to map the extent of the research activity in the field of financial competencies and nursing and identify main patterns, advances, gaps, and evidence produced to date. BACKGROUND: Financial competencies are important indicators of professionalism and may influence the quality of care in nursing; moreover, these competencies are the basis of health care sustainability. Despite their relevance, studies available on financial competencies in the nursing field have not been mapped to date. EVALUATION: A scoping review was guided according to (a) the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review and (b) the Patterns, Advances, Gaps and Evidence for practice and Research recommendations framework. KEY ISSUE(S): A total of 21 studies were included. Main research patterns have been developing/evaluating the effectiveness of education programmes and investigating the nurse's role in the context of financial management, challenges and needs perceived by them, and tool validation to assess these competencies. The most frequently used concept across studies was 'financial management competencies' (n = 19). CONCLUSION(S): The sparse production of studies across countries suggests that there is a need to invest in this research field. IMPLICATIONS FOR NURSING MANAGEMENT: Nurses with managerial roles should invest in their financial competencies by requiring formal training both at the academic and at the continuing education levels. They should also promote educational initiatives for clinical nurses, to increase their capacity to contribute, understand, and manage the emerging financial issues.

Molecular detection of SARS-CoV-2 from indoor air samples in environmental monitoring needs adequate temporal coverage and infectivity assessment.

The relevance of airborne exposure to SARS-CoV-2 in indoor environments is a matter of research and debate, with special importance for healthcare low-risk settings. Experimental approaches to the bioaerosol sampling are neither standardized nor optimized yet, leading in some cases to limited representativity of the temporal and spatial variability of viral presence in aerosols. Airborne viral viability moreover needs to be assessed. A study has been conducted collecting five 24-h PM10 samples in a COVID-19 geriatric ward in late June 2020, and detecting E and RdRp genes by RT-qPCR with a Ct between 36 and 39. The viral RNA detection at Ct = 36 was related to the maximal numerosity of infected patients hosted in the ward. Lacking a direct infectivity assessment for the collected samples an experimental model has been defined, by seeding twelve nasopharyngeal swab extracts from COVID-19 positive patients on Vero E6 cells; only the four extracts with a viral load above E+10 viral copies (approximately Ct<24) have been able to establish a persistent infection in vitro. Therefore, the cytopathic effect, a key feature of residual infectivity, could be considered unlikely for the environmental PM10 samples showing amplification of viral RNA at Ct = 36 or higher. A standardization of airborne SARS-CoV-2 long-term monitoring and of environmental infectivity assessment is urgently needed.

Identification of Neonatal Infant Pain Assessment Tools as a Possibility of Their Application in Clinical Practice in Croatia: An Integrative Literature Review.

OBJECTIVES: This article presents an integrative review of the literature with the aim of identifying instruments already in existence for measuring neonatal infant pain with a view to exploring possibilities of applying them in clinical practice in Croatia. DESIGN: An integrative review. DATA SOURCES: The databases searched included MEDLINE, Cinahl Cochrane Library, and Science Direct. The search was limited to available full-text articles in English published between 1990 and 2020. The studies were selected according to the PRISMA strategy and evaluated based on the methodologic framework proposed by Whittemore and Knafl. REVIEW/ANALYSIS METHODS: The research identified 13 scales for assessing pain in neonatal infants, including 5 one-dimensional and 8 multidimensional scales that assess acute and prolonged pain in preterm and full-term infants. RESULTS: Overall, the articles in this review confirm that pain is a multidimensional phenomenon and that professionals should consider other specific characteristics of the neonatal infant population while measuring pain. CONCLUSIONS: Our review showed that various tools exist assessing pain in neonatal infants that could be used in clinical practice in Croatia. However, it is difficult to determine the most appropriate instrument at this stage, as the choice depends on various factors that still need to be considered. The decision on which pain scale to use or which is more appropriate should be based on further psychometric tests, its accuracy, and ease of use.

Cross-cultural adaptation and psychometric evaluation of the Slovenian version of the nurse professional competence scale.

BACKGROUND: The competency-based approach to the assessment of nursing practice has been adopted as a key policy in the developed world. The continual self-assessment of competence gives nurses the opportunity to reflect on their competencies and has a significant impact on the quality of nursing practice and patient safety. The study was designed to describe the process of cross-cultural adaptation and to assess the psychometric properties of the Slovenian version of a short form of the Nurse Professional Competence scale (NPC-SF) and to evaluate the efficacy of this instrument in a sample of registered nurses. METHODS: A cross-sectional and validation study was conducted in 425 registered nurses to test the psychometric properties of the Slovenian version of a short form of the scale and to evaluate nurses' professional competence. A multilevel approach was used: Translation, back-translation, language validity, face and content validity, construct validity, and reliability of the Slovenian version of the scale were analysed respectively. Participants completed an online survey, with the data being collected between April and July 2020. RESULTS: Factor analysis showed that the Slovenian version of the scale could be used in four dimensions explained with 65 % of the variance. Cronbach's α was 0.972. The four-factor model fit the data (RMSEA = 0.083, CFI = 0.731). Self-reported competence was high and rated higher by nurses employed at the tertiary level of healthcare, followed by nurses employed at the secondary and primary, and from social care institutions. Nurses with more years of experience assessed their competence higher. CONCLUSIONS: The NPC-SF helps understand and identify nurses' self-reported core competencies in clinical settings, thereby providing an important predictor of the professional development of nursing. The Slovenian version of the scale demonstrated acceptable psychometric properties and may be used in research and clinical practice to evaluate nurses' professional competence.

Pattern Recognition and Anomaly Detection by Self-Organizing Maps in a Multi Month E-nose Survey at an Industrial Site.

Currently people are aware of the risk related to pollution exposure. Thus odor annoyances are considered a warning about the possible presence of toxic volatile compounds. Malodor often generates immediate alarm among citizens, and electronic noses are convenient instruments to detect mixture of odorant compounds with high monitoring frequency. In this paper we present a study on pattern recognition on ambient air composition in proximity of a gas and oil pretreatment plant by elaboration of data from an electronic nose implementing 10 metal-oxide-semiconductor (MOS) sensors and positioned outdoor continuously during three months. A total of 80,017 e-nose vectors have been elaborated applying the self-organizing map (SOM) algorithm and then k-means clustering on SOM outputs on the whole data set evidencing an anomalous data cluster. Retaining data characterized by dynamic responses of the multisensory system, a SOM with 264 recurrent sensor responses to air mixture sampled at the site and four main air type profiles (clusters) have been identified. One of this sensor profiles has been related to the odor fugitive emissions of the plant, by using ancillary data from a total volatile organic compound (VOC) detector and wind speed and direction data. The overall and daily cluster frequencies have been evaluated, allowing us to identify the daily duration of presence at the monitoring site of air related to industrial emissions. The refined model allowed us to confirm the anomaly detection of the sensor responses.

Breath Analysis: Comparison among Methodological Approaches for Breath Sampling.

Despite promising results obtained in the early diagnosis of several pathologies, breath analysis still remains an unused technique in clinical practice due to the lack of breath sampling standardized procedures able to guarantee a good repeatability and comparability of results. The most diffuse on an international scale breath sampling method uses polymeric bags, but, recently, devices named Mistral and ReCIVA, able to directly concentrate volatile organic compounds (VOCs) onto sorbent tubes, have been developed and launched on the market. In order to explore performances of these new automatic devices with respect to sampling in the polymeric bag and to study the differences in VOCs profile when whole or alveolar breath is collected and when pulmonary wash out with clean air is done, a tailored experimental design was developed. Three different breath sampling approaches were compared: (a) whole breath sampling by means of Tedlar bags, (b) the end-tidal breath collection using the Mistral sampler, and (c) the simultaneous collection of the whole and alveolar breath by using the ReCIVA. The obtained results showed that alveolar fraction of breath was relatively less affected by ambient air (AA) contaminants (p-values equal to 0.04 for Mistral and 0.002 for ReCIVA Low) with respect to whole breath (p-values equal to 0.97 for ReCIVA Whole). Compared to Tedlar bags, coherent results were obtained by using Mistral while lower VOCs levels were detected for samples (both breath and AA) collected by ReCIVA, likely due to uncorrected and fluctuating flow rates applied by this device. Finally, the analysis of all data also including data obtained by explorative analysis of the unique lung cancer (LC) breath sample showed that a clean air supply might determine a further confounding factor in breath analysis considering that lung wash-out is species-dependent.

Developing a Universal Nursing Competencies Framework for Registered Nurses: A Mixed-Methods Approach.

PURPOSE: To develop a methodology for identifying the universal nursing competencies required for registered nurses (RNs). DESIGN: A mixed-methods approach was used. METHODS: The research in this article entails a combination of different methodological approaches, namely the Delphi technique and an empirical quantitative nonexperimental study. A total of 14 experts with credentials in the nursing field participated in the former. Consensus was defined as at least 80% agreement. Subsequently, a purposive sample of 321 RNs participated in the empirical quantitative nonexperimental study. The data were collected during 2014. FINDINGS: In the study's first stage, 39 professional nursing competencies were identified using the Delphi technique. In the second stage, factor analysis resulted in seven factors: professional nursing clinical practice; professional communication and quality in nursing; determinants of health and safety in nursing; critical thinking and self-planning of professional work; new knowledge and knowledge transfer in nursing; management and coordination in nursing; and nursing research. Together they explain 74.9% of the variance. CONCLUSIONS AND CLINICAL RELEVANCE: In the future, the identification of the national nursing competencies should be considered. The study has some limitations; however, the proposed methodology revealed in this study may be the first step in overcoming them.

Self-Organizing Maps: An AI Tool for Identifying Unexpected Source Signatures in Non-Target Screening Analysis of Urban Wastewater by HPLC-HRMS.

(1) Background: Monitoring effluent in water treatment plants has a key role in identifying potential pollutants that might be released into the environment. A non-target analysis approach can be used for identifying unknown substances and source-specific multipollutant signatures. (2) Methods: Urban and industrial wastewater effluent were analyzed by HPLC-HRMS for non-target analysis. The anomalous infiltration of industrial wastewater into urban wastewater was investigated by analyzing the mass spectra data of "unknown common" compounds using principal component analysis (PCA) and the Self-Organizing Map (SOM) AI tool. The outcomes of the models were compared. (3) Results: The outlier detection was more straightforward in the SOM model than in the PCA one. The differences among the samples could not be completely perceived in the PCA model. Moreover, since PCA involves the calculation of new variables based on the original experimental ones, it is not possible to reconstruct a chromatogram that displays the recurring patterns in the urban WTP samples. This can be achieved using the SOM outcomes. (4) Conclusions: When comparing a large number of samples, the SOM AI tool is highly efficient in terms of calculation, visualization, and identifying outliers. Interpreting PCA visualization and outlier detection becomes challenging when dealing with a large sample size.

Bioaerosol Sampling Devices and Pretreatment for Bacterial Characterization: Theoretical Differences and a Field Experience in a Wastewater Treatment Plant.

Studies on bioaerosol bacterial biodiversity have relevance in both ecological and health contexts, and molecular methods, such as 16S rRNA gene-based barcoded sequencing, provide efficient tools for the analysis of airborne bacterial communities. Standardized methods for sampling and analysis of bioaerosol DNA are lacking, thus hampering the comparison of results from studies implementing different devices and procedures. Three samplers that use gelatin filtration, swirling aerosol collection, and condensation growth tubes for collecting bioaerosol at an aeration tank of a wastewater treatment plant in Trieste (Italy) were used to determine the bacterial biodiversity. Wastewater samples were collected directly from the untreated sewage to obtain a true representation of the microbiological community present in the plant. Different samplers and collection media provide an indication of the different grades of biodiversity, with condensation growth tubes and DNA/RNA shieldTM capturing the richer bacterial genera. Overall, in terms of relative abundance, the air samples have a lower number of bacterial genera (64 OTUs) than the wastewater ones (75 OTUs). Using the metabarcoding approach to aerosol samples, we provide the first preliminary step toward the understanding of a significant diversity between different air sampling systems, enabling the scientific community to orient research towards the most informative sampling strategy.

Self-organizing map algorithm for assessing spatial and temporal patterns of pollutants in environmental compartments: A review.

The evaluation of the spatial and temporal distribution of pollutants is a crucial issue to assess the anthropogenic burden on the environment. Numerous chemometric approaches are available for data exploration and they have been applied for environmental health assessment purposes. Among the unsupervised methods, Self-Organizing Map (SOM) is an artificial neural network able to handle non-linear problems that can be used for exploratory data analysis, pattern recognition, and variable relationship assessment. Much more interpretation ability is gained when the SOM-based model is merged with clustering algorithms. This review comprises: (i) a description of the algorithm operation principle with a focus on the key parameters used for the SOM initialization; (ii) a description of the SOM output features and how they can be used for data mining; (iii) a list of available software tools for performing calculations; (iv) an overview of the SOM application for obtaining spatial and temporal pollution patterns in the environmental compartments with focus on model training and result visualization; (v) advice on reporting SOM model details in a paper to attain comparability and reproducibility among published papers as well as advice for extracting valuable information from the model results is presented.

Radiological assessment of skeletal muscle index and myosteatosis and their impact postoperative outcomes after liver transplantation.

BACKGROUND: Liver transplantation offers curative treatment to patients with acute and chronic end-stage liver disease. The impact of nutritional status on postoperative outcomes after liver transplantation remains poorly understood. The present study investigated the predictive value of radiologically assessed skeletal muscle index (SMI) and myosteatosis (MI) on postoperative outcomes. PATIENTS AND METHODS: Data of 138 adult patients who underwent their first orthotopic liver transplantation were retrospectively analysed. SMI and MI in computer tomography (CT) scan at the third lumbar vertebra level were calculated. Results were analyzed for the length of hospitalisation and postoperative outcomes. RESULTS: In 63% of male and 28.9% of female recipients, low SMI was found. High MI was found in 45(32.6%) patients. Male patients with high SMI had longer intensive care unit (ICU) stay (P < 0.025). Low SMI had no influence on ICU stay in female patients (P = 0.544), length of hospitalisation (male, P > 0.05; female, P = 0.843), postoperative complication rates (males, P = 0.883; females, P = 0.113), infection rate (males, P = 0.293, females, P = 0.285) and graft rejection (males, P = 0.875; females, P = 0.135). The presence of MI did not influence ICU stay (P = 0.161), hospitalization (P = 0.771), postoperative complication rates (P = 0.467), infection rate (P = 0.173) or graft rejection rate (P = 0.173). CONCLUSIONS: In our study, changes in body composition of liver transplant recipients observed with SMI and MI had no impact on postoperative course after liver transplantation. CT body composition analysis of recipients and uniformly accepted cut-off points are crucial to producing reliable data in the future.

Identification of a characteristic VOCs pattern in the exhaled breath of post-COVID subjects: are metabolic alterations induced by the infection still detectable?

SARS-CoV-2 is expected to cause metabolic alterations due to viral replication and the host immune response resulting in increase of cytokine secretion and cytolytic activity. The present prospective observational study is addressed at exploring the potentialities of breath analysis in discrimination between patients with a documented previous history of symptomatic SARS-CoV-2 infection and, at the moment of the enrollment, exhibiting a negative nasopharyngeal swab and acquired immunity (post-COVID) and healthy subjects with no evidence of previous SARS-CoV-2 infection (no-COVID). The main purpose is to understand if traces of metabolic alterations induced during the acute phase of the infection are still detectable after negativization, in the form of a characteristic volatile organic compound (VOC) pattern. An overall number of 60 volunteers aged between 25 and 70 years were enrolled in the study (post-COVID: n.30; no-COVID: n. 30), according to well-determined criteria. Breath and ambient air samples were collected by means of an automated sampling system (Mistral) and analyzed by thermal desorption-gas chromatography-mass spectrometry (TD-GC/MS). Statistical tests (Wilcoxon/Kruskal-Wallis test) and multivariate data analysis (principal component analysis (PCA), linear discriminant analysis) were performed on data sets. Among all compounds detected (76 VOCs in 90% of breath samples), 5 VOCs (1-propanol, isopropanol, 2-(2-butoxyethoxy)ethanol, propanal and 4-(1,1-dimethylpropyl)phenol) showed abundances in breath samples collected from post-COVID subjects significantly different with respect to those collected from no-COVID group (Wilcoxon/Kruskal-Wallis test,p-values <0.05). Although not completely satisfactory separation between the groups was obtained, variables showing significant differences between the two groups and higher loadings for PCA are recognized biomarkers of COVID-19, according to previous studies in literature. Therefore, based on the outcomes obtained, traces of metabolic alterations induced by SARS-CoV-2 infection are still detectable after negativization. This evidence raises questions about the eligibility of post-COVID subjects in observational studies addressed at the detection of COVID-19. (Ethical Committee Registration number: 120/AG/11).

Evaluation of E-Learning Experience among Health and Allied Health Professions Students during the COVID-19 Pandemic in Slovenia: An Instrument Development and Validation Study.

COVID-19 had an impact on everyday life, especially during the lockdown. This also impacted higher education, leading to a sudden and complete shift to online e-learning. The purpose of this study was to develop, validate, and test a measurement tool suitable for evaluating students' e-learning experience among health and allied health professions students. The convenience sample consisted of 342 students. A validation of the instrument E-learning Experience Evaluation Scale (3E-Scale) was conducted before the study began. Factor structure, reliability, content, and face validity were assessed. Confirmatory factor analyses revealed a four-factor structure of the scale that explained 61% of the total variance. The overall scale demonstrated a high level of reliability and appears to be a reliable measurement tool. The results show that there are statistically significant differences between female and male students (p < 0.05). In addition, nursing and dietetics students perceive more barriers related to the open-source learning management system than other students (p < 0.05). Positive learning experiences contribute to greater learning satisfaction and, consequently, greater learning engagement. E-learning content design should be aligned with teaching pedagogy and learning outcomes. Future studies should also address the negative consequences of e-learning experiences.

Operative Protocol for Testing the Efficacy of Nasal Filters in Preventing Airborne Transmission of SARS-CoV-2.

BACKGROUND: Standardized methods for testing Viral Filtration Efficiency (VFE) of tissues and devices are lacking and few studies are available on aerosolizing, sampling and assessing infectivity of SARS-CoV-2 in controlled laboratory settings. NanoAg-coated endonasal filters appear a promising aid for lowering viable virus inhalation in both adult and younger populations (e.g., adolescents). OBJECTIVE: to provide an adequate method for testing SARS-CoV-2 bioaerosol VFE of bio-gel Ag nanoparticles endonasal filters, by a model system, assessing residual infectivity as cytopathic effect and viral proliferation on in vitro cell cultures. METHODS: A SARS-CoV-2 aerosol transmission chamber fed by a BLAM aerosol generator produces challenges (from very high viral loads (105 PFU/mL) to lower ones) for endonasal filters positioned in a Y shape sampling port connected to a Biosampler. An aerosol generator, chamber and sampler are contained in a class II cabinet in a BSL3 facility. Residual infectivity is assessed from aliquots of liquid collecting bioaerosol, sampled without and with endonasal filters. Cytopathic effect as plaque formation and viral proliferation assessed by qRT-PCR on Vero E6 cells are determined up to 7 days post inoculum. RESULTS: Each experimental setting is replicated three times and basic statistics are calculated. Efficiency of aerosolization is determined as difference between viral load in the nebulizer and in the Biosampler at the first day of experiment. Efficiency of virus filtration is calculated as RNA viral load ratio in collected bioaerosol with and without endonasal filters at the day of the experiment. Presence of infectious virus is assessed by plaque forming unit assay and RNA viral load variations. CONCLUSIONS: A procedure and apparatus for assessing SARS-CoV-2 VFE for endonasal filters is proposed. The apparatus can be implemented for more sophisticated studies on contaminated aerosols.

Nurse students' competences in interprofessional pharmaceutical care in Europe: Cross-sectional evaluation.

BACKGROUND: Safe pharmaceutical care requires competent nurses with specific knowledge, skills and attitudes. It is unclear whether nursing students are adequately prepared to perform pharmaceutical care in practice. Mapping their pharmaceutical care competences can lead to a better understanding of the extent to which curricula fit expectations of the labour market. OBJECTIVES: To assess pharmaceutical care competences of final-year nursing students of different educational levels. DESIGN: A cross-sectional survey design. SETTINGS: In 14 European countries, nursing schools who offer curricula for level 4 to 7 students were approached. PARTICIPANTS: Through convenience sampling 1741 final-year student nurses of level 4 to 7 were included. Sampling strategies were country-specific. METHODS: A web-platform was developed with an assessment of the level in which students mastered pharmaceutical care competences. Knowledge questions, case studies (basic/advanced level), self-reported practical skills and attitudes were evaluated. RESULTS: Mean scores for knowledge questions differed significantly (p < 0.001) between level 5 (56/100), level 6 (68/100) and level 7 students (72/100). For basic cases level 5 students reached lower scores (64/100) compared with level 6 (71/100) and level 7 (72/100) students (p = 0.002 and p = 0.005). For more advanced cases no difference between levels was observed (overall mean 61/100). Most students (63-90 %) considered themselves skilled to perform pharmaceutical care and had positive attitudes towards their participation in pharmaceutical care (65-97 %). CONCLUSIONS: Relatively low knowledge scores were calculated for final-year student nurses. In some domains, lower levels of students might be insufficiently prepared to take up responsibilities in pharmaceutical care. Our assessment can be used as a tool for educators to evaluate how prepared nursing students are for pharmaceutical care. Its further implementation for students of different educational levels will allow benchmarking between the levels, both within and between countries.

Measuring Cultural Awareness Among Slovene Nursing Student: A Cross-Sectional Study.

Background: Measurements of nursing students' cultural awareness are needed to evaluate education that intends to improve nurses' cultural competency skills. The purpose of this study was to assess the level of cultural awareness held by undergraduate nursing students. Method: A nonexperimental, cross-sectional design was applied to a purposive sample of 149 undergraduate nursing students. Data were collected based on the Cultural Awareness Scale (CAS). Results: The results show that the nursing students had a moderately high level of cultural awareness for all CAS subscales (M = 194.0). However, no statistically significant differences were seen between the students' demographic (gender and age) and other data (year of study and religion) related to the overall CAS score (p > .05). Discussion: Building on the satisfactory results obtained from this study, in the future, both the transcultural nursing contents as well as various strategies for teaching cultural competencies should be carefully evaluated.