Burnout and psychological distress among nurses in a Nigerian tertiary health institution

Background

The role of nurses in the health care delivery system cannot be overemphasized. Nurses are needed at all levels of healthcare and the profession requires a lot of dedication, time and energy with regards to patient management and service delivery. This time investment and dedication to duty is likely to lead to burnout and psychological distress among the nurses.

Objective

This study assesses the prevalence of burnout and psychological distress among nurses working in Nigerian tertiary health institution.

Method

The Maslach Burnout Inventory (MBI) and the General Health Questionnaire (GHQ-12) were used to assess 210 nurses working in this health institution for symptoms of burnout and psychological distress.

Results

High levels of burnout were identified in 42.9% of the respondents in the area of emotional exhaustion, 47.6% in the area of depersonalization and 53.8% in the area of reduced personal accomplishment, while 44.1% scored positive in the GHQ-12 indicating presence of psychological distress.

Conclusion

Prevalence of burnout and psychological distress is high among nurses.     

Protective and therapeutic effect of hydrogen sulfide on hemorrhagic cystitis and testis dysfunction induced with cyclophosphamide

Backround/aimCyclophosphamide (CP) is a drug used for treatment of many malignant diseases. However, it can cause serious side effects such as hemorrhagic cystitis and male infertility. Hydrogen sulfide (H2S) is a gaseous mediator and is suggested to have antioxidant, antiinflammatory, and antiapoptotic effects. In this study, dose-dependent effects of H2S donor sodium hydrosulfide (NaHS) on cyclophosphamide-induced hemorrhagic cystitis and testicular dysfunction were investigated in rats.Material and methodsRats were divided into 5 groups (n = 8): control, CP, NaHS25 μmol/kg, NaHS50 μmol/kg, and NaHS100 μmol/ kg. After treatment for 7 days intraperitoneally (ip), a single ip dose of CP 200 mg/kg was given on the 8th day. Then, treatment was continued for 7 days. In bladder and testicular tissues, IL 6, IL 10, cGMP, NO, H2S, FSH, LH, and testosterone levels were measured by ELISA. Histopathological examination with H&E staining, as well as immunohistochemical staining for acrolein in bladder and caspase-3 and APAF-1 in testis were performed.ResultsNaHS prevented the increased IL 6 and IL 10 values induced by CP as well as prevented the decrease in cGMP values associated with CP. There was no significant change in FSH values, but the LH value, which increased with CP, decreased with 25, 50, and 100 μmol/kg NaHS. In contrast, testosterone decreased in the CP group and increased in the treatment groups. NaHS was effective in many biochemical and histopathological parameters at 25 and 50 μmol/kg doses, and this effect decreased at 100 μmol/kg dose.ConclusionH2S has a protective and therapeutic effect on hemorrhagic cystitis and testicular dysfunction induced by cyclophosphamide. It can be suggested that H2S is a promising molecule in facilitating cancer treatment.     

Next generation sequencing analysis of consecutive Russian patients with clinical suspicion of inborn errors of immunity

Primary immune deficiencies are usually attributed to genetic defects and, therefore, frequently referred to as inborn errors of immunity (IEI). We subjected the genomic DNA of 333 patients with clinical signs of IEI to next generation sequencing (NGS) analysis of 344 immunity-related genes and, in some instances, additional genetic techniques. Genetic causes of the disease were identified in 69/333 (21%) of subjects, including 11/18 (61%) of children with syndrome-associated IEIs, 45/202 (22%) of nonsyndromic patients with Jeffrey Modell Foundation (JMF) warning signs, 9/56 (16%) of subjects with periodic fever, 3/30 (10%) of cases of autoimmune cytopenia, 1/21 (5%) of patients with unusually severe infections and 0/6 (0%) of individuals with isolated elevation of IgE level. There were unusual clinical observations: twins with severe immunodeficiency carried a de novo CHARGE syndrome-associated SEMA3E c.2108C>T (p.S703L) allele; however, they lacked clinical features of CHARGE syndrome. Additionally, there were genetically proven instances of Netherton syndrome, Х-linked agammaglobulinemia, severe combined immune deficiency (SCID), IPEX and APECED syndromes, among others. Some patients carried recurrent pathogenic alleles, such as AIRE c.769C>T (p.R257*), NBN c.657del5, DCLRE1C c.103C>G (p.H35D), NLRP12 c.1054C>T (p.R352C) and c.910C>T (p.H304Y). NGS is a powerful tool for high-throughput examination of patients with malfunction of immunity.     

IL-21在ITP中的表达及大剂量地塞米松对其调控的研究

目的:探究免疫性血小板减少症(immunologic thrombocytopenia,ITP)与IL-21表达异常的相关性,同时探究大剂量地塞米松(high-dose dexamethasone,HD-DXM)冲击治疗ITP的疗效是否与IL-21有关。方法:抽取26例初诊ITP患者及24例健康人的外周血10 ml,密度梯度离心法获得血清及单个核细胞,分别采用流式细胞术和实时荧光定量PCR法检测单个核细胞IL-21的表达,采用酶联免疫吸附实验(ELISA)检测ITP治疗前后及正常对照者血浆中IL-21,IFN-γ和IL-4的水平。结果:流式细胞术测定发现,ITP患者单个核细胞表面分子IL-21表达明显高于健康对照(13.07%vs 8.2%);ITP患者IL-21 mRNA(9.524±0.97)与健康对照组(3.701±0.60)存在显著统计学差异,经HD-DEX治疗后IL-21 mRNA的比率值(5.87±1.21)较治疗前显著降低(P0.01);ITP患者血清中IL-21和IFN-γ水平与健康对照组和HD-DEX治疗组相比均具有显著的统计学差异(P0.01);而IL-4在治疗后含量却上调,与治疗前相比有统计学意义。结论:IL-21的表达异常参与了ITP发病过程,地塞米松对ITP的疗效与下调IL-21表达有关。     

对苯二甲酸中微量杂质HPLC分析条件的优化

用离子交换高效液相色谱法分析对苯二甲酸中的微量杂质，并对该方法进行了系统的优化。通过选择流动相pH值使缓冲溶液的浓度降低至0．13mol／L，分析周期缩短至10min以下。结果表明：该方法的工作曲线相关系数在0．9998以上，回收率为98．7％～102．2％，相对标准偏差小于3．6％。     

The prevalence of psychiatric morbidity on a coronary care ward

Numerous studies have documented the high prevalence of psychological and emotional disorders in patients seen in general medical settings. However, despite the emphasis placed on holistic approaches to nursing care in all professional models of nursing practice, much of this distress is still missed by nursing staff. The Hospital Anxiety and Depression (HAD) scale is an easy-to-use self-administered screening instrument purportedly designed to detect psychological distress amongst hospitalized patients with physical illnesses. On using the HAD scale on patients admitted to a coronary care ward of a district general hospital, 44% were found to be suffering high levels of anxiety or depression. This figure is consistent with the results of similar studies in other cardiac wards and out-patient clinics. In most cases, the levels of distress found were not sufficiently severe to warrant seeking specialist psychiatric support. Instead, there is much that the general nurse can do to alleviate the understandable fears and worries of patients being treated for cardiac disease. However, to respond appropriately, nursing staff must be able to identify psychological distress in patients. The HAD scale, if it can be validated in cardiac in-patient settings, provides an instrument which could easily become part of the routine assessment of patients' nursing needs.     

Characterization of β-lactamase from Escherichia coli with drug-resistance to ceftazidine

Ceftazidine belongs to the third generationcephalosporin. It offers improved anti-microbialactivities against most Gram-negative enteric bac-teria and is generally used to treat severe infec-tions .The development of drug-resistance to cef-tazidine is mainly based on the production of theextended spectrumβ-lactamases(ESBLs) .In thepresent study,the characterizationofβ-lactamasesfromtwo strains ofEscherichia coliresistant toceftazidine was performed by biochemical testingand nucleic acidtec…     

BLOOD-TESTIS BARRIER: Maintained Function of Inter-Sertoli Cell Junctions in Experimental Cryptorchidism in the Rat, as Judged by a Simple Lanthanum-Immersion Technique

In order to elucidate the mechanisms behind the deleterious effects on the germinal epithelium of experimental cryptorchidism the hypothesis that a leaking blood-testis barrier is the cause of the damage was tested. The permeability of the specialized inter- Sertoli cell junctions to lanthanum after experimental cryptorchidism for 0.5 to 12 days was studied in the rat. In none of the time periods studied lanthanum had penetrated beyond the inter-Sertoli cell junctions. A simple lanthanum immersion technique was used. Testes of 15-days old rats (before the development of the barrier) were used as a positive control of the method, and in these testes lanthanum had penetrated up to the future lumen.

Zusammenfassung

Um den Mechanismus zu erklären, der für die schädigenden Einflüsse auf das Keimepithel bei experimentellem Kryptorchismus verantwortlich ist, wurde die Hypothese untersucht, wonach eine durchlässige Blut-Hoden-Schranke Ursache dieser Schäden ist. Die Permeabilität der besonders ausgebildeten Inter-Sertoli-Zell-Verbindungen für Lanthanum nach exp. Kryptorchismus wurde 0, 5 bis 12 Tage lang bei Ratten studiert. Zu keinem Zeitpunkt dieser Studie penetrierte Lanthanum durch die Inter-Sertoli-Zell- Verbindungen. Methodisch wurde eine einfache Lanthanum-Immersions-Technik benutzt. Man verwendete 15 Tage alte Ratten (vor der Entwicklung der genannten Schranke) als positive Kontrolle; in diesen Fällen war Lanthanum bis in das Lumen penetriert.