Background: Ethical challenges are common in clinical nursing practice, and an infectious environment could put nurses under ethical challenges more easily, which may cause nurses to submit to negative emotions and psychological pressure, damaging their mental health. Purpose: To examine the ethical challenges encountered by nurses caring for patients with the novel coronavirus pneumonia (COVID-19) and to provide nurses with suggestions and support regarding promotion of their mental health. Research design and method: A qualitative study was carried out using a qualitative content analysis. The participants were 18 nurses who agreed to attend an interview and describe their own experiences of providing care to COVID-19 patients in China. They were purposively sampled, and structured, in-depth interviews were performed. Data were iteratively collected and analyzed from February to March 2020. Ethical considerations: The proposal was approved by the Research Ethics Committee of the Second Hospital of Shandong University, China. Findings: The findings revealed three main themes and 10 categories. The themes were the following: (1) ethical challenges (people with COVID-19, inequality, professional ethics, and job competency); (2) coping styles (active control and planning, seeking support as well as catharsis, and staying focused); and (3) impacts on career (specialized nursing skills, scientific research ability, and management skills). Conclusion: Nurses faced ethical challenges on multiple fronts in caring for COVID-19 patients. The results may help nurses with more safety, ethics, and humanistic care in nursing practice.
long non-coding rna (lncrna) and exosomes are involved in the pathological process of alzheimer's disease (ad), the pathological changes of which are usually first observed in the entorhinal cortex and hippocampus. The aim of the present study was to determine whether the measurement of plasma exosomal lncrna combined with image data of the entorhinal cortex and hippocampus could be used as a biomarker of ad. a total of 72 patients with ad and 62 controls were recruited, and the expression levels of several lncrnas were assessed. of the recruited participants, 22 patients and 26 controls received brain 3d-BraVo sequence magnetic resonance imaging (Mri) scans, which were analyzed using an automated analysis tool. The plasma exosomal β-site amyloid precursor protein cleaving enzyme-1-antisense transcript (BACE1-AS) levels in patients with AD were significantly higher compared with the controls (P<0.005). receiver operating characteristic curve analysis revealed that the area under the curve (auc) was 0.761 for Bace1-aS, the sensitivity was 87.5%, and the specificity was 61.3%. Analysis of MRI images indicated that the right entorhinal cortex volume (P=0.015) and thickness (P= 0.022) in patients with AD were significantly smaller. The auc was 0.688 for the right entorhinal cortex volume, with a sensitivity of 59.1%, and the specificity was 84.6%. The auc was 0.689 for right entorhinal cortex thickness, with a sensitivity of 80.8%, and the specificity was 59.1%. a series-parallel test which integrated the Bace1-aS with the right entorhinal cortex volume and thickness, raised the specificity and sensitivity to 96.15 and 90.91%, respectively. a logistic regression model demonstrated that combination of the 3 indices provided improved sensitivity and specificity simultaneously, particularly when adjusting for age and sex (AUC, 0.819; sensitivity, 81%; specificity, 73.1%). The results of the present study demonstrated that detection of plasma exosomal Bace1-aS levels combined with the volume and thickness of the right entorhinal cortex may be used as a novel biomarker of ad.
The molecular mechanisms underlying sevoflurane (SEVO)-induced impairment of learning and memory remain unclear. Specifically, a role of microRNAs (miRNAs) in the control of the neuron proliferation in the developing brain exposed to SEVO has not been reported previously. Here, we studied the effects of SEVO exposure on the neural cell proliferation, and on the learning and memory of neonatal rats. We found that SEVO exposure significantly decreased neuron cell proliferation, reduced BDNF levels in brain, and impaired learning and memory of neonatal rats in Morris water maze test and Plus-Maze discriminative avoidance task (PM-DAT), likely through downregulation of CCNA2 protein. Next, we used bioinformatic tools to predict CCNA2-binding microRNAs (miRNAs), and found that miR-19-3p was upregulated in neurons exposed to SEVO. Moreover, miR-19-3p functionally inhibited the protein translation of CCNA2 in a human neural cell line, HCN-2. Furthermore, intracranial injection of adeno-associated virus carrying antisense of miR-19-3p under a CMV promoter into the neonatal rats significantly alleviated SEVO exposure-induced impairment of neuron cell proliferation, as well as the learning and memory of the rats. Together, our data suggest that SEVO-induced upregulation of miR-19-3p post-transcriptionally inhibits CCNA2, which contributes to the SEVO-associated impairment of learning and memory of the neonatal rats.
Purpose To explore the ethical experiences of new nurse managers when working at their units and propose response strategies accordingly. Design and methods A qualitative approach was taken at a Grade 3A hospital in Shandong, China. Data were collected via semi‐structured long interviews and analyzed using interpretative phenomenological analysis. A total of 19 new frontline nurse managers participated in the study. Findings The sample consisted of 17 females and two males, with an age range of 40.11 ± 2.71 years and each worked in a variety of units. Trust crisis, tests on capability, and conflicts with the administration were the main ethical issues of new nurse managers, and trust crisis was the most common, especially with nurses in the unit. Eleven subthemes were also involved in these three themes. Conclusions New nurse managers encountered a variety of ethical conflicts and dilemmas in their first year. They should enhance their leadership to cope with the issues, and policy support at the hospital level is also needed. Clinical relevance Senior hospital managers could use these findings to design interventions that might solve new frontline nurse managers’ ethical issues. And medical staff might understand the ethical experiences of new nurse managers and support them in the most critical period of role transition. Findings are conducted in the hope of facilitating new nurse managers to quickly settle into the new position, establishing a good relationship with physicians and patients and improving the quality of nursing services.
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