Influence of Sleep Characteristic Changes on Nurses’ Quality of Life during Their Transition to Practice: A Prospective Cohort Study

Aim: To explore the effect of changes in sleep characteristics on changes in quality of life during the transition period of new graduate nurses. Background: Sleep problems among nurses are associated with negative physical and psychological consequences. Methods: This prospective cohort study was conducted at a tertiary hospital in South Korea. Participants included 88 newly graduated nurses. Data were collected twice, prior to shift work and after 4 months of working as a nurse, via online structured self-report questionnaires created using Survey Monkey from March 2018 to February 2020. A generalized linear mixed model was used to analyze the influence of changes in sleep characteristics on quality of life. Results: A generalized linear mixed model showed that changes in the subjective quality of sleep, subjective health perception, and daytime dysfunction influenced quality of life changes during the transition. This implies that deterioration already existed. From their undergraduate period to four months after they began working as nurses, a significant decrease was observed in the quality of sleep. Participants’ quality of life significantly decreased. Conclusions: Changes in the quality of life of new graduate nurses may show deterioration with a significant drop in subjective sleep quality. Institutions should improve existing work adaptation programs provided during new graduate nurses’ transition to practice by including information on changes in nurses’ health caused by changes in sleep characteristics and sleep quality.

Degradation of White Birch Shelterbelts by the Attack of White-Spotted Longicorn Beetles in Central Hokkaido, Northern Japan

A widespread decline of white birch (Betula platyphylla var. japonica) shelterbelts was observed in central Hokkaido, Japan. Many exit holes bored by white-spotted longicorn beetles (Anoplophora malasiaca) were found at the base of the trunks of trees in these stands. The present study aims to evaluate the effects of infestation on the degradation, and demonstrates whether the number of exit holes (Nholes) can be used as an index of the decline of trees. We selected 35 healthy appearing stands and 16 degraded stands in the study area. A generalized linear mixed model with zero inflation revealed that Nholes of standing dead trees tended to be greater than that of living trees, and the tree vigor decreased with increasing Nholes. These results implied that the degradation of the shelterbelts was caused by the beetle. We also found size-dependent mortality, i.e., only a few larvae can cause the death of smaller trees, but not larger trees. Furthermore, evaluation of the degradation at the stand level (Nholes) using a logistic regression analysis revealed that the degradation at the stand level could be predicted by Nholes. Our findings can be used as a useful index marker for diagnosing white birch shelterbelts.

Estimating COVID-19-induced Excess Mortality in Lombardy

We compare the expected all-cause mortality with the observed one for different age classes during the pandemic in Lombardy, which was the epicenter of the epidemic in Italy and still is the region most affected by the pandemic. A generalized linear mixed model is introduced to model weekly mortality from 2011 to 2019, taking into account seasonal patterns and year-specific trends. Based on the 2019 year-specific conditional best linear unbiased predictions, a significant excess of mortality is estimated in 2020, leading to approximately 35000 more deaths than expected, mainly arising during the first wave. In 2021, instead, the excess mortality is not significantly different from zero, for the 85+ and 15-64 age classes, and significant reductions with respect to the 2020 estimated excess mortality are estimated for other age classes.

STIGMATIZATION AND QUALITY OF LIFE OF MALE-TO-FEMALE- TRANSGENDER UNIVERSITY STUDENTS IN THE NORTHEAST OF THAILAND

Transgender students are vulnerable to mental and physical health problems, impacting their quality of life (QOL). This research aims to study the stigma influence on the QOL of male-to-female transgender university students in Northeastern Thailand. This cross-sectional study was conducted among 765 male-to-female transgender students selected from 17 universities of the Northeast of Thailand using a multistage random sampling to respond to a self-administered structured questionnaire. The generalized linear mixed model (GLMM) was performed to identify factors associated with quality of life when controlling the effects of covariates, presenting adjusted OR and 95% confidence intervals. Among 765 male-to-female transgender students, more than half of them had good QOL (52.81%; 95%CI = 49.25-56.33). The generalized linear mixed model (GLMM) observed that factors associated with good QOL including moderate-low stigmatization (adj.OR=6.39; 95%CI = 2.72-15.02), good health behaviors (adj.OR=1.88; 95%1.47-2.86), no stress problem (adj.OR=1.81; 95%CI = 1.30-2.51), good self-acceptance (adj.OR=1.67; 95%CI = 1.37-2.03) and good social environment (adj.OR=1.41; 95%CI = 1.13-1.76). These findings could provide data to support evidence for family, community, societal and relevant sectors under the Ministry of Public Health and Ministry of Education and local administration organizations to promote the quality of life in transgender people effectively.

Technical contribution: Use of continuous recording video monitoring of maintenance and pain behaviors in piglets after surgical castration to validate six continuous time sampling periods for behavior scoring

Castration is a painful procedure routinely performed on piglets. Specific periods relative to castration and time sampling rules are used widely to quantify deviations in piglet’s behavior associated with castration rather than assessing behavior for the entire trial period. However, very limited work has evaluated time sampling recording rules to quantify behavioral changes to piglets undergoing castration. Therefore, the objective of this study was to validate the accuracy of six continuous time sampling periods (5, 10, 15, 20, 30, and 45 min), to quantify piglet behavior post-castration when compared with a full 60 min observation period. Sixteen Yorkshire-Landrace x Duroc piglets were surgically castrated. Data was collected using continuous observation (recording rule) of each individual male piglet per litter for 60 min post-castration. The 60 min continuous behavioral data set was then subdivided into six data subsets for each defined continuous time sampling period (5, 10, 15, 20, 30, and 45 min). Data from each continuous time sampling period and the full period data were analyzed using both a generalized linear mixed model and linear regression analysis. For the generalized linear mixed model, 30 and 45 min continuous time sampling periods were not different (P > 0.05) when compared with the full observation period data for all behaviors. For the linear regression analysis, affiliative interaction, sitting, walking, huddled up, prostrated, scratching, spasms, and trembling behaviors met the pairwise comparison accuracy criteria [1) the coefficient of determination (R 2) was > than 0.90, 2) the intercept did not differ from 0 (P > 0.05), and 3) the slope did not differ from 1 (P > 0.05)] at the 45 min continuous time sampling period compared to full observation period. Results from this study suggest that a 45 min continuous time sampling period would be necessary to accurately investigate piglet behavior during the acute pain sensitivity time post-castration when considering both maintenance and pain associated behaviors.

Early kidney injury predicts disease progression in patients with COVID-19: a cohort study

Background The receptor of severe respiratory syndrome coronavirus 2 (SARS-CoV-2), angiotensin-converting enzyme 2, is more abundant in kidney than in lung tissue, suggesting that kidney might be another important target organ for SARS-CoV-2. However, our understanding of kidney injury caused by Coronavirus Disease 2019 (COVID-19) is limited. This study aimed to explore the association between kidney injury and disease progression in patients with COVID-19. Methods A retrospective cohort study was designed by including 2630 patients with confirmed COVID-19 from Huoshenshan Hospital (Wuhan, China) from 1 February to 13 April 2020. Kidney function indexes and other clinical information were extracted from the electronic medical record system. Associations between kidney function indexes and disease progression were analyzed using Cox proportional-hazards regression and generalized linear mixed model. Results We found that estimated glomerular filtration rate (eGFR) and creatinine clearance (Ccr) decreased in 22.0% and 24.0% of patients with COVID-19, respectively. Proteinuria was detected in 15.0% patients and hematuria was detected in 8.1% of patients. Hematuria (HR 2.38, 95% CI 1.50–3.78), proteinuria (HR 2.16, 95% CI 1.33–3.51), elevated baseline serum creatinine (HR 2.84, 95% CI 1.92–4.21) and blood urea nitrogen (HR 3.54, 95% CI 2.36–5.31), and decrease baseline eGFR (HR 1.58, 95% CI 1.07–2.34) were found to be independent risk factors for disease progression after adjusted confounders. Generalized linear mixed model analysis showed that the dynamic trajectories of uric acid was significantly related to disease progression. Conclusion There was a high proportion of early kidney function injury in COVID-19 patients on admission. Early kidney injury could help clinicians to identify patients with poor prognosis at an early stage. Graphic abstract

Quality of Life in Patients With Velopharyngeal Insufficiency in West China

Objective This study aimed to investigate the quality of life (QOL) of patients with cleft lip and palate and velopharyngeal insufficiency (VPI) in relation to sex, age, age at initial cleft lip surgery, and age at initial cleft palate surgery. Design This is a cross-sectional study. Setting The study was conducted in a tertiary medical center. Participants The participants were caregivers of 72 patients with cleft lip and palate and VPI aged 4 to 20 years. Main Outcome Measure(s) Participants completed the Chinese version of the caregiver report of the VPI Effects on Life Outcomes (VELO) questionnaire. The Mann–Whitney U test was used to evaluate the patients’ sex, age, age at initial cleft lip repair, and age at initial cleft palate repair in relation to VELO total score and domains. Spearman correlation analysis was completed including all study variables. Associations between the study variables and the VELO total score were tested using a generalized linear mixed model. Results In the univariate analysis, patients’ age and age at initial cleft palate surgery influenced the QOL of patients with VPI. There were no differences in the VELO total score or domains based on sex or age at first cleft lip surgery. In the generalized linear mixed model, patients older than 8 years had higher VELO total scores. Conclusions By caregiver report, the QOL of patients under age 8 years with VPI was lower than older patients. In addition, the caregiver impact domain was higher for parents of children who had their initial cleft palate surgery at age 2 years or younger.

Slowed Saccadic Reaction Times in Seemingly Normal Parts of Glaucomatous Visual Fields

Purpose: In eye movement perimetry, peripheral stimuli are confirmed by goal-directed eye movements toward the stimulus. The saccadic reaction time (SRT) is regarded as an index of visual field responsiveness, whereas in standard automated perimetry (SAP), the visual field sensitivity is tested. We investigated the relation between visual field sensitivity and responsiveness in corresponding locations of the visual field in healthy controls and in patients with mild, moderate and advanced glaucoma.Materials and Methods: Thirty-four healthy control subjects and 42 glaucoma patients underwent a 54-point protocol in eye movement perimetry (EMP) and a 24-2 SITA standard protocol in a Humphrey Field Analyzer. The visual field points were stratified by total deviation sensitivity loss in SAP into 6 strata. A generalized linear mixed model was applied to determine the influence of the various factors.Results: The generalized linear mixed model showed that the mean SRT increased with increasing glaucoma severity, from 479 ms in the control eyes to 678 ms in the eyes of patients with advanced glaucoma (p < 0.001). Mean SRTs significantly increased with increasing SAP sensitivity loss. Even at the locations where no sensitivity loss was detected by SAP (total deviation values greater or equal than 0 dB), we found lengthened SRTs in mild, moderate and advanced glaucoma compared to healthy controls (p < 0.05) and in moderate and advanced glaucoma compared to mild glaucoma (p < 0.05). At locations with total deviation values between 0 and −3 dB, −3 and −6 dB and −6 and −12 dB, we found similar differences.Conclusions: The lengthened SRT in areas with normal retinal sensitivities in glaucomatous eyes, i.e., planning and execution of saccades to specific locations, precede altered sensory perception as assessed with SAP. Better understanding of altered sensory processing in glaucoma might allow earlier diagnosis of emerging glaucoma.