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PurposeIntensive Care Unit (ICU) staff report that a large part of the work-related distress they experience is related to communication situations with colleagues, patients, and relatives. Based on these findings, the aim of the present study was to preliminary evaluate the effects of a novel Communication Skills Training (CST) program on mental health among ICU staff.MethodsThe CST program was delivered to the entire work force of an ICU at a Swedish hospital and was evaluated as an uncontrolled clinical trial with three repeated measures. 100 participants were eligible and included in the analyses. The theoretical framework for the program was learning theory and cognitive behavioral therapy. The program was delivered by two psychologists and included one full-day lecture and three subsequent two-hour supervision sessions. Changes in mental health was evaluated with self-report questionnaires measuring perceived stress, general mental health, work engagement, and psychological flexibility.ResultsAnalyses of three repeated measures showed significant improvements with 1.3 points lower perceived stress and 2.0 points lower general mental health after the intervention. No differences were seen in measures of work engagement or psychological flexibility.ConclusionFindings of the study supports the utility of the CST program as an intervention to target perceived stress and general mental health within intensive care. These findings should be further validated in trials with improved design.

Vascular smooth muscle cell plasticity plays a pivotal role in the pathophysiology of vascular diseases. Despite compelling evidence demonstrating the importance of transcription factor GATA6 in vascular smooth muscle, the functional role of GATA6 remains poorly understood. The aim of this study was to elucidate the role of GATA6 on cell migration and to gain insight into GATA6-sensitive genes in smooth muscle. We found that overexpression of GATA6 promotes migration of human coronary artery smooth muscle cells in vitro, and that silencing of GATA6 in smooth muscle cells resulted in reduced cellular motility. Furthermore, a complete microarray screen of GATA6-sensitive gene transcription resulted in 739 upregulated and 248 downregulated genes. Pathways enrichment analysis showed involvement of transforming growth factor beta (TGF-β) signaling which was validated by measuring mRNA expression level of several members. Furthermore, master regulators prediction based on microarray data revealed several members of (mitogen activated protein kinase) MAPK pathway as a master regulators, reflecting involvement of MAPK pathway also. Our findings provide further insights into the functional role of GATA6 in vascular smooth muscle and suggest that targeting GATA6 may constitute as a new approach to inhibit vascular smooth muscle migration.

The COVID-19 pandemic highlighted the need for psychological support initiatives directed toward frontline healthcare workers, which can be rapidly and sustainably implemented during an infectious disease outbreak. The current case study presents a comprehensive model of psychological support that was implemented at an intensive care unit (ICU) during the first wave of the COVID-19 pandemic. The psychological support model aimed at promoting a resilient stress reaction among frontline staff by protecting physical, social, and psychological resources. The initiatives, targeting different groups of workers, included education and training, peer support, psychologist-supervised and unsupervised group sessions, on-boarding for transferred staff, manager support, and individual sessions for workers experiencing strong stress reactions. The results of the process evaluation of this rapid implementation suggest that peer support initiatives as well as daily group sessions were the most appreciated forms of psychological support. Psychologists involved in organizing and providing the support highlighted several aspects of a successful implementation of the support model: offering support during work hours (preferably after shift), positive attitude of line managers that framed support initiatives as a team effort, and involvement of experienced psychologists able to quickly adjust the content of the support according to the current needs. The study also identified two main problems of the current implementation: the lack of efficient planning due to the use of volunteer work and the need for more structural resources on the organizational level to ensure long-term sustainability of the support model and its implementation among all groups of healthcare staff. The current case study highlights the importance of establishing permanent structural resources and routines for psychological support integrated in clinical practice by healthcare organizations to improve both rapid and sustainable response to future crises.

Intensive care settings place specific work-related demands on health care professionals that may elicit stress and negatively influence occupational health and work engagement. Psychological flexibility has emerged as a promising construct that could help explain variation in reported health. Understanding the role of psychological flexibility in occupational psychological health among intensive care medical staff may potentially guide the development of effective interventions. Thus, the present study evaluated the relationships between psychological flexibility (Work-related Acceptance and Action Questionnaire), distress (Perceived Stress Scale, General Health Questionnaire) and work engagement (Utrecht Work Engagement Scale) in a sample of 144 health care professionals from one adult (ICU, N = 98) and one pediatric (PICU, N = 46) intensive care unit. In addition to cross-sectional analyses, a subset of data (PICU, N = 46) was analyzed using a longitudinal design. Results illustrated that higher levels of distress were associated with lower levels of work engagement. Furthermore, psychological flexibility was related to greater work engagement, and psychological flexibility had a significant indirect effect on the relationship between distress and work engagement. Lastly, increased psychological flexibility over time corresponded with increased work engagement. Although tentative, the results suggest the importance of psychological flexibility for work engagement in health care professionals within intensive care settings.

Aortic aneurysms are defined as an irreversible increase in arterial diameter by more than 50% relative to the normal vessel diameter. The incidence of aneurysm rupture is about 10 in 100,000 persons per year and ruptured arterial aneurysms inevitably results in serious complications, which are fatal in about 40% of cases. There is also a hereditary component of the disease and dilation of the ascending thoracic aorta is often associated with congenital heart disease such as bicuspid aortic valves (BAV). Furthermore, specific mutations that have been linked to aneurysm affect polymerization of actin filaments. Polymerization of actin is important to maintain a contractile phenotype of smooth muscle cells enabling these cells to resist mechanical stress on the vascular wall caused by the blood pressure according to the law of Laplace. Interestingly, polymerization of actin also promotes smooth muscle specific gene expression via the transcriptional co-activator MRTF, which is translocated to the nucleus when released from monomeric actin. In addition to genes encoding for proteins involved in the contractile machinery, recent studies have revealed that several non-coding microRNAs (miRNAs) are regulated by this mechanism. The importance of these miRNAs for aneurysm development is only beginning to be understood. This review will summarize our current understanding about the influence of smooth muscle miRNAs and actin polymerization for the development of arterial aneurysms.