Search

Aim To investigate the role stressors, and how coping strategies cultivated nurse managers' resilience in rural workplaces. Background A stressful workplace can impair the mental and physical health of nurse managers leading to poor performance. Building and sustaining manager resilience in complex and stressful practice environments is necessary to attract and maintain competent and skilled managers. Method In this qualitative exploratory inquiry, a purposive sampling method was used to recruit 16 nurse managers in rural western Canada. Results Coping strategies fostered manager's resilience that made their work meaningful, and included putting out fires, psychologically reframing a situation, serving others and receiving support. Conclusions Managers brought expertise, knowledge and skill to make their work meaningful and central to ongoing health service delivery in these rural communities. Nurse manager resilience can be strengthened by using evidence-based strategies in an increasingly complex health care environment. Implications for nursing management Managers need to be supported and encouraged to develop awareness of their own protective factors as they cope with challenging situations. Building resilience through formal education, social support and meaningful recognition is an important focus for nurse leaders in establishing a healthy work environment and maintaining a stable nursing workforce.

International students are at heightened risk of developing psychological distress, yet little research has been conducted on their mental health or support needs. This quantitative study focused on undergraduate students at two mid-sized universities in Manitoba, Canada. Online and paper surveys were completed by 932 participants, of whom 21% identified as international students. This paper, descriptive in nature, outlines the sociodemographic profiles, current mental health status, psychological characteristics, and coping strategies of international students compared to domestic students in each institution. Data show that international students are more likely to report excellent mental health, score higher on the mental health scale, and report higher life satisfaction, higher self-esteem, and more positive body image than domestic respondents. However, they are less likely to talk about their hardships. Providing culturally-adapted supports that take into consideration ethnolinguistic differences, religious practice, and mental health literacy will better meet the needs of international students on campus.

Purpose In this exploratory study, the effect of postprocedural flushing with crystalloids after oxaliplatin-based hyperthermic intraperitoneal chemotherapy (HIPEC) on platinum concentrations in peritoneal tissue, blood, and drain fluid was studied. Interpatient variability in oxaliplatin pharmacokinetics and the relation between platinum concentration in peritoneal fluid and platinum exposure in tissue and blood was explored. Methods Ten patients with peritoneal carcinomatosis of colorectal origin were treated with HIPEC including postprocedural flushing, followed by ten patients without flushing afterwards. Tissue, peritoneal fluid, blood, and drain fluid samples were collected for measurement of total and ultrafiltered platinum concentrations. Results Peritoneal tissue concentration and systemic ultrafiltered platinum exposure showed large inter individual variability, ranging from 65 to 1640 µg/g dry weight and 10.5 to 28.0 µg*h/ml, respectively. No effect of flushing was found on geometric mean platinum concentration in peritoneal tissue (348 vs. 356 µg/g dry weight), blood (14.8 vs. 18.1 µg*h/ml), or drain fluid (day 1: 7.6 vs. 7.7 µg/ml; day 2: 1.7 vs. 1.9 µg/ml). The platinum concentration in peritoneal fluid at the start of HIPEC differed twofold between patients and was positively correlated with systemic exposure (p = .04) and peak plasma concentration (p = .04). Conclusion In this exploratory study, no effect was found for postprocedural flushing on platinum concentrations in peritoneal tissue, blood, or drain fluid. BSA-based HIPEC procedure leads to large interpatient variability in platinum exposure in all compartments. The study was registered at ClinicalTrials.gov on 7 December 2017 under registration number NCT03364907.

A study regarding the role and uniqueness of psychiatric nursing was conducted with 94 participants from Manitoba, Canada. The primary theme of comprehensive knowledge of mental health, mental illness, and addictions was foundational for the application of the sub-themes of therapeutic relationship, holistic approach, recovery orientation, stigma reduction, and advocacy for change. Values, beliefs, and attitudes towards people with mental illness and addictions need to be instilled in psychiatric nursing students throughout their educational program to provide high quality, compassionate, and safe care. Implications for incorporation of the theme and sub-themes into psychiatric nursing curriculum are described in the paper.

OBJECTIVES While clinical guidelines exist for the management of bipolar disorder (BD), there are significant challenges to their widespread dissemination and implementation in clinical practice. The Canadian Network of Mood and Anxiety Treatment Improving Patient Care and Outcomes in the Treatment of Bipolar Disorder (C-IMPACT BD) web-based application was developed for use at the point-of-care to improve adherence to guidelines for evidence-based pharmacological management of BD. METHODS C-IMPACT BD uses a point-of-care practice assessment which, via adaptive questioning of patient-specific information, text/video descriptions of the guidelines, and pop-up prompts delivers personalized, evidence-based treatment recommendations for patients with BD. In order to inform quality improvement of the newly developed tool, a sample of Canadian physicians were invited to use the application and record its influence on their prescribing behavior. RESULTS Of 375 patients with bipolar I (BD-I) or bipolar II (BD-II) disorder for whom a point-of-care practice assessment was completed, a change in therapy was considered for 225 (60.0%). Prior to completing the assessment, 59.6% of these patients were receiving first-line therapy recommended for their phase of illness. Following the assessment, the overall number of patients for whom a first-line recommended therapy was being considered increased significantly to 76.9% (p = 0.0001). CONCLUSIONS Outcomes suggest that the C-IMPACT BD web-based application has the potential to improve physician adherence to clinical treatment guidelines. Formal research investigations are warranted to explore the impact of this tool on physician prescribing behavior and patient outcomes.

This study aimed to find out the significant relationship between the educational change amidst COVID-19 and the well-being of the teachers at Calauan District. This study utilized the descriptive-correlation type of research. The respondents are composed of the one hundred fifty-six (156) public elementary school teacher in Calauan District for the school year 2020-2021 and the total enumeration was employed in selecting the respondents of the study. The study found that the respondents perceived educational change to teacher’s well-being in terms of physical health found to be significantly related. However, mental health found no significant relationship to educational change. Based on the above findings the following recommendations are set forth: The teachers may continue using blended learning when normal schooling starts since modular distance learning taught students the value of self-reliance, independence and being responsible in their studies which may help them minimize the bulk of workloads in everyday teaching if the school permit. Despite the “no significant” relationship was found between the educational change and well-being in terms of mental and emotional health of the teachers, it is still advised by the researcher that changes in education with or without Coronavirus pandemic should not limit themselves from taking care of their well-being. Health must be the first priority without neglecting the duties and responsibilities of being a teacher. Teachers may consider to prioritize well-being no matter how busy or how many workloads they may have, still healthy mind and body matters most to do the job well.

Introduction: Neoadjuvant chemotherapy (CT) for locally advanced colon cancer (LACC) could potentially lead to tumor shrinkage, eradication of micrometastases, and prevention of tumor cell shedding during surgery. This retrospective study investigates the surgical and oncological outcomes of preoperative CT for LACC. Methods: Using the Netherlands Cancer Registry, data of patients with stage II or III colon cancer, diagnosed between 2008 and 2016 was collected. A propensity score matching (PSM; 1:2) was performed and compared patients with clinical tumor (cT) 4 colon cancer who were treated with neoadjuvant CT to patients with cT4 colon cancer treated with adjuvant CT (Fig. 1). Results: A total of 192 patients treated with neoadjuvant CT were compared to 1,954 patients that received adjuvant CT. After PSM, 149 patients in the neoadjuvant group were compared to 298 patients in the control group. No significant differences were found in baseline characteristics after PSM. After neoadjuvant CT, a significant response was observed in 13 (9%) patients with 5 (4%) patients showing a complete response. Complete resection margins (R0) were achieved in 77% in the neoadjuvant group versus 86% in the adjuvant treated group (p = 0.037). Significantly less tumor positive lymph nodes were found in the neoadjuvant group (median 0 vs. 2, p < 0.001). Major complication rates and 5-year overall survival did not differ between both groups (67–65%, p = 0.87). Conclusion: Neoadjuvant CT seems safe and feasible with similar long-term survival compared to patients who are treated with adjuvant CT.

Many Qatari families are opting to have their children educated at international schools with curricula based upon western thought and educational standards. Exploring the perceptions of Qatari ado...

Intraoperative image guidance may aid in clinical decision-making during surgical treatment of colorectal cancer. We developed the dual-labeled carcinoembryonic antigen-targeting tracer, [SGM-101 was conjugated with p-isothiocyanatobenzyl-diethylenetriaminepentaacetic acid (DTPA) and labeled with Indium-111 (The optimal protein dose of [[