We examined the serum levels of IL-6, IL-8, TNF, IL-6R, TNF-R1, and CRP and the dynamics of changes in these levels according to age. The study included healthy individuals of 20–90 years of age. Participants were divided into subgroups based on their decade of life, and into subgroups of ≥65 or <65 years. Serum cytokine levels were assayed by ELISA, and CRP using an immunoturbidimetric method. Serum CRP levels were within the normal range for all subgroups. The 60- to 70-year age group showed higher CRP than the 20- to 30- (p = 0.003), 30- to 40- (p = 0.009), and 40- to 50- (p = 0.030) year age groups. Serum cytokine levels were low. It was greater in the 60- to 70-year age group than in the 20- to 30- (p = 0.008) and 30- to 40- (p = 0.040) year groups, and was greater in the 70- to 90-year group than the 20- to 30-year group (p = 0.043). Serum TNF-R1 level in the 70- to 90-year group was greater than in all other age groups (p = 0.000 for all comparisons). Other measured parameters did not differ between groups. Serum levels of IL-6, CRP, and TNF-R1 were greater in participants ≥65 than <65 years of age. Healthy older people showed low serum levels of CRP and pro-inflammatory cytokines, but higher than in younger population. Therefore, the adjustment of normal ranges in the elderly should be considered. Serum levels of pro-inflammatory cytokines elevated beyond normal ranges indicate particular diseases.

ObjectivesSafe pharmaceutical care (PC) requires an interprofessional team approach, involving physicians, nurses and pharmacists. Nurses’ roles however, are not always explicit and clear, complicating interprofessional collaboration. The aim of this study is to describe nurses’ practice and interprofessional collaboration in PC, from the viewpoint of nurses, physicians and pharmacists.DesignA cross-sectional survey.SettingThe study was conducted in 17 European countries, each with their own health systems.ParticipantsPharmacists, physicians and nurses with an active role in PC were surveyed.Main outcome measuresNurses’ involvement in PC, experiences of interprofessional collaboration and communication and views on nurses’ competences.ResultsA total of 4888 nurses, 974 physicians and 857 pharmacists from 17 European countries responded. Providing patient education and information (PEI), monitoring medicines adherence (MMA), monitoring adverse/therapeutic effects (ME) and prescribing medicines were considered integral to nursing practice by 78%, 73%, 69% and 15% of nurses, respectively. Most respondents were convinced that quality of PC would be improved by increasing nurses’ involvement in ME (95%), MMA (95%), PEI (91%) and prescribing (53%). Mean scores for the reported quality of collaboration between nurses and physicians, collaboration between nurses and pharmacists and interprofessional communication were respectively <7/10, ≤4/10, <6/10 for all four aspects of PC.ConclusionsME, MMA, PEI and prescribing are part of nurses’ activities, and most healthcare professionals felt their involvement should be extended. Collaboration between nurses and physicians on PC is limited and between nurses and pharmacists even more.

ObjectivesIn the present study, we aimed to investigate the prevalence of bullying among Polish nurses, and to identify the most common negative acts, as well as individual and work-related risk factors for workplace bullying.MethodsCross-sectional study designed using an online survey. The total study sample was 404 nurses, each having over 6 months of working experience. Data were collected using the Polish version of the Negative Act Questionnaire-Revised. Linear stepwise regression analysis and logistic regression analysis were performed to assess predictors of greater reporting of perceived workplace bullyingResultsBullying was experienced by 65.84% of participants. Perceived workplace bullying was associated with sex (p=0.043), age (p=0.003), seniority (p=0.006), number of working hours per week (p=0.010) and position (p=0.029). Logistic regression analysis with the dependent variable of bullying according to Leymann’s rigorous criteria revealed that the model could include four variables: age from 50 to 59, seniority of 11–15 years,>45 working hours per week and a bachelor’s degree in nursing.ConclusionsAn alarming percentage of nurses were victims of bullying. Among all variables included in the regression model, the most significant predictors of perceived workplace bullying were age, seniority, work overtime and bachelor’s degree education. Bullying prevention and improvement of well-being at work must be addressed as part of an overall strategy to deal with turnover.

Aims:To report a synthesis of the empirical studies that used the Negative Acts Questionnaire-Revised (NAQ-R) to assess bullying among nurses based on evaluation of the psychometric properties and use and usability of the instrument and identification of the variables associated with bullying.Design: Systematic review and meta-analysis. Data sources: Four databases were used in the literature search: PubMed, CINAHL, PsycINFO and Scopus. The search was limited to original publications describing results of empirical studies written in English or Polish and published in peer-reviewed journals between 2002 and 2018.Review methods: Two reviewers independently assessed eligibility, extracted data and conducted quality assessment. Based on the extracted data, three separate meta-analyses were conducted.Results: Thirty-one articles were included in the review, 13 of which were selected for meta-analysis. In studies where participants reported bullying (N = 19), its prevalence ranged from 17-94%. Variables most often associated with bullying were age, educational level and years of professional experience. Usability of this instrument in different countries was supported by a high reliability in each study. In two metaanalyses, which included 12 studies with mean NAQ-R and item scores, the heterogeneity of data was calculated as high and moderate respectively. Conclusion:The good quality of the NAQ-R in determining variables related to bullying is endorsed. Variables related to bullying identified in this review could be used to map out a model of a potential bullying victim for preventative measures. Impact:The NAQ-R is a useful and reliable tool for measuring bullying among nurses; however, there remains a strong need to assure that a verified, standardized and updated bullying taxonomy is used in future studies to ensure reliable and comparable data. A model of a potential bullying victim may help nursing directors foster a healthier workplace environment, thereby improving patient outcomes in the long-term. K E Y W O R D Sbullying, management, meta-analysis, nursing practice, systematic review

Background: Novice nurses (newly qualified within the first 3-year period of professional practice after registration) must first face the reality and complexity of caring for high-acuity patients in the critical care setting, which can be an unfamiliar and demanding environment. The successful transition from education to professional practice of novice nurses hired for intensive care must be supported.Aim: To explore Polish novice nurses' readiness to practice in an intensive care unit (ICU). Our study objectives included investigating pre-registration preparation for work in an ICU, identifying the most needed competencies to work in an ICU, and analysing organizational aspects of the professional orientation period.Study design: A qualitative phenomenology design was applied.Methods: We conducted qualitative content analysis based on individual semistructured in-depth interviews. Study recruitment was performed using a purposeful and network sampling strategy. The final number of participants was 17 Polish novice nurses. Results:The majority of responders replied that they were not prepared to work in an ICU after graduation. Professional orientation was planned-generally for a period of 3 months; however, in most places it was shortened. The respondents identified the five competencies most needed to work in an ICU: communication, teamwork, professional self-confidence, and knowledge and its practical use. Their enhancement could be achieved through simulations during both pre-registration and professional training. Conclusion:Analysis of the novice nurses' orientation period revealed many difficulties that indicated a lack of readiness to practice in an ICU after graduation. Identifying novice nurses' strengths and weaknesses regarding clinical competence is important to guide the design of orientation programmes in ICU settings and nursing education programmes.Relevance to clinical practice: Readiness for ICU work may be improved by enriching education with simulations that enable training in the practical use of knowledge and